Latest / Fork U with Dr. Terry Simpson / From Starving to Stuffed

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From Starving to Stuffed · Fork U with Dr. Terry Simpson

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  >> Dr. Terry Simpson: Mhm.
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  Today we're tackling a topic that's as big as the
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  problem itself. Obesity in
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  America. How did we go from starving in
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  the Mississippi Delta in the 1960s to
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  a nation grappling with an obesity
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  epidemic? It's a fascinating story
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  of policy, agriculture, culture itself and
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  food science. So grab a fork and or a
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  notebook and let's dig in.
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  I am um, your Chief Medical Explanationist, Dr. Terry
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  Simpson, and this is Forku
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  Fork University, where we make sense of the madness
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  in this case of obesity in America and
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  bust a few myths along the way.
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  In the early 1960s, America faced a
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  shocking paradox. The land of plenty was
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  also home to profound hunger.
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  Images of starving children in the Mississippi Delta
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  shocked the nation. Hunger wasn't just an
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  abstract concept. It was a grim
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  reality, especially for marginalized
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  communities in rural America. Not only the Mississippi Delta,
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  but also the Appalachians. During
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  his presidential campaign in 1964, President
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  Lyndon Johnson declared a war on
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  poverty, which included efforts to address
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  malnutrition, uh, through programs like food stamps and school
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  lunch initiatives. These programs were life
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  saving for many, but only
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  scratched the surface of a much larger
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  issue. Systemic inequality
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  in food access.
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  Forward to the 1970s, where a different
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  problem was brewing. Richard Nixon's secretary
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  of agriculture, Earl Butz, transformed
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  how America produced food.
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  Butts mantra was get big or get out.
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  And farms shifted to monocultural crops,
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  meaning corn, soybeans, wheat, all
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  heavily subsidized by the government. This
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  shift created a surplus of cheap
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  ingredients that became the building blocks of
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  ultra processed food. We had
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  ultra processed and highly processed food in the
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  1960s and and it consumed 6 to 10%
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  of our diet. But now we had an
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  abundance of them. High fructose corn
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  syrup, hydrogenated oils and refined
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  flours flooded the food supply,
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  making the ingredients for calorie dense
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  nutrient poor products that became affordable
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  and accessible. More so than ever
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  before. What started as a solution to
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  hunger inadvertently laid the
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  groundwork for obesity. Enter the age of
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  abundance. By the 1980s, portion
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  sizes in America began to balloon.
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  Fast food chains eager to attract customers started offering
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  larger servings for just a few cents more.
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  A strategy known as value marketing.
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  This trend extended to sit down restaurants and
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  even home cooking. What used to be a
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  reasonable portion became a laughingly small compared
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  to the norm. For example, the typical
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  hamburger at McDonald's was about two
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  and a half ounces. The
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  Junior Whopper today is
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  about double that.
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  Meanwhile, ultra processed foods,
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  foods that were packed with sugar, fat and
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  salt, began to dominate the shelves.
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  These foods weren't just cheap, they were Engineered
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  to be shelf stable, hyper palatable,
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  meaning they really taste good and
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  almost impossible to stop eating. You remember
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  the Lay's Potato Chip ad from the 1970s? I bet
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  you can't just eat one. The combination
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  of bigger portions and calorie dense,
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  nutrient poor foods begin the
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  process of obesity.
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  But as the waistlines expanded, and although at this
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  time, and not as much as they have become, so did
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  the backlash. The low carb movement championed
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  by the likes of Dr. Atkins, promised weight loss
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  by cutting out carbohydrates. Now
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  the trick is that when using the term
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  generic carbohydrates, he was mostly
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  referring to junk food, as opposed to
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  fruits, vegetables, beans,
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  whole grains, all of which aren't junk food,
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  but a part of a healthy balanced diet that are made of predominantly
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  carbohydrates, which do not tend to contribute to
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  obesity. So while this low
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  carb approach was effective for some, the diet
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  often led to an increased consumption of calorie
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  dense meats and fats, potentially
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  undermining its benefits for calorie control.
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  Meaning people who bought into the
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  low carb education
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  believed that meats and fats did not produce
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  fats and they were themselves in fact diet
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  foods. Nothing like a, uh, 1200
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  calorie steak thinking it's a diet
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  food. On the other end of the spectrum,
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  vegetarianism gained traction, partly again as
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  a response to the environmental and health concerns tied
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  to industrial agriculture. So by
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  focusing on whole food plant based,
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  the vegetarians attempted to counteract the over
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  processing of the modern diet. Both
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  movements were reactions to the rise of ultra processed foods, but
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  each had its own challenges in addressing the
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  obesity epidemic holistically.
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  So where does that leave us today? The obesity
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  epidemic isn't just a matter of personal
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  choice. It's deeply intertwined with
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  industrial practices and cultural norms.
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  Addressing it requires more than just telling people to eat
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  less and move more. It demands systemic
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  change, from reforming agricultural subsidies
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  to redesigning our food environments to make us
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  easily have more available, healthier
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  choices. But on an individual
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  level, awareness is the key.
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  Understanding the history of how we got here can empower us
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  to make more informed choices.
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  But hope also has arisen, as you know, because among the
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  obesity epidemic sciences introduced one promising
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  new tool besides surgery, which are the
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  GLP1 receptor agonists. Now
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  these were first introduced in 2005 by
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  the brand name of Bieta, which was
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  predominantly used for type 2
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  diabetes. Because they proved
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  remarkably effective in helping people
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  manage their diabetes by
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  decreasing insulin resistance. They did it by two
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  mechanisms. They increased the production of, uh,
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  insulin by the Pancreas, and
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  they increased sensitivity of insulin
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  from the tissue cells. What scientists
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  noticed when they started introducing these drugs to patients with
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  diabetes is that these patients started
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  to lose weight. And weight loss, as
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  you might think, is a remarkable option.
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  The next generation of GLP receptor agonists, you know
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  the names of Ozempic or Wegovy,
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  Zapbound or Mounjaro,
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  they also began to come in and it showed
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  remarkable in diabetics that they were losing
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  weight. So they began to test them on people
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  who were simply overweight. And with
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  amazing results. They have now become
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  introduced. So how do they work?
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  As you know, GLP1 stands for glucagon. Like
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  peptide 1, it's a hormone that plays
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  a role in regulating appetite and digestion. They mimic
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  the action of actual GLP1 that
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  your body makes, which slows down gastric
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  emptying, signaling, uh, your brain that you're full.
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  So normally Your body makes GLP1
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  when it says, all right, we've had enough to eat, we're getting
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  some food here, so we're gonna slow down digestion so you're
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  gonna feel full. But it also works
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  in the brain. It signals the
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  brain that you're full. It is that head
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  hunger that gets shut down when you
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  eat food. Now here's what's
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  fascinating. The GLP one that
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  your body produces lasts just a few minutes.
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  But oftentimes these cells, which are
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  located in the distal part of the small intestine, are
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  destroyed by bacteria.
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  Bacteria that happen to thrive in an environment
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  of ultra processed
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  foods. Now, there's a lot of speculation in what
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  I'm going to say now, but we do know the following
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  facts for certain. Certain bacteria
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  clearly destroy the cells that make
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  GLP1. And
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  certain fibers, particularly fiber like
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  inulin, allow those cells
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  to thrive. Inulin is found in things
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  like Jerusalem artichoke, chicory, et
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  cetera. Also another group of fibers called
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  beta fructans, which are found in whole grains and
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  bananas. They allow these cells to thrive while the
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  ultra processed foods change the microbiome to bacteria
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  that actually kill those cells. Let's get
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  back to medication. These
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  medicines blunt
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  food noise, or what we call the hedonic
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  drive, the pleasure seeking, almost
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  compulsive craving for ultra, um, processed
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  foods. Bet you can't just eat one.
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  So while we like to think that big food is
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  tricking our brain into the reward system,
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  they simply discovered that if you
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  put salt and sugar and
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  fat together, you are going to love it,
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  especially with flavor. I mean, consider the book called the
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  Dorito Effect. Where we know that a Dorito has a lot more
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  flavor than bland chicken. That's
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  also why you can find yourself halfway through a bag
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  of chips or a pint of ice cream without even
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  realizing it. There's no fiber to stop you. You
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  have that hedonic effect. But the GLP1 medications
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  break this cycle. By reducing
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  or blunting the brain's response to these foods,
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  they enable the patient to regain
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  control over their eating habits.
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  So what's revolutionary about the GLP1 medications
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  is how they're helping shift the narrative around
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  obesity. For years, obesity was framed as
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  a failure of willpower, Even though those who studied it,
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  such as myself and the AMA, declared it a
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  disease as early as 2013.
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  These medications underscore the biologic
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  underpinnings of obesity, showing that it's not
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  just about eating less or exercising more. It's
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  about addressing the complex systems in our
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  bodies and brains that drive food
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  intake. For many,
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  GLP1s are creating a, ah, window of
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  opportunity. People who once felt powerless
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  against their cravings are finding it easier to make
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  healthier choices, helping them out not only to lose
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  weight, but sustain those
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  losses. This isn't a magic
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  bullet. These medications,
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  clearly in clinical studies, work best when
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  they are combined with diet and lifestyle.
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  But it is a powerful tool against a
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  problem that's decades in the making.
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  Imagine realizing that you don't need
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  to eat the pint of ice cream. A taste is enough.
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  Redesigning your relationship with food and
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  the lifestyle changes. By eating more foods
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  that contain fiber and contain the fibers like
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  inulin and beta fructans, allow your
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  own natural GLP1s to
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  repopulate. Now,
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  there is a huge leap between allowing your natural
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  GLP1s to repopulate to
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  not needing the medications. And I want you to
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  frame it in your brain this way. We
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  want you to build a healthier relationship with
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  food. We want you to enjoy whole
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  foods. We want you to realize that grains are
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  not the enemy. Whole grains actually reduce obesity, et
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  cetera. Refined grains are, uh, not necessarily the problem, but they
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  can be. But the closing
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  message is this. You didn't gain the weight
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  because of high fructose corn syrup or because of seed
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  oils. You gained the weight because all of these things were
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  processed together in a tightly wonderful package that
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  tastes delicious. But some ultra processed
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  foods are quite good for you. Take whole grain bread.
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  It's actually quite healthy. So
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  we can't lump all ultra processed foods
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  together. But with GLP medications, we are
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  seeing how science can help counteract the damage caused
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  by decades of ultra processed foods and
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  oversized portions. And it's a,
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  uh, reminder that solutions to obesity aren't
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  just about an individual effort.
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  They're about understanding the systems that created the
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  problem and leveraging modern medicine to
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  help reverse that trend. That's the
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  promise and the challenge of the road
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  ahead. Thank
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  you for joining me on this episode of Forku. You
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  can find references for this in my blog, which is@, uh,
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  yourdoctorsorders.com and
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  forku.com so if you like
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  today's discussion about obesity, ultra processed food and
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  GLP1 medications, hopefully it's given you something to
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  chew on. Please be sure and share and
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  describe. And always remember, your
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  fork is a tool. It's not a weapon.
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  Use it wisely. I'm
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  Dr. Terry Simpson, and while I am a, um, medical
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  doctor, I am not your
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  medical doctor. If you seek to have
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  GLP1 medications, I'm not the guy to ask about
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  them. I would ask you to please find a board
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  certified medical physician who specializes in
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  obesity medication. There are plenty of doctors
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  selling plenty of little GLP one like things out there
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  which may or may not be good for you.
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  So that's why I advocate people go to some place like
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  Accomplished health who, by the way, has not paid for that
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  endorsement. Today's podcast was distributed by
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  our friends at Simpler media and the pod
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  God, Mr. Evo Terra. Thanks
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  for listening, everybody. Until next time,
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  enjoy your food, don't feel guilty, and if you
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  need help, find a good board certified physician to
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  ask for it.
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  Hey, Evo, you know what I like about the new
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  GLP1 medications? I like that we're
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  empowering people to have a
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  way forward with their fork.
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  I kind of think it's fun.
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  So here's the thing, doc. You gotta stop
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  trying the, uh, food wordplay.
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  It just makes me dig deeper into bags
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  of, ultra processed, uh, potato chips.
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  You're not helping my problem.