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[00:00:06.720 --> 00:00:14.160] It is Thursday, the 10th of July, 2025, and you're listening to Skeptics with a K, the podcast for science, reason, and critical thinking.
[00:00:14.160 --> 00:00:25.520] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society, a non-profit organisation for the promotion of scientific skepticism on Merseyside around the UK and internationally.
[00:00:25.520 --> 00:00:26.960] I'm your host, Mike Hall.
[00:00:26.960 --> 00:00:28.160] With me today is Marsh.
[00:00:28.160 --> 00:00:28.720] Hello.
[00:00:28.720 --> 00:00:29.600] And Alice.
[00:00:29.600 --> 00:00:30.560] Hello.
[00:00:30.880 --> 00:00:37.520] Okay, so I think it's finally time to have the conversation that I have thrown forward to and said we'll talk about it at some point.
[00:00:37.520 --> 00:00:39.680] So many times it is unreal.
[00:00:39.680 --> 00:00:41.680] We should have a conversation about Azempic.
[00:00:41.680 --> 00:00:42.480] Okay, okay.
[00:00:42.800 --> 00:00:53.440] Because, I mean, just today, as of recording, which is a couple of weeks before this goes out, I just checked for Googled Azempic and clicked news.
[00:00:53.440 --> 00:00:59.920] And there's a news article from 18 hours ago, a different one from 13 hours ago, a different one from a day ago.
[00:00:59.920 --> 00:01:02.480] These are all three completely different stories.
[00:01:02.480 --> 00:01:06.240] Another one from a day ago, another one from a day ago, again, different stories.
[00:01:06.240 --> 00:01:11.040] Another one from 18 hours ago, two hours ago, 11 hours ago, three days ago, three days ago.
[00:01:11.040 --> 00:01:14.880] Like, it is constant conversation on Azempic.
[00:01:15.200 --> 00:01:20.320] And also, bear in mind that the vast majority of these articles are using Azempic in the title because that's the term people know.
[00:01:20.320 --> 00:01:22.240] But Azempic is not what they're talking about.
[00:01:22.320 --> 00:01:24.160] Yeah, I was about to say that's just a Zempic.
[00:01:24.240 --> 00:01:26.400] There are other versions of Azempic out there as well.
[00:01:26.400 --> 00:01:27.680] Well, not even that.
[00:01:27.680 --> 00:01:38.480] So in pretty much every single one of those articles, they will, in most cases, they'll not be talking about Azempic full stop because Azempic is the brand name for diabetes medication.
[00:01:38.480 --> 00:01:46.080] The same medication, the same drug, when marketed for weight management is WeGovy.
[00:01:46.080 --> 00:01:46.720] Yeah, yeah, yeah.
[00:01:46.880 --> 00:01:47.760] It's a different name.
[00:01:47.760 --> 00:01:49.920] Are they both manufactured by Nova Nordisk?
[00:01:49.920 --> 00:01:50.480] I think so.
[00:01:50.560 --> 00:01:57.440] So I did a little bit of work for Nova Nordisk once, but all I was doing some animated videos for Big Pharma, just for Big Pharma.
[00:01:57.600 --> 00:01:59.120] Just doing videos for Big Pharma.
[00:01:59.280 --> 00:02:08.840] It was specifically about how to set your computer and your desk chair up correctly so that it's at the right height for your workspace to not be harmful, your occupational health.
[00:02:08.840 --> 00:02:10.760] But that's the most that I've ever done for big pharma.
[00:02:10.920 --> 00:02:13.240] I did about three hours' work on that.
[00:02:14.520 --> 00:02:20.360] So let's start off by talking a bit about appetite, or more specifically, the biology of appetite.
[00:02:20.680 --> 00:02:27.160] And there's so many different ways to structure a conversation on appetite, but we'll start by talking about the homeostatic elements of that.
[00:02:27.160 --> 00:02:33.960] So the process by which our hunger and satiety cues are regulated by our physiological needs for energy.
[00:02:33.960 --> 00:02:42.760] And there's different things that feed into appetite, obviously, like psychology, need for connection, need for comfort, you know, that kind of emotional regulation of appetite.
[00:02:42.760 --> 00:02:47.080] But we'll talk specifically about those kind of physiological needs for energy.
[00:02:47.080 --> 00:03:01.880] And energy is obviously such a crucial resource that our bodies have multiple layers of regulation when it comes to A, acquiring energy, B, using energy, and C, storing energy for future use in case we have reduced environmental access to energy.
[00:03:01.880 --> 00:03:08.840] And in fact, D, maintaining those stores for as long as possible when environmental energy access is reduced.
[00:03:09.080 --> 00:03:16.360] You don't want to just burn through it on day one of not having access to energy because then you've not got stores to keep you going.
[00:03:16.680 --> 00:03:35.880] There's a whole bunch of regulatory processes involved in this, including stretch receptors in the GI tract, which signal to the brain that physical sensation of fullness, hormone signals released from cells of the pancreas, the stomach, adipose tissue, or further down the GI tract, and that can either reduce or increase appetite depending on the feedback detected.
[00:03:35.880 --> 00:03:46.640] And psychologists even think that psychology can have an impact on appetite, such as habituation to foods that we like and want, which can then reduce the like and want if we have good access to those foods.
[00:03:46.960 --> 00:03:55.360] One of the key things that we often discuss on this show is that every body is different, and that's largely because the human body is really fucking complicated.
[00:03:55.360 --> 00:04:06.720] And we have around 37 trillion cells in each of us, hundreds of different cell types in the human body, dozens of different organs, 20,000 genes which can be modified in a bunch of different ways.
[00:04:06.720 --> 00:04:12.240] I like to think of it like the terraced houses in the streets around where you and I, Marsh, live.
[00:04:12.240 --> 00:04:14.320] I thought you said terrorist houses for a second.
[00:04:14.320 --> 00:04:16.480] I was like, what do you know about these streets?
[00:04:17.120 --> 00:04:24.160] So, in the UK, as I'm sure is true in plenty of other places, many urban areas have the pockets of rows of terraced houses.
[00:04:24.160 --> 00:04:31.600] And often, in those individual pockets of houses, all of those houses in that area are roughly similar in terms of their layout.
[00:04:32.080 --> 00:04:40.400] So, for example, Marsh, you and I live around the corner from each other, or you live on the street, the next street over from me, or I live on the street next over from you because you moved in first.
[00:04:40.400 --> 00:04:45.120] If you want to keep describing it too many more ways, you're basically going to dox the two of us.
[00:04:45.440 --> 00:04:50.800] People could g between that and the ice cream van that goes past sometimes you hear in recordings, they'll be able to gee all kids.
[00:04:51.760 --> 00:05:04.240] And if we set aside all of the surface-level modifications, like I have hardwood floors downstairs and you have hardwood floors upstairs, and just think about the physical layout of the house, our houses are very similar.
[00:05:04.240 --> 00:05:08.400] Yeah, we both have houses that have a hallway, two downstairs reception rooms.
[00:05:08.400 --> 00:05:11.280] We both happen to have made one a living room and one a dining room.
[00:05:11.280 --> 00:05:17.040] We both have a kitchen, three upstairs bedrooms, two of which are larger rooms and one of which is a smaller room, and a bathroom.
[00:05:19.920 --> 00:05:24.960] Your house has been modified since it was built to add on an additional downstairs bathroom.
[00:05:24.960 --> 00:05:33.960] But if we were just to focus on what was there when it was first built, I say that the bathroom and third bedroom and kitchen will have been added on when like bedroom, indoor toilets and separate kitchens became a vacuum.
[00:05:38.120 --> 00:05:39.080] I'm making a point.
[00:05:40.040 --> 00:05:41.320] And you interrupted the line.
[00:05:42.760 --> 00:05:46.680] You might say that our houses have the same blueprint, the same body.
[00:05:46.680 --> 00:05:47.240] Sure.
[00:05:47.560 --> 00:06:00.760] Except they aren't exactly the same because when you make something from so many components, in this case, bricks, and you make it with the support of so many different builders and with a slightly different map, you're going to end up with something slightly different.
[00:06:00.760 --> 00:06:03.400] In our cases, that means that your house is slightly wider than mine.
[00:06:03.400 --> 00:06:07.880] You have a bit more space in the hallway, slightly larger living room and dining room, and your bathroom is slightly bigger.
[00:06:07.880 --> 00:06:11.960] In my house, there's a small step to the front door, and yours has two larger steps to the front door.
[00:06:12.280 --> 00:06:15.480] In my house, there's a small step between the landing and the bathroom and yours level.
[00:06:15.480 --> 00:06:17.560] Like there are small differences.
[00:06:17.560 --> 00:06:20.520] And I'm sure if we really broke it down to the basics, there will be other differences.
[00:06:20.520 --> 00:06:23.080] Maybe your house is built slightly differently to mine.
[00:06:23.080 --> 00:06:26.600] Maybe that makes it easier or harder to heat the house and keep the heat in.
[00:06:26.600 --> 00:06:29.240] Maybe it makes one house slightly more damp than the other.
[00:06:29.240 --> 00:06:31.560] I don't know, we need like Paul and Kumagarity to help us.
[00:06:31.880 --> 00:06:37.160] Yeah, it's definitely my cat that makes my house damp because she occasionally pisses in the corner of the living room.
[00:06:37.160 --> 00:06:47.720] But the point I'm trying to illustrate is that once you have something big and complex made of lots of smaller components, then that introduces differences even if you try and build the same version over and over again.
[00:06:47.720 --> 00:06:58.680] And that's without getting into intentional differences in how we build different houses or how our DNA codes for deliberate differences or variation in our bodies, which is part and parcel of survival.
[00:06:59.000 --> 00:07:13.960] Which is to say that when it comes to complicated processes such as appetite, there are lots of ways that this can vary from person to person, even before getting into the cases where something has gone wrong or changes that are made throughout our lifetime by interacting with external influences.
[00:07:13.960 --> 00:07:20.160] There's loads of different hormones involved when it comes to regulating appetite, hunger, and satiety.
[00:07:20.160 --> 00:07:26.480] There's two in particular that people usually talk about: ghrelin, which is sometimes called the hunger hormone, and leptin.
[00:07:26.800 --> 00:07:29.520] Oh, is that the G and L in GLP?
[00:07:29.840 --> 00:07:30.480] Nope.
[00:07:30.480 --> 00:07:31.120] Okay.
[00:07:33.280 --> 00:07:34.880] Let's just won't go any further.
[00:07:34.880 --> 00:07:36.960] We will come back to what GLP stands for.
[00:07:37.280 --> 00:07:39.200] I can have some inpins back.
[00:07:39.840 --> 00:07:44.880] Ghrelin is produced by cells in the stomach and makes us hungry, but it also does loads of other things in the body.
[00:07:44.880 --> 00:07:50.080] It's involved in the release of growth hormone, insulin production for glucose regulation, and lipid metabolism.
[00:07:50.080 --> 00:08:01.120] And how, when, and how much ghrelin is produced is regulated by a whole range of different stimuli, including the levels of lots of other hormones like leptin, glucagon, and insulin.
[00:08:01.120 --> 00:08:03.520] Glucagon is one of is the G in GLP.
[00:08:03.520 --> 00:08:04.320] Oh, okay.
[00:08:04.640 --> 00:08:10.000] So leptin is often considered the opposition to ghrelin in that it tells us when we're no longer hungry.
[00:08:10.000 --> 00:08:11.840] But that's a massive oversimplification.
[00:08:11.840 --> 00:08:27.040] There are loads of different types of regulation in play when it comes to appetite and satiety, but we know that leptin is quite important because in humans and animals with leptin deficiency, we see increased body weight and hyperphasia and an unusually strong desire to eat.
[00:08:28.000 --> 00:08:42.400] But of course, you might have noticed that when it comes to appetite and satiety, and so I think like maybe 10 years ago, maybe longer, you would hear about ghrelin occasionally in the news, and you'd hear about leptin occasionally in the news.
[00:08:42.400 --> 00:08:44.320] But I don't think that is true anymore.
[00:08:44.320 --> 00:08:52.560] Now, the social understanding of the hormones at play has really shifted, and we're almost exclusively talking about GLP-1.
[00:08:52.880 --> 00:08:56.480] So, GLP-1 is glucagon-like peptide 1.
[00:08:56.480 --> 00:09:01.720] It's a small hormone that's produced by the cells of the intestine and the brainstem in response to food intake.
[00:08:59.840 --> 00:09:06.760] And it's one of a few proteins that directly stimulates the release of insulin.
[00:09:07.080 --> 00:09:21.320] Insulin release is mostly stimulated by nutrient levels, so it's often a reaction just to glucose itself in the body, but there are some hormones that also have a direct impact on insulin production, and GLP-1 is one of them.
[00:09:21.640 --> 00:09:42.120] And it's insulin that then gets to work to make use of all of the nutrients available after we've eaten by increasing the uptake of glucose by muscle and adipose tissues, so the body can use the glucose for energy in the muscles or lay it down for storage in the adipose tissues, as well as the uptake of other things that we need circulating in the blood, like amino acids.
[00:09:42.120 --> 00:09:51.000] It also makes the glucose easier to break down for use, so it's more accessible, as well as reducing the reliance on other energy sources for the body.
[00:09:51.000 --> 00:09:57.000] So, for example, it reduces the level of gluconeogenesis, which is the production of glucose in the body.
[00:09:57.000 --> 00:10:09.240] We don't need to make any, we've got plenty of eating in the blood, and it also reduces protein breakdown and autophagy because we don't need to break things down in the body to get hold of energy from elsewhere if we've got plenty of glucose available.
[00:10:10.360 --> 00:10:26.920] But again, GLP-1 does more than just stimulate the release of insulin, it does a range of other things because regulating the human body is complicated and multi-layered, as it must be if you have so many systems running concurrently that have shared dependencies and/or are dependent on each other.
[00:10:27.240 --> 00:10:37.160] Another thing GLP-1 does is slow gastric emptying, meaning it takes a little bit longer to digest our food and therefore we're not getting hungry so quickly after eating.
[00:10:37.160 --> 00:10:44.760] So, in 2005, the FDA approved the first what they call an well, what scientists call an incretin mimetic.
[00:10:45.120 --> 00:10:54.960] So an incretin is a hormone that stimulates insulin release and a memetic is something that mimics that.
[00:10:54.960 --> 00:10:55.600] Okay.
[00:10:55.920 --> 00:11:04.080] So they approved exenatide, also known as bieta, I think that's the brand name, as an injectable for type 2 diabetes.
[00:11:04.080 --> 00:11:13.360] So the first GLP-1 receptor agonist drug was approved in 2005 in America.
[00:11:13.920 --> 00:11:16.080] That's a lot longer ago than I thought.
[00:11:16.080 --> 00:11:19.520] Yeah, so these have been around for use in diabetes for a while.
[00:11:19.520 --> 00:11:30.880] And we've known, so we started researching this like way back in the 90s and even earlier to understand kind of what GLP-1, the kind of native GLP-1 is doing in the body and what kind of impacts it's having.
[00:11:30.880 --> 00:11:34.400] And we knew that it was a potential target for diabetes particularly.
[00:11:34.720 --> 00:11:36.560] So there are two types of diabetes.
[00:11:36.560 --> 00:11:43.040] Type 1 is an autoimmune disorder in which the insulin producing cells are attacked and destroyed by the immune system.
[00:11:43.040 --> 00:11:51.840] And then type 2 arises from either the body not producing enough insulin or the body becoming resistant to the insulin that it is producing.
[00:11:51.840 --> 00:12:00.640] And in the case of type 2 diabetes, there are a number of different treatment options, of which GLP-1 receptor agonist injections are one option for some people in some cases.
[00:12:00.640 --> 00:12:08.880] So not everybody who has type 2 diabetes is going to be eligible for taking GLP-1 receptor agonists, but for some people, it's a good option.
[00:12:08.880 --> 00:12:19.120] I think, isn't there a thing, and I'm on very sketchy ground here, isn't there some small degree of evidence that a keto diet or a similar kind of diet actually has can have some effect on type 2 diabetes?
[00:12:19.360 --> 00:12:21.600] So there's lots of good evidence.
[00:12:21.680 --> 00:12:36.520] So for most people who are diagnosed with type 2 diabetes, the first or pre-diabetes, the first thing you'll be told is to try different dietary modifications and adding more exercise to your diet and lots of things that you can just do for yourself.
[00:12:36.840 --> 00:12:43.960] Most people who have type 2 diabetes will at some point require some kind of medical intervention support.
[00:12:44.280 --> 00:12:48.600] The goal is to maybe not be on those medications long term if you don't need to.
[00:12:48.600 --> 00:13:00.120] If you can get things under control and you can get into a kind of stable phase with your diabetes, you can often then manage it with diet and exercise, but obviously sometimes you can't.
[00:13:00.440 --> 00:13:02.920] And obviously, type 1 is very different.
[00:13:02.920 --> 00:13:03.160] Yes.
[00:13:03.640 --> 00:13:04.840] You just do not have the insulin.
[00:13:04.840 --> 00:13:05.080] Yeah.
[00:13:05.240 --> 00:13:06.440] You cannot do it.
[00:13:06.440 --> 00:13:08.680] So can I ask a clarifying question?
[00:13:08.680 --> 00:13:18.520] So my understanding is that typical first-line therapy for diabetes is you would just inject insulin.
[00:13:18.520 --> 00:13:24.120] So you get artificial insulin and you would use that to manage your own insulin levels.
[00:13:24.120 --> 00:13:28.840] And this is a way of actually stimulating your body to make insulin.
[00:13:28.840 --> 00:13:36.280] The GLP-1 memetic is about stimulating your body to make insulin rather than you just injecting yourself with neat insulin.
[00:13:36.440 --> 00:13:37.720] Second part correct.
[00:13:37.720 --> 00:13:41.240] First part, I think it depends on the individual case.
[00:13:41.240 --> 00:13:43.880] You wouldn't always necessarily need to inject insulin.
[00:13:43.880 --> 00:13:44.200] Okay.
[00:13:44.440 --> 00:13:48.600] And not every person with diabetes would inject insulin.
[00:13:48.600 --> 00:13:51.240] But yes, GLP-1 is just stimulating.
[00:13:51.240 --> 00:13:53.800] It is stimulating insulin production.
[00:13:53.800 --> 00:14:00.840] So that is one reason it's used to treat these receptor GLP1 receptor organists are used to treat diabetes.
[00:14:00.840 --> 00:14:09.800] The other is that it does have appetite-suppressing pathways that will ultimately lead the person to lose weight.
[00:14:09.800 --> 00:14:13.320] And we know that weight loss can have an impact on diabetes.
[00:14:13.480 --> 00:14:20.560] So if that helps, then that can be also an additional benefit of taking GLP-1 receptor agonists.
[00:14:22.080 --> 00:14:34.720] Different types of GLP-1 receptor agonist medications have developed and used to treat type 2 diabetes since the early 2000s, with semaglutide brand name as EMPIC, being approved in 2018.
[00:14:34.720 --> 00:14:36.800] So Zempic is relatively new.
[00:14:37.760 --> 00:14:43.600] It was approved in 2018 in Europe for use in type 2 diabetes.
[00:14:43.600 --> 00:14:53.680] There is a precedent for using GLP-1 receptor agonists to treat overweight and obesity in lyroglutide, which was approved in 2014.
[00:14:54.000 --> 00:15:00.560] And we've known for a long time that GLP-1 and GLP-1 receptor agonists can regulate appetite and therefore have an impact on body weight.
[00:15:00.560 --> 00:15:10.080] But it's really taken off since semaglutide was approved by the FDA for use in weight management in 2022 at a dose marketed as WeGovy.
[00:15:10.400 --> 00:15:16.720] Semaglutide is more effective for weight management than previous GLP-1 receptor agonists used for this purpose.
[00:15:16.720 --> 00:15:22.640] And as you will have seen since 2022, the use of this medication for weight management has just absolutely skyrocketed.
[00:15:22.800 --> 00:15:23.840] Oh, yeah, yeah.
[00:15:24.160 --> 00:15:29.840] By now, there are quite a few different GLP-1 receptor agonists which can and are being used for weight management.
[00:15:29.840 --> 00:16:14.360] And we're seeing a real trend towards open GLP-1 receptor agonist use in celebrities where they're sharing their use of these medications openly, but also instances of rapid and drastic body weight changes in celebrities and influencers, which may either be due to GLP-1 receptor agonist medication directly that they're just not talking openly about, which is fine, or indirectly in response to the notable trend towards weight loss that's captured the celebrity world and that's being fed by GLP-1 receptor agonist use and availability, but maybe that individual is not actually taking the medication and is just has just lost a lot of weight for perhaps because they've been influenced by that conversation.
[00:16:14.680 --> 00:16:18.360] I think Alex Jones falls into the former of those two camps.
[00:16:18.360 --> 00:16:20.360] He's lost a huge, huge amount of weight.
[00:16:20.360 --> 00:16:23.320] But whenever he talks about it, he says, I've not been taking any of the drugs.
[00:16:23.320 --> 00:16:25.480] I've just been working out super, super hard.
[00:16:25.480 --> 00:16:31.800] And I think that goes beyond, like, nobody owes you disclosing their medical history or their medical details.
[00:16:31.800 --> 00:16:38.280] But I think it is damaging when somebody lies about having done it and says, no, this was just regular exercise.
[00:16:38.280 --> 00:16:48.680] Because what that's, especially when they're in such a prominent position, what he's saying to his viewers is, if you had the same amount of willpower and grind as I have, you could get these kind of results as well.
[00:16:48.680 --> 00:16:49.000] Yeah.
[00:16:49.000 --> 00:16:49.880] And bollocks, can't you?
[00:16:50.120 --> 00:17:12.920] And well, and there's a potentially an additionally interesting conversation because he's so prominent in the kind of manosphere spaces where there is a lot of toxicity around, and we've talked on the show before, around both weight management but also kind of weight management again, but with the bulking of muscles and gaining muscle weight but losing weight through fat loss.
[00:17:13.240 --> 00:17:21.880] So contributing to that conversation in a negative way probably isn't helpful and just providing no comment would be potentially enough.
[00:17:21.880 --> 00:17:24.680] But in many ways it's the worst thing Alex Jones has ever done.
[00:17:24.680 --> 00:17:25.800] Oh, absolutely.
[00:17:26.760 --> 00:17:34.040] Now, of course, there are a number of issues with GLP-1 receptor agonist use for weight management.
[00:17:34.040 --> 00:17:42.760] One, of course, is that this rapid uptake in demand for these medications means that people with type 2 diabetes who are using these medications have been impacted by shortages.
[00:17:43.080 --> 00:17:45.000] I think this has settled out a little bit now.
[00:17:45.200 --> 00:17:51.360] I think this was more around the 2022, 2023 sort of time when it was really rapidly rising.
[00:17:51.520 --> 00:17:56.080] I'm seeing less news reporting around that now than at the time.
[00:17:56.080 --> 00:18:02.400] I was you were seeing that quite often is there were shortages because so many people were buying it for weight loss, you couldn't get it.
[00:18:02.400 --> 00:18:03.760] And buying it off label.
[00:18:03.760 --> 00:18:04.320] Yes.
[00:18:04.640 --> 00:18:13.200] So people were buying Ozempic, the diabetes medication, and using that for weight loss, which caused shortages for people with diabetes.
[00:18:13.200 --> 00:18:15.520] But you don't see those news articles so much anymore.
[00:18:15.520 --> 00:18:18.400] So maybe that's settled down, or maybe just the news isn't interested anymore.
[00:18:18.960 --> 00:18:33.040] Yeah, and there may well be part of it that as people were kind of, as journalists were scrambling for information on Azempic, as it was the hot topic to talk about, but they maybe hadn't got to grips with the science behind it yet.
[00:18:33.040 --> 00:18:38.160] And there were fewer news articles on the science behind it, it was the easy story to cover, right?
[00:18:38.160 --> 00:18:40.800] That it was having an impact on people with diabetes.
[00:18:40.800 --> 00:18:42.960] That's what Alex Johns looks like now, by the way.
[00:18:43.120 --> 00:18:44.480] He looks unrecognizable.
[00:18:46.000 --> 00:19:07.360] Another issue is that you'd be forgiven for thinking that taking WeGovy or other weight loss medications does only good things, when in fact, the side effects of these medications can be quite significant, with common side effects including nausea, constipation, diarrhea, risk of low or high blood sugar, which comes with a whole host of other symptoms, and then a less kind of common side effect, but a meaningful risk of acute pancreatitis.
[00:19:07.360 --> 00:19:10.240] And that's something that's been in the news a little bit over the last couple of days in particular.
[00:19:10.240 --> 00:19:13.520] I've seen there's been an uptick in people having pancreas issues.
[00:19:13.520 --> 00:19:21.200] So I don't know what the outcome of that was as to whether it's been anything other than a warning that this is a possible side effect.
[00:19:21.200 --> 00:19:25.280] Yeah, so I haven't looked at this very much.
[00:19:25.280 --> 00:19:49.880] What I have seen in my coverage, my research for today's piece, and maybe it's something we can come back to on a future episode, is that so lyroglutide, the first GLP-1 receptor agonist that was approved for use for weight management, did have slightly more significant issues with both pancreatitis and thyroid tumours or potentially an increased risk of thyroid cancer.
[00:19:49.880 --> 00:19:58.120] I think there is some concern that there might be risks of that with semaglutide too, hopefully smaller risk.
[00:19:58.120 --> 00:20:03.320] I left the thyroid cancer bit out of the story originally because I didn't want to contribute to any scaremongering.
[00:20:03.560 --> 00:20:06.440] We will have listeners who are taking semaglutide.
[00:20:06.440 --> 00:20:21.960] I think the risk is my understanding is, and again, this is maybe something we'll cover in a future show, the risk is relatively low unless you already have a family history of thyroid cancer, but that's something that the medical professional prescribing it should be discussing with you.
[00:20:21.960 --> 00:20:26.600] Obviously, that's then an issue if people are taking it without the support of a medical professional.
[00:20:26.920 --> 00:20:35.800] But yeah, there are potentially risks of these medications for pancreatitis and thyroid tumours and/or thyroid cancer risk.
[00:20:35.800 --> 00:20:40.200] And that will be a mechanism thing because it's been seen with lyroglutide as well as semaglutide.
[00:20:41.640 --> 00:20:52.200] Additionally, there are some really important conversations to be had and research to be done to understand how these sorts of medications might be used for long-term weight management.
[00:20:52.200 --> 00:20:55.800] So GLP-1 receptor agonists are having an impact on our physiology.
[00:20:55.800 --> 00:21:01.080] They're changing the levels of hormones in our body, which are fundamentally changing appetite.
[00:21:01.080 --> 00:21:18.080] That's potentially a really useful tool for some people, in some cases, who are experiencing detrimental health impacts due to body weight, or even have made an aesthetic choice that they want to lose weight, which is a choice that anybody has the right to make, right?
[00:21:18.080 --> 00:21:45.600] And I think it does also go some way towards challenging the idea that body weight has much, if anything, to do with motivation or willpower when we're seeing people choosing to take GLP-1 receptor agonists who have maybe been fat their entire lives and have dieted their entire lives and now are actually managing to lose weight with relative ease because it's a physiology thing, it's not just about trying harder.
[00:21:45.600 --> 00:21:57.680] And I think it's there's potentially something useful for us to understand there because we definitely have a lot of issues with assuming that there's some kind of moral judgment on body weight.
[00:21:57.680 --> 00:22:07.120] Yeah, and the moral judgment as well on how to lose that body weight as well, as there's a huge amount of moral judgment on people who are taking things like wear Golvie as you see the narratives around, well, why are they doing that?
[00:22:07.120 --> 00:22:17.920] That's the cheat way of losing weight, as if the weight that you lose through exercise and diet is somehow more worthy, is somehow worth more, and makes you worth more for having lost weight that way.
[00:22:17.920 --> 00:22:18.880] Yeah, absolutely.
[00:22:18.880 --> 00:22:27.200] And that's always been an issue and always been a conversation that's happened around kind of, for example, gastric surgery types of weight loss.
[00:22:27.200 --> 00:22:49.760] And I think the ubiquity of people using GLP-1 receptor agonists probably helps us challenge that thinking a little bit as well because it kind of almost desensitizes you to that as a method and hopefully therefore challenges the idea that there's a particularly morally right way to lose weight.
[00:22:49.760 --> 00:22:53.280] Major asterisk on that, which we're going to come back to.
[00:22:53.600 --> 00:23:01.800] However, does it mean then that people will need to continue taking these medications for life in order to maintain their body weight?
[00:23:01.960 --> 00:23:13.480] If this is a change in physiology and it's not about embedding certain practical weight management tools, is there a consequence that people need to stay on the medications for life?
[00:23:13.480 --> 00:23:20.520] We know that yo-yo dieting is likely to actually be much more harmful to health than simply living with a higher body weight.
[00:23:20.520 --> 00:23:32.040] So, is there then also a risk of these medications contributing to weight gain, weight loss, cycling, and extreme fluctuations for some people, which might have an impact on their health in the longer term?
[00:23:32.040 --> 00:23:53.240] These are important, nuanced discussion and research points around the kind of long-term value, long-term safety, and actual kind of long-term consequences of taking these medications, especially if access to those medications changes throughout your lifetime and you might be subject to that kind of fluctuation that is that we know is potentially damaging.
[00:23:53.560 --> 00:24:00.040] I don't have time to do that conversation justice today, but again, it's maybe something we could come back to in the future.
[00:24:00.040 --> 00:24:17.160] But one of the biggest issues that I think we're experiencing right now is that the sudden rise in access, use, and unrestrained media coverage of these medications for the purpose of managing body weight is having a massive impact on our society and potentially, therefore, on individuals within our society.
[00:24:17.480 --> 00:24:21.480] So, let's be clear: I believe in health at any size.
[00:24:21.480 --> 00:24:25.000] I think it is possible to be healthy and exist in a bigger body.
[00:24:25.000 --> 00:24:32.720] That is not to say that some people don't experience detrimental impacts on their individual of their individual body weight on their individual health, yeah.
[00:24:33.000 --> 00:24:35.800] But body weight isn't the be-all and end-all of health.
[00:24:35.800 --> 00:24:39.960] And I also think that health isn't the be-all and end-all full stop.
[00:24:39.960 --> 00:24:42.040] Like, I am not quote-unquote healthy.
[00:24:42.040 --> 00:24:44.440] I have multiple disabilities and conditions that impact on my health.
[00:24:44.440 --> 00:24:46.720] That doesn't mean I'm less valuable as a human being.
[00:24:44.840 --> 00:24:47.600] Yeah, that's not why.
[00:24:49.200 --> 00:24:54.640] If a person does experience health implications of their body weight, so what?
[00:24:54.640 --> 00:25:00.640] Of course, it's not anyone else's business, but even if it were, someone's health does not equate to their worth.
[00:25:00.640 --> 00:25:17.040] If someone is experiencing health impacts due to any circumstances in their life, that is for their consideration, along with the people they choose to include in that journey and their personal medical professionals who hopefully aren't subjecting them to medical bias or weight stigma, although we know that that is often happening.
[00:25:17.040 --> 00:25:23.200] And if that consideration leads them to choose to take GLP-1 receptor agonists to manage their body weight, that is entirely up to them.
[00:25:23.200 --> 00:25:27.440] Medical choices are highly personal and are entirely up to individuals.
[00:25:27.440 --> 00:25:43.200] However, there is a definite issue that we are encountering right now in that the public discourse has become entirely saturated in both subtle and explicit and of course very pervasive ideas of what is considered an appropriate body weight.
[00:25:43.200 --> 00:25:56.080] We know weight stigma is already an issue, but now after years of the body positivity and body neutrality movements growing, we're suddenly in a space where skinny is fashionable again and not just fashionable.
[00:25:56.080 --> 00:26:11.200] On social media, promotion of extreme weight loss is rampant with the rise of hashtag skinny talk, a hashtag which has now been blocked from searches by TikTok because of the potential dangers to people, particularly young women and girls.
[00:26:11.520 --> 00:26:24.080] This content has been likened to the pro-ANA content, which has circulated, long circulated among people living with anorexia on social media, often as a symptom of their illness, but which is believed to contribute to illness progression.
[00:26:24.080 --> 00:26:34.600] We know that this has an impact both on people with eating disorders, but also on people without eating disorders who might be susceptible to those.
[00:26:34.920 --> 00:26:37.720] So, this is one of a few significant risks.
[00:26:37.720 --> 00:26:44.680] Firstly, there is a risk of creating a climate which leads people towards disordered eating, which then might develop into an eating disorder.
[00:26:45.000 --> 00:26:55.560] There's a risk of creating a climate which increases the risk of relapse in people who are managing their eating disorder, and there's a risk of exacerbating an eating disorder in people who are currently struggling with their illness.
[00:26:55.560 --> 00:27:01.160] But it's not just people who have, have had, or will have an illness relating to food intake and body weight.
[00:27:01.480 --> 00:27:07.320] We also know that weight stigma has a negative impact on mental health more broadly.
[00:27:07.640 --> 00:27:11.480] We know that weight stigma has an impact on physical health and mortality.
[00:27:11.480 --> 00:27:19.640] One study even suggests that weight-based discrimination might lead to a 60% increase in mortality among specific individuals.
[00:27:19.640 --> 00:27:28.360] And we know that this shift in the public discussion of weight is really potentially going to have a massive negative impact on weight bias and experience of stigma.
[00:27:28.360 --> 00:27:37.400] And I'm seeing and feeling that already: the amount of people who've talked about these things, but even just the people challenging these ideas to some point.
[00:27:37.400 --> 00:28:02.400] And that's why I've taken my time to actually come and talk about this on the show: I don't want to talk about it to debunk it just flippantly because actually sometimes seeing that debunking content is making you think about it more and is exposing you to it more and is making you more potentially susceptible to the idea that well everybody's losing weight and everybody should be losing weight and all of those kind of potentially damaging ideas that just kind of creep into your brain.
[00:28:02.720 --> 00:28:05.600] Yeah, you can't debunk an idea without stating the idea.
[00:28:05.600 --> 00:28:06.080] Yeah.
[00:28:06.160 --> 00:28:08.320] As you found out the hardware, your flat earth videos.
[00:28:08.480 --> 00:28:08.640] Yeah.
[00:28:08.800 --> 00:28:10.160] Fucking yes.
[00:28:10.800 --> 00:28:15.200] Still, you can still go to Flat Earth antarctica and get those fucking videos reported.
[00:28:15.200 --> 00:28:42.800] And while I said earlier that maybe GLP-1 receptor agonists help us understand that perhaps body weight really doesn't have much, if anything, to do with willpower and motivation, which could in theory help reduce some weight bias, I can also see a world where the conversation shifts towards assuming that anyone who is fat but not taking GLP-1 receptor agonists is therefore choosing to do some sort of harm to their body because we've already got those biases so staunchly ingrained.
[00:28:42.800 --> 00:29:54.760] Yeah, that's one of the things that I worry about is the denial of health care to somebody who is especially overweight or indeed especially underweight on the basis of well you did this to yourself so you deserve it and that's fucking bullshit yeah right you see people make that argument towards smokers yeah happily that's not where the medical profession goes they try to encourage you to give up smoking but there's no suggestion that you should be denied health care because you smoke but there is a suggestion you should be denied health care because you're overweight and that's fucking appalling yeah you know and and that's that's in the british context obviously there are contexts where people are denied medication and healthcare because of the fact that they are overweight or smoke or all these other things yeah when you have a for-profit healthcare and this is it is we all you know when when we say that mortality is higher for people in bigger bodies there's lots of reasons for that and there's that we don't fully understand all of the reasons for that we know some of the reasons for that are likely because people who are fat and having medical problems are going to avoid seeing their doctors because they've experienced weight stigma from doctors before and they don't see the point in trying to to have that conversation.
[00:29:54.760 --> 00:30:17.720] But we also know that there are medical professionals who are so biased against people in bigger bodies that they will inadvertently, I think, but still literally deny healthcare to patients because, well, you know, it's just a weight issue, therefore, lose weight, come back once you've lost some weight, and we can have a conversation if you've still got the symptoms sort of thing.
[00:30:17.960 --> 00:30:19.320] I have had that conversation with my doctor.
[00:30:19.640 --> 00:30:22.840] I'm not an enormous bloke by any stretch of the imagination.
[00:30:22.840 --> 00:30:27.960] I am overweight to the technical BMI, yada, yada, yada, BMI bullshit definition.
[00:30:27.960 --> 00:30:37.240] So I'm not enormous by any stretch of the imagination, but I have had that conversation with my doctor when I've gone in with a health complaint and they've said, but could be a weight, lose weight and come back if it's still there.
[00:30:37.240 --> 00:30:37.640] Yeah.
[00:30:37.640 --> 00:30:38.200] Yeah.
[00:30:38.520 --> 00:30:46.920] I'm actually surprised I haven't had that conversation because my body weight is quite a bit higher than you would expect looking at me because I'm just dense.
[00:30:47.400 --> 00:30:53.560] And so whenever a doctor weighs me, I'm expecting to have the conversation about why my body weight is slightly higher than you would expect it to be.
[00:30:53.560 --> 00:30:56.520] And luckily, it's never come up for me yet, but that's because I look thin.
[00:30:56.520 --> 00:30:58.920] So I've got that additional privilege.
[00:30:58.920 --> 00:31:03.960] But I think there are even more reasons for skeptics to be extra interested in this conversation.
[00:31:03.960 --> 00:31:11.000] GRP1 receptor agonists are expensive and their prescription is and should be regulated.
[00:31:11.000 --> 00:31:16.600] We shouldn't be giving these to just anyone, especially not in the context of eating disorders and disordered eating.
[00:31:16.600 --> 00:31:21.000] There should be a cut-off for who can have access to things that suppress their appetite.
[00:31:21.000 --> 00:31:26.120] Of course, we need to be careful to not cause people serious harm.
[00:31:26.440 --> 00:31:31.640] But given the cultural context, there is a high demand for simple and effective weight loss tools.
[00:31:31.640 --> 00:31:40.600] There's always been a high demand for these sorts of tools, which has led to people taking things like diet teas, which include high doses of laxatives and can cause significant harm to the body, for example.
[00:31:40.600 --> 00:31:44.760] But now we know that there are medications that seem to work like magic.
[00:31:44.960 --> 00:31:51.680] Like it used to be that the wellness industry would sell you things and try and pretend that they were like magic weight loss.
[00:31:51.680 --> 00:31:53.360] Yeah, treatment still does, yeah.
[00:31:53.520 --> 00:32:02.320] But any level of thought, critical thinking would say, well, but there is no magical tool for weight loss, and therefore this can't be true.
[00:32:02.560 --> 00:32:11.520] The exploitative ads on websites are going to have to find something else because all that kind of burns belly fat in seconds, those kinds of stuff.
[00:32:11.760 --> 00:32:18.720] We've got something admittedly as expensive, but there is a solution that actually works rather than those bullshit ads selling you complete bullshit.
[00:32:18.960 --> 00:32:20.400] Let me tell you what it is.
[00:32:20.400 --> 00:32:23.040] Now we know that we have a medication that works.
[00:32:23.040 --> 00:32:27.040] You can just take a GLP1 receptor agonist and your appetite reduces and the weight just falls off.
[00:32:27.040 --> 00:32:31.280] So of course we now have companies providing access to GLP1 receptor agonists, right?
[00:32:31.280 --> 00:32:40.560] So there are now direct-to-consumer companies who will set you up with a private doctor and prescribe you the GL1 receptor agonists.
[00:32:40.560 --> 00:33:01.760] But there are also plenty of companies selling things like Sensi Labs Essentials GLP1 Active High Dose, a herbal supplement which claims to stimulate the satiety hormone GLP1 and support your weight loss with no hormones at a price of £30 for a 30-day supply or Tommy Tox's GLP1 balance Hollywood weight loss formula.
[00:33:01.760 --> 00:33:03.440] Oh god, all those words.
[00:33:04.080 --> 00:33:09.040] Another herbal supplement which claims to boost GLP1 and cost £50 for a 30-day supply.
[00:33:09.040 --> 00:33:23.040] And even the product that kind patches, the patch company that we discussed in episode 389, thanks to Seligman for the Skeptic with a K Transcript Search Cool, which have launched the GLP1 patch, which Skeptic Mag sub-editor Marianne shared.
[00:33:23.040 --> 00:33:34.280] Their post read: When all three cutting-season GLP disruptions are addressed, 92% experience less cravings, while 0% experience side effects.
[00:33:34.680 --> 00:33:35.400] No side effects.
[00:33:29.840 --> 00:33:36.040] No side effects.
[00:33:36.360 --> 00:33:37.960] 0% side effects.
[00:33:37.960 --> 00:33:40.840] This is a difficult to translate post from kind patches.
[00:33:40.840 --> 00:33:41.560] Let me repeat that.
[00:33:41.560 --> 00:33:46.520] When all three cutting season GLP disruptions are addressed.
[00:33:46.520 --> 00:33:48.120] Yeah, it's a mouthful.
[00:33:48.120 --> 00:33:53.720] I think they're borrowing the cut phrase from the gym space where you might have a cut phase to lose weight.
[00:33:54.120 --> 00:33:54.760] I see.
[00:33:54.760 --> 00:34:01.320] A maintenance phase and then a bulking phase where you aim to gain muscle, mass and increase the caloric intake to facilitate that.
[00:34:01.320 --> 00:34:15.000] And then I think they're combining it with the concept of summer ready or beach body to imply that this is the time of the year where we have a season in which we all go on caloric deficits in order to cut and then combine it with the Azempic GLP1.
[00:34:15.480 --> 00:34:19.000] I've also just figured out why the podcast maintenance phase is called that.
[00:34:21.960 --> 00:34:26.680] So these sorts of products are now almost ubiquitous in the wellness space.
[00:34:26.680 --> 00:34:40.040] Every company that is selling wellness stuff is now selling GLP1 supplements to stimulate, naturally stimulate your own GLP-1 so that you can lose weight naturally using their supplements.
[00:34:40.040 --> 00:34:40.920] And they're everywhere.
[00:34:40.920 --> 00:34:43.080] They are absolutely everywhere.
[00:34:43.080 --> 00:34:47.400] So yes, that's what's replaced the belly fat burning stuff.
[00:34:47.400 --> 00:34:48.440] That makes sense now.
[00:34:48.760 --> 00:34:58.600] And in most cases, of course, these are herbal supplements which are going to do absolutely nothing for weight loss unless you're talking about making your wallet a bit lighter.
[00:34:58.600 --> 00:35:05.320] Obviously, this is a massive topic, and I've barely scratched the surface, but I think I've talked for quite a while.
[00:35:05.320 --> 00:35:12.440] So, hopefully, I've provided listeners who might be hearing a lot about Azempic a bit of non-sensational context on the discussion.
[00:35:12.440 --> 00:35:19.680] But I'm sure this is a topic we'll come back to again in the future, especially if listeners want us to expand on any relevant parts of the discussion.
[00:35:23.520 --> 00:35:30.160] So, a couple of weeks ago, well, a little bit longer than that, we had Hamilton playing in Liverpool.
[00:35:30.160 --> 00:35:31.280] And I know you went to see it, Alex.
[00:35:32.000 --> 00:35:32.640] It was really good.
[00:35:32.640 --> 00:35:33.360] I really enjoyed it.
[00:35:33.360 --> 00:35:33.680] Did you?
[00:35:34.000 --> 00:35:35.280] Was that your first time seeing it live?
[00:35:35.520 --> 00:35:39.600] My first time seeing it live because so I really like musicals.
[00:35:39.600 --> 00:35:40.000] Yes.
[00:35:40.000 --> 00:35:41.840] And I really like Hamilton.
[00:35:41.840 --> 00:35:44.160] And I saw it when it came out on Disney Plus.
[00:35:44.160 --> 00:35:44.560] Yes.
[00:35:44.560 --> 00:35:52.480] And I've watched it a few times, not quite as many times as Emma has, but I have watched it a few times and listened to the soundtrack a few times.
[00:35:52.480 --> 00:35:55.760] But I have a real aversion to spending money.
[00:35:55.760 --> 00:35:57.120] Yeah, that's reasonable.
[00:35:57.280 --> 00:36:07.440] So, like, going down to London to pay, obviously, it's quite expensive to go and see a musical, to see musical theatre anyway for the tickets, and then the travel to London and the accommodations.
[00:36:08.000 --> 00:36:12.560] London hotel prices and so that had never drawn to me.
[00:36:12.560 --> 00:36:19.360] And then it was showing in Manchester, I think, last year, and I was tempted, but Warren's not that into music.
[00:36:19.360 --> 00:36:21.120] Like, I haven't got people to go to things like this.
[00:36:21.120 --> 00:36:23.600] It's like I'm going to spend all this money to go on my own.
[00:36:23.600 --> 00:36:26.400] Yeah, so you could have definitely got Emma to go with you.
[00:36:27.440 --> 00:36:29.920] Emma's already going a million times with everybody else.
[00:36:30.160 --> 00:36:30.960] She'd go a million away.
[00:36:32.320 --> 00:36:40.880] So when it was playing in Liverpool, I was like, well, this is my opportunity to go because I can go on my own and not have to pay a fortune in travel.
[00:36:40.880 --> 00:36:42.800] And actually, the tickets were really reasonable.
[00:36:42.800 --> 00:36:43.760] They were very reasonable.
[00:36:44.240 --> 00:36:46.880] So I went to see it and it was amazing.
[00:36:46.880 --> 00:36:47.600] It was really good.
[00:36:47.600 --> 00:36:48.400] I really enjoyed it.
[00:36:48.400 --> 00:36:51.360] Bob from the Said Skeptic Society also, he's also on the board.
[00:36:51.360 --> 00:36:52.560] He also went to see it.
[00:36:52.560 --> 00:36:53.200] Hated it.
[00:36:53.200 --> 00:36:53.760] I know he did.
[00:36:53.840 --> 00:36:55.760] Only person who's ever properly hated it.
[00:36:56.400 --> 00:36:57.200] He's got no taste.
[00:36:57.200 --> 00:36:57.760] That's fine.
[00:36:59.040 --> 00:36:59.440] He's alright.
[00:36:59.440 --> 00:37:00.520] He's allowed to have no taste.
[00:37:01.160 --> 00:37:02.920] I'm not going to judge him for it very much.
[00:37:02.920 --> 00:37:04.760] We have balance on the board.
[00:37:05.400 --> 00:37:09.240] But yeah, so I've been to London a couple of times to see Hamilton.
[00:37:09.240 --> 00:37:11.400] I didn't go and see it in Manchester.
[00:37:11.400 --> 00:37:14.520] I considered it, but it's like, it's Manchester, though, isn't it?
[00:37:14.520 --> 00:37:20.360] But when we heard it was coming to Liverpool, I bought tickets to go with Emma as a surprise.
[00:37:20.360 --> 00:37:22.840] And I text Emma and said, I've got a ticket to go to Hamilton.
[00:37:22.840 --> 00:37:25.480] She texts me back saying, yeah, I've got his tickets to go to Hamilton.
[00:37:26.120 --> 00:37:28.600] All right, well, I guess we're going to Hamilton twice then.
[00:37:29.080 --> 00:37:29.720] Fair enough.
[00:37:29.720 --> 00:37:31.000] I guess that's what we're doing.
[00:37:31.000 --> 00:37:32.680] So we went to see it.
[00:37:32.680 --> 00:37:34.120] We went to see it a week apart.
[00:37:34.120 --> 00:37:37.800] And it was what was interesting to me, because obviously I've seen it live before.
[00:37:37.800 --> 00:37:39.320] I really enjoyed it.
[00:37:39.320 --> 00:37:42.760] Seeing the differences between the two performances was really interesting.
[00:37:43.000 --> 00:37:51.560] So the first night that we went, I don't know how it compared for your performance you saw, Alice, but the King got a huge round of applause when he first appeared on stage.
[00:37:51.720 --> 00:37:53.560] Do you know what it was?
[00:37:53.720 --> 00:37:56.840] Annoyed me how much the audience loved the King.
[00:37:56.840 --> 00:37:57.800] In Liverpool.
[00:37:58.120 --> 00:38:00.040] Because, like, boo him, you're in Liverpool.
[00:38:00.280 --> 00:38:01.560] He's a well-written character.
[00:38:02.040 --> 00:38:03.560] It was well performed.
[00:38:03.560 --> 00:38:04.760] Great comedy.
[00:38:04.760 --> 00:38:05.160] Yes.
[00:38:05.240 --> 00:38:05.880] Lovely.
[00:38:05.880 --> 00:38:12.040] But also, like, it's a bit part that he's just a comedic relief.
[00:38:12.040 --> 00:38:12.360] Yeah.
[00:38:12.360 --> 00:38:15.160] Like, I don't understand why people love him so much.
[00:38:15.720 --> 00:38:20.600] I think it's largely actually because of Jonathan Groff's performance as the king, is what.
[00:38:20.920 --> 00:38:22.040] Because they've not seen.
[00:38:22.280 --> 00:38:23.320] I say they've not.
[00:38:23.320 --> 00:38:25.480] I had several times at this point.
[00:38:25.480 --> 00:38:31.000] But most people in the audience hadn't seen that portrayal of the king before, but they will have seen the Disney Plus version.
[00:38:31.000 --> 00:38:38.200] But I think he did a good job, like, and made it his own a little bit while still having all the nods to the other performance.
[00:38:38.160 --> 00:38:42.600] So, the other person who got a massive cheer when they came out on stage was Thomas Jefferson.
[00:38:42.600 --> 00:38:45.120] I don't know if you saw that in your performance.
[00:38:45.600 --> 00:38:46.960] But Thomas Jefferson got a massive.
[00:38:47.600 --> 00:38:49.120] I don't think that happened when I went.
[00:38:44.920 --> 00:38:52.000] Whooping cheer, which was really bizarre.
[00:38:54.160 --> 00:38:58.800] Yeah, do we only cheer the villains in this performance?
[00:38:58.800 --> 00:38:59.760] What's going on here?
[00:39:00.080 --> 00:39:06.480] No one whooped and cheered when Hamilton fucking came on stage for the first time, but only when the bad guys turned up for the first time.
[00:39:06.480 --> 00:39:12.080] But watching between the two performances, the second performance, the King, fucking silence.
[00:39:12.400 --> 00:39:14.800] No reaction to the King the second time I saw it.
[00:39:14.800 --> 00:39:15.360] Wow.
[00:39:15.360 --> 00:39:17.600] But still, big whooping cheers for Jefferson.
[00:39:17.600 --> 00:39:23.520] But also, the guy who was playing Jefferson was really egging the crowd on, going, come on, give me a.
[00:39:23.680 --> 00:39:25.680] No, no, no, no, that's enough, that's enough.
[00:39:25.680 --> 00:39:31.520] No, come on, give me another one, give me another one, and really working the crowd to really get the crowd.
[00:39:31.920 --> 00:39:38.240] To be fair, there was a little bit of that in the debating scenes that worked quite well.
[00:39:38.240 --> 00:39:43.520] And yeah, so there probably was a little bit of cheering for Jefferson, partly because of that egging on.
[00:39:43.840 --> 00:39:48.080] But it wasn't like, it wasn't noteworthy to the point that I was like, that's a bit weird.
[00:39:48.080 --> 00:39:51.520] But also, the cast was massively different between the two performances.
[00:39:51.520 --> 00:39:55.440] It was the same King, it was the same Hamilton, but like it was a totally different George Washington.
[00:39:55.440 --> 00:39:57.280] It was a different Eliza.
[00:39:57.280 --> 00:40:01.280] It was, and I was surprised that the cast was changing.
[00:40:01.280 --> 00:40:04.800] I don't think we saw it because we went to see it more times than I've mentioned.
[00:40:05.120 --> 00:40:10.960] Did you just manage to see them on their break day and see all the understudies then?
[00:40:10.960 --> 00:40:17.920] Because they did, like, there's a listing for who's in which role, and there's only one name for all of the roles.
[00:40:17.960 --> 00:40:20.800] Yeah, but if it's running every day for two weeks, then they must have.
[00:40:20.880 --> 00:40:22.080] I thought they might just have a day off.
[00:40:22.640 --> 00:40:23.760] A day off, yeah, exactly.
[00:40:23.760 --> 00:40:29.880] So maybe the understudies just do one performance, a couple of performances a week or something.
[00:40:29.440 --> 00:40:35.640] Well, we ended up, so I say, I got tickets and Emma and I went, and then Emma got tickets and Emma and I went.
[00:40:35.960 --> 00:40:39.720] And then Emma's sister Karen said, I'd like to see Hamilton, and I'll see Hamilton live.
[00:40:39.720 --> 00:40:42.440] So it's like, all right, well, we'll go a third time.
[00:40:42.440 --> 00:40:45.000] So we went and we went with Karen as well.
[00:40:45.000 --> 00:40:48.120] Because Karen is a mum, she can't be staying out late.
[00:40:48.120 --> 00:40:51.960] So we went to the matinee performance of a Saturday afternoon, which makes sense, right?
[00:40:51.960 --> 00:40:53.160] So we went out to that.
[00:40:53.160 --> 00:40:54.360] Different cast again.
[00:40:55.720 --> 00:40:59.800] A third different person for some of the big names, or just a different mix and match.
[00:40:59.800 --> 00:41:00.200] Oh, okay.
[00:41:01.960 --> 00:41:03.800] Yeah, so a third set.
[00:41:03.800 --> 00:41:09.480] And it was really, you know, we were coming out going, well, Eliza wasn't as good this time as she was last time.
[00:41:10.280 --> 00:41:11.400] It was terrible.
[00:41:11.400 --> 00:41:18.760] There was one time the guy who kind of understudied George Washington was just in the chorus for the rest of his channel.
[00:41:18.920 --> 00:41:19.720] So he wash.
[00:41:19.800 --> 00:41:23.480] He was George Washington for one performance and then was in the chorus the rest of the time.
[00:41:23.720 --> 00:41:25.000] One minute you're watching him the next.
[00:41:25.320 --> 00:41:26.760] You can make use of your understudies.
[00:41:26.760 --> 00:41:30.920] You can't just have them sitting and watching for the whole two weeks or whatever.
[00:41:31.080 --> 00:41:33.480] That means he's an understudy for his chorus part.
[00:41:34.120 --> 00:41:38.280] No, it means he's an understudy for the main part and then is in the chorus when he's not.
[00:41:38.600 --> 00:41:41.080] That means he has an understudy for his chorus part.
[00:41:41.240 --> 00:41:44.040] Well, I bet all the chorus just like chop and change anyway.
[00:41:44.040 --> 00:41:46.360] There's a lot of chopping and changing in the chorus.
[00:41:46.360 --> 00:41:52.760] But we came out of watching it on the Saturday afternoon and we thought that was, you know, it was a great performance and really enjoyed it.
[00:41:52.760 --> 00:41:56.840] We saw Karen off to the bus and Emma and I went off to get something to eat.
[00:41:56.840 --> 00:42:01.160] And just as we're sitting there eating, it was like, should we go again?
[00:42:01.640 --> 00:42:05.320] So we went back and watched it again that evening.
[00:42:05.560 --> 00:42:06.120] Ridiculous.
[00:42:06.120 --> 00:42:09.160] For a fourth time, having seen it twice in a day.
[00:42:09.160 --> 00:42:11.160] I'm not convinced it was the same cast.
[00:42:11.480 --> 00:42:12.960] Emma thinks it was the same cast.
[00:42:12.960 --> 00:42:16.880] The final when we went to see it twice in one day, Emma thinks it was the same cast.
[00:42:16.880 --> 00:42:18.640] I'm not persuaded it was the same cast.
[00:42:14.920 --> 00:42:21.040] I think there were some different people in there.
[00:42:21.280 --> 00:42:22.880] You are ridiculous, human beings.
[00:42:23.200 --> 00:42:27.920] I turned down the chance to go and see one of my favourite brands in the world, Bright Eyes.
[00:42:28.320 --> 00:42:29.280] We went to see them.
[00:42:29.280 --> 00:42:30.000] We booked for tickets.
[00:42:30.000 --> 00:42:35.520] Alice and I booked tickets to go and see two years ago and they were delayed and then it was postponed for a year.
[00:42:35.520 --> 00:42:37.520] And it was in Wolverhampton because they were only doing Wolverhampton.
[00:42:38.240 --> 00:42:39.600] That time they were only doing Wolverhampton.
[00:42:39.680 --> 00:42:45.840] And then after you bought the tickets, they announced other shows around the UK, including one in Manchester and Leeds and very including one in Nottingham.
[00:42:45.840 --> 00:42:51.680] And that night, there were so many gigs on because I went to see Tim Minchin in Nottingham on the 16th of June.
[00:42:51.680 --> 00:42:56.320] Yeah, I went to see the AES, which I had to turn down because I had tickets to see Tim Minchin.
[00:42:56.640 --> 00:43:01.600] And then we couldn't go and see Bright Eyes in Nottingham on the 16th of June because we were both on the gigs.
[00:43:01.600 --> 00:43:03.520] And I looked at, I could have gone to see them in Leeds.
[00:43:03.600 --> 00:43:04.560] We went to the Manchester.
[00:43:04.560 --> 00:43:05.680] Sorry, went to the one in Wolverad.
[00:43:05.760 --> 00:43:07.200] We already had tickets to the one in Wolverhampton.
[00:43:07.360 --> 00:43:08.480] I could have gone to see them in Leeds.
[00:43:08.480 --> 00:43:09.520] And I thought, oh, it's a bit ridiculous.
[00:43:09.600 --> 00:43:14.080] Drive all the way to Leeds to see a band that I'm going to see the week after in Wolverhampton.
[00:43:14.080 --> 00:43:20.720] And then I saw they were playing in Manchester, and I got an email saying there's two free tickets if you want to answer a question.
[00:43:20.720 --> 00:43:21.840] And I knew the answer to the question.
[00:43:21.840 --> 00:43:24.480] So I emailed her, like, immediately, here's the answer to the question.
[00:43:24.480 --> 00:43:27.200] The email back said, congratulations, you've won the two tickets.
[00:43:27.200 --> 00:43:32.400] And then I remembered the reason we weren't going to Manchester because it was the same night we were in Manchester seeing Pulp.
[00:43:33.360 --> 00:43:35.440] So I was already at a gig in Manchester that night.
[00:43:35.440 --> 00:43:36.320] I was like, great.
[00:43:36.320 --> 00:43:38.160] Thanks for the two free tickets.
[00:43:38.160 --> 00:43:38.960] No, thank you.
[00:43:38.960 --> 00:43:40.160] I can't, I can't come.
[00:43:40.160 --> 00:43:41.200] You give them to someone else.
[00:43:41.200 --> 00:43:42.800] So, yeah, ridiculous.
[00:43:42.800 --> 00:43:46.880] So it's just a ridiculous, like, two days, five gigs.
[00:43:46.880 --> 00:43:47.280] Yeah.
[00:43:48.240 --> 00:43:50.240] We kind of wanted to be at all of them.
[00:43:50.240 --> 00:43:51.920] I mean, you didn't want to go and see Tim Minchin.
[00:43:52.000 --> 00:43:53.280] I didn't want to go and see Tim Minshin.
[00:43:53.280 --> 00:43:53.520] No.
[00:43:53.520 --> 00:43:55.440] Well, you can smell his feet, can't you?
[00:43:58.560 --> 00:43:59.280] We'll leave it there.
[00:43:59.480 --> 00:44:00.040] We'll leave it there.
[00:44:00.040 --> 00:44:00.520] It's fine.
[00:43:59.920 --> 00:44:03.160] The 2010s were a long time ago.
[00:44:08.840 --> 00:44:14.360] So, Mercy Side Skeptic Society have our annual summer picnic coming up.
[00:44:14.360 --> 00:44:20.360] That's going to be this Sunday, which is the 13th of July, in Sefton Park from 2 p.m.
[00:44:20.600 --> 00:44:22.760] And if you're in the Liverpool area, you should definitely come along to that.
[00:44:22.760 --> 00:44:23.720] It's going to be a fantastic time.
[00:44:24.680 --> 00:44:31.880] It's our family-friendly event, so you can bring any kiddies, pets, as long as they're not going to bite or attack anybody.
[00:44:31.880 --> 00:44:33.640] That's why I don't bring Micah.
[00:44:35.720 --> 00:44:37.800] And she doesn't bite, really.
[00:44:37.800 --> 00:44:41.240] She definitely doesn't attack kids, but she's not predictable to bring people.
[00:44:41.320 --> 00:44:42.200] She would attack adults.
[00:44:43.000 --> 00:44:43.800] No, she does.
[00:44:43.800 --> 00:44:47.160] She wouldn't, especially not adults that she knows that are my.
[00:44:48.120 --> 00:44:55.480] She does do a little bit of redirection if somebody's walking directly at her who is a complete stranger, but that's the extent of it.
[00:44:56.440 --> 00:44:59.320] I mean, I do muzzle her if I'm going to be in close contact with people just in case.
[00:44:59.480 --> 00:45:00.520] You're a very responsible dog.
[00:45:01.160 --> 00:45:01.880] But she's not going to be there.
[00:45:02.200 --> 00:45:04.280] She's not going to be there because she can't be trusted.
[00:45:04.600 --> 00:45:10.840] Because although she won't be any danger to the people there, she will just bark incessantly, constantly.
[00:45:10.840 --> 00:45:14.600] And if there are any other dogs there, she might well get a bit aggro at them.
[00:45:14.920 --> 00:45:18.600] And Lupin can't be there because he can't be trusted because he tries and steal everything.
[00:45:18.920 --> 00:45:22.040] Try and eat all the food, try and escape.
[00:45:22.040 --> 00:45:22.760] Try and lick everybody.
[00:45:23.000 --> 00:45:24.520] Try and lick everybody.
[00:45:24.520 --> 00:45:27.320] Just generally need me to keep hold of him the whole time.
[00:45:27.320 --> 00:45:30.440] And he is really strong and it is really exhausting.
[00:45:30.440 --> 00:45:35.160] So he also can't trust us because he just can't chill.
[00:45:35.160 --> 00:45:35.880] He can't chill.
[00:45:35.880 --> 00:45:42.600] But it will be a fun day, assuming the weather is fine, which we can't predict because we're recording this two weeks in advance.
[00:45:42.600 --> 00:45:45.000] Yeah, I'm sure it'll be fine, though, given the way the weather has been.
[00:45:45.200 --> 00:45:46.400] We'll get the chemtrails out.
[00:45:46.560 --> 00:45:47.200] It's all fantastic.
[00:45:48.240 --> 00:45:49.440] Yeah, so we will be catering that.
[00:45:49.440 --> 00:45:53.120] So there will be free food available if you would like to come along, you know, which you're more than welcome to.
[00:45:53.120 --> 00:45:55.040] There will also be soft drinks available.
[00:45:55.520 --> 00:46:02.800] And if you would like alcoholic drinks, you're welcome to bring your own to the extent that you're allowed to consume such things in a public space.
[00:46:02.800 --> 00:46:05.360] Yeah, you'll be able to spot us because we'll have our flag up.
[00:46:05.360 --> 00:46:09.360] We've got a Mercy Sound Skeptics flag that's got our logo on, which you'll be able to spot.
[00:46:09.360 --> 00:46:13.040] But we're going to be heading towards the north end of the palmhouse.
[00:46:13.520 --> 00:46:14.320] Off the road by the palmhouse.
[00:46:14.400 --> 00:46:15.600] We're usually near the palmhouse.
[00:46:15.600 --> 00:46:18.800] Yeah, I always think of it as the north end of the park by the palmhouse.
[00:46:18.800 --> 00:46:19.600] I don't know that it is.
[00:46:19.600 --> 00:46:20.880] I don't know the Lark Lane end.
[00:46:20.880 --> 00:46:21.360] It's the south.
[00:46:21.520 --> 00:46:21.760] No.
[00:46:21.760 --> 00:46:24.960] I've never actually got a fucking compass out, but it's the bit by the palm house.
[00:46:25.840 --> 00:46:27.200] On the big field near the palmhouse.
[00:46:27.280 --> 00:46:28.640] Yeah, by the road by the palmhouse.
[00:46:28.640 --> 00:46:32.320] People who are going, check up our meetup, you'll see details of where to find us there.
[00:46:32.320 --> 00:46:33.840] We'll drop it in there when it comes to it.
[00:46:33.840 --> 00:46:37.280] Yeah, so that's going to be from two o'clock, and you should definitely come along to that.
[00:46:37.280 --> 00:46:38.480] It's going to be a brilliant time.
[00:46:38.480 --> 00:46:39.040] I'm going to be there.
[00:46:39.040 --> 00:46:39.760] You're going to be there.
[00:46:39.840 --> 00:46:40.400] I'll probably be there.
[00:46:40.720 --> 00:46:40.880] Yeah.
[00:46:41.040 --> 00:46:42.160] Going to be a cracking time.
[00:46:42.160 --> 00:46:42.560] It will.
[00:46:42.560 --> 00:46:49.120] I'll also mention that obviously I've mentioned a couple of times on the show over the last couple of months that I do another show with Cecil Cicarello from Cognitive Distance.
[00:46:49.120 --> 00:46:50.880] I do the No Rogan experience.
[00:46:50.880 --> 00:46:53.520] We finished our first series a couple of weeks ago.
[00:46:53.520 --> 00:46:55.120] We're in a mid-series break.
[00:46:55.120 --> 00:46:59.280] I think we did like 27 episodes and then some bonus episodes and things.
[00:46:59.280 --> 00:47:21.520] So if people haven't checked that out, if you want to know what is happening on the largest podcast platform in the world, which is the Joe Rogan experience, but you don't want to listen to Joe Rogan, you want to listen to essentially Cecil and I explaining what is happening and pointing out where he's wrong and bringing the context and the evidence and putting together a larger picture, by all means, check out norogan.com.
[00:47:21.520 --> 00:47:23.760] I'm really happy with how we've done the first series.
[00:47:23.760 --> 00:47:31.160] I think we've done some interesting stuff being able to put together the pieces of what's going to have been happening in America when it was recorded.
[00:47:31.240 --> 00:47:40.280] You can hear like this times that he's interviewing someone who is going to go on to become quite important in the Trump administration, and you can hear what they have planned.
[00:47:40.280 --> 00:47:42.760] And it's all right there on Joe Rogan's shore.
[00:47:42.760 --> 00:47:46.440] And the reason none of us knew it was happening is because none of us listened to Joe Rogan.
[00:47:46.440 --> 00:47:50.200] And so we went ahead and did that in order to do the skeptical service on it.
[00:47:50.200 --> 00:47:52.840] So yeah, if you want to check it out, go to noorogan.com.
[00:47:52.840 --> 00:47:55.960] And we should also give a quick plug for our Patreon as well.
[00:47:56.280 --> 00:48:05.480] So if you like the show, if you enjoy what we do, you can support the show by going to patreon.com forward slash skeptics with a K, where you can donate as little as a pound a month.
[00:48:05.480 --> 00:48:06.680] That helps support the show.
[00:48:06.680 --> 00:48:09.480] It helps us keep things going, helps us keep things running.
[00:48:09.480 --> 00:48:12.840] And in exchange for that, you also get an ad-free version of the show.
[00:48:12.840 --> 00:48:15.000] So no ads, nice and clean.
[00:48:15.000 --> 00:48:17.000] It just gets straight into it.
[00:48:17.000 --> 00:48:19.640] And you'll be able to get that from Patreon.
[00:48:19.640 --> 00:48:20.120] Yes.
[00:48:20.120 --> 00:48:27.560] We don't have any bonus material there, but what your money does do is say to us that you appreciate the work that Mike and I and Alice do on the show.
[00:48:27.560 --> 00:48:28.200] Yeah.
[00:48:28.200 --> 00:48:36.280] You can also support the Mercy Skeptic Society by going to their Patreon, which is patreon.com forward slash Merseyskeptics, which does things like catering the picnic.
[00:48:36.280 --> 00:48:42.280] In fact, it's exactly what that kind of money goes for: for supporting the Mersey Science Skeptics, support the work that we're doing.
[00:48:42.280 --> 00:48:44.040] It also supports this show.
[00:48:44.040 --> 00:48:47.800] And you also get an ad-free version of the show from that venue as well.
[00:48:47.800 --> 00:48:53.560] But if you're not feeling like you financially are in a position where you want to contribute to a podcast, and that's totally fine.
[00:48:53.960 --> 00:48:56.920] No one's saying you're a bad person because you can't pay for a podcast.
[00:48:56.920 --> 00:48:57.480] What you can do.
[00:48:57.800 --> 00:49:00.600] Alice was saying that off air, but she hasn't said it on air.
[00:49:00.840 --> 00:49:03.800] The abuse that Alice gives to our listeners who don't go on Patreon.
[00:49:04.440 --> 00:49:06.240] It's fucking astonishing, to be honest.
[00:49:06.200 --> 00:49:07.040] Morgan gets to hear it.
[00:49:09.000 --> 00:49:11.320] It is only our editor Morgan who gets to hear this.
[00:49:11.800 --> 00:49:13.880] But yeah, and she always does it on a hot mic.
[00:49:13.880 --> 00:49:15.200] Never, never in the drivers.
[00:49:14.840 --> 00:49:16.720] Always on a hot mic.
[00:49:17.040 --> 00:49:26.160] But if you're the sort of person Alice despises, what you can do to help us if you're not willing to pay or not able to pay, which is a totally reasonable thing to do, is you can leave a review.
[00:49:26.160 --> 00:49:26.480] Yeah.
[00:49:26.480 --> 00:49:30.160] Leave a review on whatever podcasting platform is of your choice.
[00:49:30.160 --> 00:49:32.960] Tell a friend, you know, try and get the show out there.
[00:49:32.960 --> 00:49:35.440] Try and help us spread skepticism.
[00:49:35.440 --> 00:49:38.080] And that's going to, hopefully we'll win.
[00:49:38.080 --> 00:49:38.800] We're going to win this.
[00:49:38.880 --> 00:49:39.360] We're going to win.
[00:49:39.360 --> 00:49:39.920] It's fine.
[00:49:39.920 --> 00:49:40.560] It's going to be good.
[00:49:40.560 --> 00:49:41.280] It's going to be fine.
[00:49:41.280 --> 00:49:41.760] Trust us.
[00:49:41.760 --> 00:49:42.560] We've got this.
[00:49:42.560 --> 00:49:43.520] We've got this.
[00:49:43.520 --> 00:49:46.080] You just need to leave us reviews.
[00:49:46.400 --> 00:49:48.800] Aside from that, then, I think that's all we have time for.
[00:49:48.800 --> 00:49:49.360] I think it is.
[00:49:49.360 --> 00:49:52.000] All that remains then is for me to thank Marsh for coming along today.
[00:49:52.000 --> 00:49:52.480] Cheers.
[00:49:52.480 --> 00:49:53.520] Thank you to Alice.
[00:49:53.520 --> 00:49:53.920] Thank you.
[00:49:54.160 --> 00:49:56.160] Alice, I'm going to have to cut that out.
[00:49:56.160 --> 00:49:58.320] You can't say that on a hot mic.
[00:49:58.400 --> 00:50:00.480] It's a fucking disgrace.
[00:50:00.480 --> 00:50:03.280] We'll beat Skeptics with a K, and we will see you next time.
[00:50:03.280 --> 00:50:03.920] Bye now.
[00:50:03.920 --> 00:50:04.880] Bye.
[00:50:09.680 --> 00:50:14.800] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society.
[00:50:14.800 --> 00:50:24.160] For questions or comments, email podcast at skepticswithakay.org and you can find out more about Merseyside Skeptics at merseyside skeptics.org.uk.

Prompt 2: Key Takeaways

Now please extract the key takeaways from the transcript content I provided.

Extract the most important key takeaways from this part of the conversation. Use a single sentence statement (the key takeaway) rather than milquetoast descriptions like "the hosts discuss...". 

Limit the key takeaways to a maximum of 3. The key takeaways should be insightful and knowledge-additive. 

IMPORTANT: Return ONLY valid JSON, no explanations or markdown. Ensure:
- All strings are properly quoted and escaped
- No trailing commas
- All braces and brackets are balanced
Format: {"key_takeaways": ["takeaway 1", "takeaway 2"]}

Prompt 3: Segments

Now identify 2-4 distinct topical segments from this part of the conversation.

For each segment, identify:
- Descriptive title (3-6 words)  
- START timestamp when this topic begins (HH:MM:SS format)
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Most important Key takeaway from that segment. Key takeaway must be specific and knowledge-additive.
- Brief summary of the discussion

IMPORTANT: The timestamp should mark when the topic/segment STARTS, not a range. Look for topic transitions and conversation shifts.

Return ONLY valid JSON. Ensure all strings are properly quoted, no trailing commas:
{
  "segments": [
    {
      "segment_title": "Topic Discussion", 
      "timestamp": "01:15:30",
      "key_takeaway": "main point from this segment",
      "segment_summary": "brief description of what was discussed"
    }
  ]
}

Timestamp format: HH:MM:SS (e.g., 00:05:30, 01:22:45) marking the START of each segment.

Prompt 4: Media Mentions

Now scan the transcript content I provided for ACTUAL mentions of specific media titles:

Find explicit mentions of:
- Books (with specific titles)
- Movies (with specific titles)  
- TV Shows (with specific titles)
- Music/Songs (with specific titles)

DO NOT include:
- Websites, URLs, or web services
- Other podcasts or podcast names

IMPORTANT: 
- Only include items explicitly mentioned by name. Do not invent titles.
- Valid categories are: "Book", "Movie", "TV Show", "Music"
- Include the exact phrase where each item was mentioned
- Find the nearest proximate timestamp where it appears in the conversation
- THE TIMESTAMP OF THE MEDIA MENTION IS IMPORTANT - DO NOT INVENT TIMESTAMPS AND DO NOT MISATTRIBUTE TIMESTAMPS
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- Timestamps are given as ranges, e.g. 01:13:42.520 --> 01:13:46.720. Use the EARLIER of the 2 timestamps in the range.

Return ONLY valid JSON. Ensure all strings are properly quoted and escaped, no trailing commas:
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Full Transcript

[00:00:06.720 --> 00:00:14.160] It is Thursday, the 10th of July, 2025, and you're listening to Skeptics with a K, the podcast for science, reason, and critical thinking.
[00:00:14.160 --> 00:00:25.520] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society, a non-profit organisation for the promotion of scientific skepticism on Merseyside around the UK and internationally.
[00:00:25.520 --> 00:00:26.960] I'm your host, Mike Hall.
[00:00:26.960 --> 00:00:28.160] With me today is Marsh.
[00:00:28.160 --> 00:00:28.720] Hello.
[00:00:28.720 --> 00:00:29.600] And Alice.
[00:00:29.600 --> 00:00:30.560] Hello.
[00:00:30.880 --> 00:00:37.520] Okay, so I think it's finally time to have the conversation that I have thrown forward to and said we'll talk about it at some point.
[00:00:37.520 --> 00:00:39.680] So many times it is unreal.
[00:00:39.680 --> 00:00:41.680] We should have a conversation about Azempic.
[00:00:41.680 --> 00:00:42.480] Okay, okay.
[00:00:42.800 --> 00:00:53.440] Because, I mean, just today, as of recording, which is a couple of weeks before this goes out, I just checked for Googled Azempic and clicked news.
[00:00:53.440 --> 00:00:59.920] And there's a news article from 18 hours ago, a different one from 13 hours ago, a different one from a day ago.
[00:00:59.920 --> 00:01:02.480] These are all three completely different stories.
[00:01:02.480 --> 00:01:06.240] Another one from a day ago, another one from a day ago, again, different stories.
[00:01:06.240 --> 00:01:11.040] Another one from 18 hours ago, two hours ago, 11 hours ago, three days ago, three days ago.
[00:01:11.040 --> 00:01:14.880] Like, it is constant conversation on Azempic.
[00:01:15.200 --> 00:01:20.320] And also, bear in mind that the vast majority of these articles are using Azempic in the title because that's the term people know.
[00:01:20.320 --> 00:01:22.240] But Azempic is not what they're talking about.
[00:01:22.320 --> 00:01:24.160] Yeah, I was about to say that's just a Zempic.
[00:01:24.240 --> 00:01:26.400] There are other versions of Azempic out there as well.
[00:01:26.400 --> 00:01:27.680] Well, not even that.
[00:01:27.680 --> 00:01:38.480] So in pretty much every single one of those articles, they will, in most cases, they'll not be talking about Azempic full stop because Azempic is the brand name for diabetes medication.
[00:01:38.480 --> 00:01:46.080] The same medication, the same drug, when marketed for weight management is WeGovy.
[00:01:46.080 --> 00:01:46.720] Yeah, yeah, yeah.
[00:01:46.880 --> 00:01:47.760] It's a different name.
[00:01:47.760 --> 00:01:49.920] Are they both manufactured by Nova Nordisk?
[00:01:49.920 --> 00:01:50.480] I think so.
[00:01:50.560 --> 00:01:57.440] So I did a little bit of work for Nova Nordisk once, but all I was doing some animated videos for Big Pharma, just for Big Pharma.
[00:01:57.600 --> 00:01:59.120] Just doing videos for Big Pharma.
[00:01:59.280 --> 00:02:08.840] It was specifically about how to set your computer and your desk chair up correctly so that it's at the right height for your workspace to not be harmful, your occupational health.
[00:02:08.840 --> 00:02:10.760] But that's the most that I've ever done for big pharma.
[00:02:10.920 --> 00:02:13.240] I did about three hours' work on that.
[00:02:14.520 --> 00:02:20.360] So let's start off by talking a bit about appetite, or more specifically, the biology of appetite.
[00:02:20.680 --> 00:02:27.160] And there's so many different ways to structure a conversation on appetite, but we'll start by talking about the homeostatic elements of that.
[00:02:27.160 --> 00:02:33.960] So the process by which our hunger and satiety cues are regulated by our physiological needs for energy.
[00:02:33.960 --> 00:02:42.760] And there's different things that feed into appetite, obviously, like psychology, need for connection, need for comfort, you know, that kind of emotional regulation of appetite.
[00:02:42.760 --> 00:02:47.080] But we'll talk specifically about those kind of physiological needs for energy.
[00:02:47.080 --> 00:03:01.880] And energy is obviously such a crucial resource that our bodies have multiple layers of regulation when it comes to A, acquiring energy, B, using energy, and C, storing energy for future use in case we have reduced environmental access to energy.
[00:03:01.880 --> 00:03:08.840] And in fact, D, maintaining those stores for as long as possible when environmental energy access is reduced.
[00:03:09.080 --> 00:03:16.360] You don't want to just burn through it on day one of not having access to energy because then you've not got stores to keep you going.
[00:03:16.680 --> 00:03:35.880] There's a whole bunch of regulatory processes involved in this, including stretch receptors in the GI tract, which signal to the brain that physical sensation of fullness, hormone signals released from cells of the pancreas, the stomach, adipose tissue, or further down the GI tract, and that can either reduce or increase appetite depending on the feedback detected.
[00:03:35.880 --> 00:03:46.640] And psychologists even think that psychology can have an impact on appetite, such as habituation to foods that we like and want, which can then reduce the like and want if we have good access to those foods.
[00:03:46.960 --> 00:03:55.360] One of the key things that we often discuss on this show is that every body is different, and that's largely because the human body is really fucking complicated.
[00:03:55.360 --> 00:04:06.720] And we have around 37 trillion cells in each of us, hundreds of different cell types in the human body, dozens of different organs, 20,000 genes which can be modified in a bunch of different ways.
[00:04:06.720 --> 00:04:12.240] I like to think of it like the terraced houses in the streets around where you and I, Marsh, live.
[00:04:12.240 --> 00:04:14.320] I thought you said terrorist houses for a second.
[00:04:14.320 --> 00:04:16.480] I was like, what do you know about these streets?
[00:04:17.120 --> 00:04:24.160] So, in the UK, as I'm sure is true in plenty of other places, many urban areas have the pockets of rows of terraced houses.
[00:04:24.160 --> 00:04:31.600] And often, in those individual pockets of houses, all of those houses in that area are roughly similar in terms of their layout.
[00:04:32.080 --> 00:04:40.400] So, for example, Marsh, you and I live around the corner from each other, or you live on the street, the next street over from me, or I live on the street next over from you because you moved in first.
[00:04:40.400 --> 00:04:45.120] If you want to keep describing it too many more ways, you're basically going to dox the two of us.
[00:04:45.440 --> 00:04:50.800] People could g between that and the ice cream van that goes past sometimes you hear in recordings, they'll be able to gee all kids.
[00:04:51.760 --> 00:05:04.240] And if we set aside all of the surface-level modifications, like I have hardwood floors downstairs and you have hardwood floors upstairs, and just think about the physical layout of the house, our houses are very similar.
[00:05:04.240 --> 00:05:08.400] Yeah, we both have houses that have a hallway, two downstairs reception rooms.
[00:05:08.400 --> 00:05:11.280] We both happen to have made one a living room and one a dining room.
[00:05:11.280 --> 00:05:17.040] We both have a kitchen, three upstairs bedrooms, two of which are larger rooms and one of which is a smaller room, and a bathroom.
[00:05:19.920 --> 00:05:24.960] Your house has been modified since it was built to add on an additional downstairs bathroom.
[00:05:24.960 --> 00:05:33.960] But if we were just to focus on what was there when it was first built, I say that the bathroom and third bedroom and kitchen will have been added on when like bedroom, indoor toilets and separate kitchens became a vacuum.
[00:05:38.120 --> 00:05:39.080] I'm making a point.
[00:05:40.040 --> 00:05:41.320] And you interrupted the line.
[00:05:42.760 --> 00:05:46.680] You might say that our houses have the same blueprint, the same body.
[00:05:46.680 --> 00:05:47.240] Sure.
[00:05:47.560 --> 00:06:00.760] Except they aren't exactly the same because when you make something from so many components, in this case, bricks, and you make it with the support of so many different builders and with a slightly different map, you're going to end up with something slightly different.
[00:06:00.760 --> 00:06:03.400] In our cases, that means that your house is slightly wider than mine.
[00:06:03.400 --> 00:06:07.880] You have a bit more space in the hallway, slightly larger living room and dining room, and your bathroom is slightly bigger.
[00:06:07.880 --> 00:06:11.960] In my house, there's a small step to the front door, and yours has two larger steps to the front door.
[00:06:12.280 --> 00:06:15.480] In my house, there's a small step between the landing and the bathroom and yours level.
[00:06:15.480 --> 00:06:17.560] Like there are small differences.
[00:06:17.560 --> 00:06:20.520] And I'm sure if we really broke it down to the basics, there will be other differences.
[00:06:20.520 --> 00:06:23.080] Maybe your house is built slightly differently to mine.
[00:06:23.080 --> 00:06:26.600] Maybe that makes it easier or harder to heat the house and keep the heat in.
[00:06:26.600 --> 00:06:29.240] Maybe it makes one house slightly more damp than the other.
[00:06:29.240 --> 00:06:31.560] I don't know, we need like Paul and Kumagarity to help us.
[00:06:31.880 --> 00:06:37.160] Yeah, it's definitely my cat that makes my house damp because she occasionally pisses in the corner of the living room.
[00:06:37.160 --> 00:06:47.720] But the point I'm trying to illustrate is that once you have something big and complex made of lots of smaller components, then that introduces differences even if you try and build the same version over and over again.
[00:06:47.720 --> 00:06:58.680] And that's without getting into intentional differences in how we build different houses or how our DNA codes for deliberate differences or variation in our bodies, which is part and parcel of survival.
[00:06:59.000 --> 00:07:13.960] Which is to say that when it comes to complicated processes such as appetite, there are lots of ways that this can vary from person to person, even before getting into the cases where something has gone wrong or changes that are made throughout our lifetime by interacting with external influences.
[00:07:13.960 --> 00:07:20.160] There's loads of different hormones involved when it comes to regulating appetite, hunger, and satiety.
[00:07:20.160 --> 00:07:26.480] There's two in particular that people usually talk about: ghrelin, which is sometimes called the hunger hormone, and leptin.
[00:07:26.800 --> 00:07:29.520] Oh, is that the G and L in GLP?
[00:07:29.840 --> 00:07:30.480] Nope.
[00:07:30.480 --> 00:07:31.120] Okay.
[00:07:33.280 --> 00:07:34.880] Let's just won't go any further.
[00:07:34.880 --> 00:07:36.960] We will come back to what GLP stands for.
[00:07:37.280 --> 00:07:39.200] I can have some inpins back.
[00:07:39.840 --> 00:07:44.880] Ghrelin is produced by cells in the stomach and makes us hungry, but it also does loads of other things in the body.
[00:07:44.880 --> 00:07:50.080] It's involved in the release of growth hormone, insulin production for glucose regulation, and lipid metabolism.
[00:07:50.080 --> 00:08:01.120] And how, when, and how much ghrelin is produced is regulated by a whole range of different stimuli, including the levels of lots of other hormones like leptin, glucagon, and insulin.
[00:08:01.120 --> 00:08:03.520] Glucagon is one of is the G in GLP.
[00:08:03.520 --> 00:08:04.320] Oh, okay.
[00:08:04.640 --> 00:08:10.000] So leptin is often considered the opposition to ghrelin in that it tells us when we're no longer hungry.
[00:08:10.000 --> 00:08:11.840] But that's a massive oversimplification.
[00:08:11.840 --> 00:08:27.040] There are loads of different types of regulation in play when it comes to appetite and satiety, but we know that leptin is quite important because in humans and animals with leptin deficiency, we see increased body weight and hyperphasia and an unusually strong desire to eat.
[00:08:28.000 --> 00:08:42.400] But of course, you might have noticed that when it comes to appetite and satiety, and so I think like maybe 10 years ago, maybe longer, you would hear about ghrelin occasionally in the news, and you'd hear about leptin occasionally in the news.
[00:08:42.400 --> 00:08:44.320] But I don't think that is true anymore.
[00:08:44.320 --> 00:08:52.560] Now, the social understanding of the hormones at play has really shifted, and we're almost exclusively talking about GLP-1.
[00:08:52.880 --> 00:08:56.480] So, GLP-1 is glucagon-like peptide 1.
[00:08:56.480 --> 00:09:01.720] It's a small hormone that's produced by the cells of the intestine and the brainstem in response to food intake.
[00:08:59.840 --> 00:09:06.760] And it's one of a few proteins that directly stimulates the release of insulin.
[00:09:07.080 --> 00:09:21.320] Insulin release is mostly stimulated by nutrient levels, so it's often a reaction just to glucose itself in the body, but there are some hormones that also have a direct impact on insulin production, and GLP-1 is one of them.
[00:09:21.640 --> 00:09:42.120] And it's insulin that then gets to work to make use of all of the nutrients available after we've eaten by increasing the uptake of glucose by muscle and adipose tissues, so the body can use the glucose for energy in the muscles or lay it down for storage in the adipose tissues, as well as the uptake of other things that we need circulating in the blood, like amino acids.
[00:09:42.120 --> 00:09:51.000] It also makes the glucose easier to break down for use, so it's more accessible, as well as reducing the reliance on other energy sources for the body.
[00:09:51.000 --> 00:09:57.000] So, for example, it reduces the level of gluconeogenesis, which is the production of glucose in the body.
[00:09:57.000 --> 00:10:09.240] We don't need to make any, we've got plenty of eating in the blood, and it also reduces protein breakdown and autophagy because we don't need to break things down in the body to get hold of energy from elsewhere if we've got plenty of glucose available.
[00:10:10.360 --> 00:10:26.920] But again, GLP-1 does more than just stimulate the release of insulin, it does a range of other things because regulating the human body is complicated and multi-layered, as it must be if you have so many systems running concurrently that have shared dependencies and/or are dependent on each other.
[00:10:27.240 --> 00:10:37.160] Another thing GLP-1 does is slow gastric emptying, meaning it takes a little bit longer to digest our food and therefore we're not getting hungry so quickly after eating.
[00:10:37.160 --> 00:10:44.760] So, in 2005, the FDA approved the first what they call an well, what scientists call an incretin mimetic.
[00:10:45.120 --> 00:10:54.960] So an incretin is a hormone that stimulates insulin release and a memetic is something that mimics that.
[00:10:54.960 --> 00:10:55.600] Okay.
[00:10:55.920 --> 00:11:04.080] So they approved exenatide, also known as bieta, I think that's the brand name, as an injectable for type 2 diabetes.
[00:11:04.080 --> 00:11:13.360] So the first GLP-1 receptor agonist drug was approved in 2005 in America.
[00:11:13.920 --> 00:11:16.080] That's a lot longer ago than I thought.
[00:11:16.080 --> 00:11:19.520] Yeah, so these have been around for use in diabetes for a while.
[00:11:19.520 --> 00:11:30.880] And we've known, so we started researching this like way back in the 90s and even earlier to understand kind of what GLP-1, the kind of native GLP-1 is doing in the body and what kind of impacts it's having.
[00:11:30.880 --> 00:11:34.400] And we knew that it was a potential target for diabetes particularly.
[00:11:34.720 --> 00:11:36.560] So there are two types of diabetes.
[00:11:36.560 --> 00:11:43.040] Type 1 is an autoimmune disorder in which the insulin producing cells are attacked and destroyed by the immune system.
[00:11:43.040 --> 00:11:51.840] And then type 2 arises from either the body not producing enough insulin or the body becoming resistant to the insulin that it is producing.
[00:11:51.840 --> 00:12:00.640] And in the case of type 2 diabetes, there are a number of different treatment options, of which GLP-1 receptor agonist injections are one option for some people in some cases.
[00:12:00.640 --> 00:12:08.880] So not everybody who has type 2 diabetes is going to be eligible for taking GLP-1 receptor agonists, but for some people, it's a good option.
[00:12:08.880 --> 00:12:19.120] I think, isn't there a thing, and I'm on very sketchy ground here, isn't there some small degree of evidence that a keto diet or a similar kind of diet actually has can have some effect on type 2 diabetes?
[00:12:19.360 --> 00:12:21.600] So there's lots of good evidence.
[00:12:21.680 --> 00:12:36.520] So for most people who are diagnosed with type 2 diabetes, the first or pre-diabetes, the first thing you'll be told is to try different dietary modifications and adding more exercise to your diet and lots of things that you can just do for yourself.
[00:12:36.840 --> 00:12:43.960] Most people who have type 2 diabetes will at some point require some kind of medical intervention support.
[00:12:44.280 --> 00:12:48.600] The goal is to maybe not be on those medications long term if you don't need to.
[00:12:48.600 --> 00:13:00.120] If you can get things under control and you can get into a kind of stable phase with your diabetes, you can often then manage it with diet and exercise, but obviously sometimes you can't.
[00:13:00.440 --> 00:13:02.920] And obviously, type 1 is very different.
[00:13:02.920 --> 00:13:03.160] Yes.
[00:13:03.640 --> 00:13:04.840] You just do not have the insulin.
[00:13:04.840 --> 00:13:05.080] Yeah.
[00:13:05.240 --> 00:13:06.440] You cannot do it.
[00:13:06.440 --> 00:13:08.680] So can I ask a clarifying question?
[00:13:08.680 --> 00:13:18.520] So my understanding is that typical first-line therapy for diabetes is you would just inject insulin.
[00:13:18.520 --> 00:13:24.120] So you get artificial insulin and you would use that to manage your own insulin levels.
[00:13:24.120 --> 00:13:28.840] And this is a way of actually stimulating your body to make insulin.
[00:13:28.840 --> 00:13:36.280] The GLP-1 memetic is about stimulating your body to make insulin rather than you just injecting yourself with neat insulin.
[00:13:36.440 --> 00:13:37.720] Second part correct.
[00:13:37.720 --> 00:13:41.240] First part, I think it depends on the individual case.
[00:13:41.240 --> 00:13:43.880] You wouldn't always necessarily need to inject insulin.
[00:13:43.880 --> 00:13:44.200] Okay.
[00:13:44.440 --> 00:13:48.600] And not every person with diabetes would inject insulin.
[00:13:48.600 --> 00:13:51.240] But yes, GLP-1 is just stimulating.
[00:13:51.240 --> 00:13:53.800] It is stimulating insulin production.
[00:13:53.800 --> 00:14:00.840] So that is one reason it's used to treat these receptor GLP1 receptor organists are used to treat diabetes.
[00:14:00.840 --> 00:14:09.800] The other is that it does have appetite-suppressing pathways that will ultimately lead the person to lose weight.
[00:14:09.800 --> 00:14:13.320] And we know that weight loss can have an impact on diabetes.
[00:14:13.480 --> 00:14:20.560] So if that helps, then that can be also an additional benefit of taking GLP-1 receptor agonists.
[00:14:22.080 --> 00:14:34.720] Different types of GLP-1 receptor agonist medications have developed and used to treat type 2 diabetes since the early 2000s, with semaglutide brand name as EMPIC, being approved in 2018.
[00:14:34.720 --> 00:14:36.800] So Zempic is relatively new.
[00:14:37.760 --> 00:14:43.600] It was approved in 2018 in Europe for use in type 2 diabetes.
[00:14:43.600 --> 00:14:53.680] There is a precedent for using GLP-1 receptor agonists to treat overweight and obesity in lyroglutide, which was approved in 2014.
[00:14:54.000 --> 00:15:00.560] And we've known for a long time that GLP-1 and GLP-1 receptor agonists can regulate appetite and therefore have an impact on body weight.
[00:15:00.560 --> 00:15:10.080] But it's really taken off since semaglutide was approved by the FDA for use in weight management in 2022 at a dose marketed as WeGovy.
[00:15:10.400 --> 00:15:16.720] Semaglutide is more effective for weight management than previous GLP-1 receptor agonists used for this purpose.
[00:15:16.720 --> 00:15:22.640] And as you will have seen since 2022, the use of this medication for weight management has just absolutely skyrocketed.
[00:15:22.800 --> 00:15:23.840] Oh, yeah, yeah.
[00:15:24.160 --> 00:15:29.840] By now, there are quite a few different GLP-1 receptor agonists which can and are being used for weight management.
[00:15:29.840 --> 00:16:14.360] And we're seeing a real trend towards open GLP-1 receptor agonist use in celebrities where they're sharing their use of these medications openly, but also instances of rapid and drastic body weight changes in celebrities and influencers, which may either be due to GLP-1 receptor agonist medication directly that they're just not talking openly about, which is fine, or indirectly in response to the notable trend towards weight loss that's captured the celebrity world and that's being fed by GLP-1 receptor agonist use and availability, but maybe that individual is not actually taking the medication and is just has just lost a lot of weight for perhaps because they've been influenced by that conversation.
[00:16:14.680 --> 00:16:18.360] I think Alex Jones falls into the former of those two camps.
[00:16:18.360 --> 00:16:20.360] He's lost a huge, huge amount of weight.
[00:16:20.360 --> 00:16:23.320] But whenever he talks about it, he says, I've not been taking any of the drugs.
[00:16:23.320 --> 00:16:25.480] I've just been working out super, super hard.
[00:16:25.480 --> 00:16:31.800] And I think that goes beyond, like, nobody owes you disclosing their medical history or their medical details.
[00:16:31.800 --> 00:16:38.280] But I think it is damaging when somebody lies about having done it and says, no, this was just regular exercise.
[00:16:38.280 --> 00:16:48.680] Because what that's, especially when they're in such a prominent position, what he's saying to his viewers is, if you had the same amount of willpower and grind as I have, you could get these kind of results as well.
[00:16:48.680 --> 00:16:49.000] Yeah.
[00:16:49.000 --> 00:16:49.880] And bollocks, can't you?
[00:16:50.120 --> 00:17:12.920] And well, and there's a potentially an additionally interesting conversation because he's so prominent in the kind of manosphere spaces where there is a lot of toxicity around, and we've talked on the show before, around both weight management but also kind of weight management again, but with the bulking of muscles and gaining muscle weight but losing weight through fat loss.
[00:17:13.240 --> 00:17:21.880] So contributing to that conversation in a negative way probably isn't helpful and just providing no comment would be potentially enough.
[00:17:21.880 --> 00:17:24.680] But in many ways it's the worst thing Alex Jones has ever done.
[00:17:24.680 --> 00:17:25.800] Oh, absolutely.
[00:17:26.760 --> 00:17:34.040] Now, of course, there are a number of issues with GLP-1 receptor agonist use for weight management.
[00:17:34.040 --> 00:17:42.760] One, of course, is that this rapid uptake in demand for these medications means that people with type 2 diabetes who are using these medications have been impacted by shortages.
[00:17:43.080 --> 00:17:45.000] I think this has settled out a little bit now.
[00:17:45.200 --> 00:17:51.360] I think this was more around the 2022, 2023 sort of time when it was really rapidly rising.
[00:17:51.520 --> 00:17:56.080] I'm seeing less news reporting around that now than at the time.
[00:17:56.080 --> 00:18:02.400] I was you were seeing that quite often is there were shortages because so many people were buying it for weight loss, you couldn't get it.
[00:18:02.400 --> 00:18:03.760] And buying it off label.
[00:18:03.760 --> 00:18:04.320] Yes.
[00:18:04.640 --> 00:18:13.200] So people were buying Ozempic, the diabetes medication, and using that for weight loss, which caused shortages for people with diabetes.
[00:18:13.200 --> 00:18:15.520] But you don't see those news articles so much anymore.
[00:18:15.520 --> 00:18:18.400] So maybe that's settled down, or maybe just the news isn't interested anymore.
[00:18:18.960 --> 00:18:33.040] Yeah, and there may well be part of it that as people were kind of, as journalists were scrambling for information on Azempic, as it was the hot topic to talk about, but they maybe hadn't got to grips with the science behind it yet.
[00:18:33.040 --> 00:18:38.160] And there were fewer news articles on the science behind it, it was the easy story to cover, right?
[00:18:38.160 --> 00:18:40.800] That it was having an impact on people with diabetes.
[00:18:40.800 --> 00:18:42.960] That's what Alex Johns looks like now, by the way.
[00:18:43.120 --> 00:18:44.480] He looks unrecognizable.
[00:18:46.000 --> 00:19:07.360] Another issue is that you'd be forgiven for thinking that taking WeGovy or other weight loss medications does only good things, when in fact, the side effects of these medications can be quite significant, with common side effects including nausea, constipation, diarrhea, risk of low or high blood sugar, which comes with a whole host of other symptoms, and then a less kind of common side effect, but a meaningful risk of acute pancreatitis.
[00:19:07.360 --> 00:19:10.240] And that's something that's been in the news a little bit over the last couple of days in particular.
[00:19:10.240 --> 00:19:13.520] I've seen there's been an uptick in people having pancreas issues.
[00:19:13.520 --> 00:19:21.200] So I don't know what the outcome of that was as to whether it's been anything other than a warning that this is a possible side effect.
[00:19:21.200 --> 00:19:25.280] Yeah, so I haven't looked at this very much.
[00:19:25.280 --> 00:19:49.880] What I have seen in my coverage, my research for today's piece, and maybe it's something we can come back to on a future episode, is that so lyroglutide, the first GLP-1 receptor agonist that was approved for use for weight management, did have slightly more significant issues with both pancreatitis and thyroid tumours or potentially an increased risk of thyroid cancer.
[00:19:49.880 --> 00:19:58.120] I think there is some concern that there might be risks of that with semaglutide too, hopefully smaller risk.
[00:19:58.120 --> 00:20:03.320] I left the thyroid cancer bit out of the story originally because I didn't want to contribute to any scaremongering.
[00:20:03.560 --> 00:20:06.440] We will have listeners who are taking semaglutide.
[00:20:06.440 --> 00:20:21.960] I think the risk is my understanding is, and again, this is maybe something we'll cover in a future show, the risk is relatively low unless you already have a family history of thyroid cancer, but that's something that the medical professional prescribing it should be discussing with you.
[00:20:21.960 --> 00:20:26.600] Obviously, that's then an issue if people are taking it without the support of a medical professional.
[00:20:26.920 --> 00:20:35.800] But yeah, there are potentially risks of these medications for pancreatitis and thyroid tumours and/or thyroid cancer risk.
[00:20:35.800 --> 00:20:40.200] And that will be a mechanism thing because it's been seen with lyroglutide as well as semaglutide.
[00:20:41.640 --> 00:20:52.200] Additionally, there are some really important conversations to be had and research to be done to understand how these sorts of medications might be used for long-term weight management.
[00:20:52.200 --> 00:20:55.800] So GLP-1 receptor agonists are having an impact on our physiology.
[00:20:55.800 --> 00:21:01.080] They're changing the levels of hormones in our body, which are fundamentally changing appetite.
[00:21:01.080 --> 00:21:18.080] That's potentially a really useful tool for some people, in some cases, who are experiencing detrimental health impacts due to body weight, or even have made an aesthetic choice that they want to lose weight, which is a choice that anybody has the right to make, right?
[00:21:18.080 --> 00:21:45.600] And I think it does also go some way towards challenging the idea that body weight has much, if anything, to do with motivation or willpower when we're seeing people choosing to take GLP-1 receptor agonists who have maybe been fat their entire lives and have dieted their entire lives and now are actually managing to lose weight with relative ease because it's a physiology thing, it's not just about trying harder.
[00:21:45.600 --> 00:21:57.680] And I think it's there's potentially something useful for us to understand there because we definitely have a lot of issues with assuming that there's some kind of moral judgment on body weight.
[00:21:57.680 --> 00:22:07.120] Yeah, and the moral judgment as well on how to lose that body weight as well, as there's a huge amount of moral judgment on people who are taking things like wear Golvie as you see the narratives around, well, why are they doing that?
[00:22:07.120 --> 00:22:17.920] That's the cheat way of losing weight, as if the weight that you lose through exercise and diet is somehow more worthy, is somehow worth more, and makes you worth more for having lost weight that way.
[00:22:17.920 --> 00:22:18.880] Yeah, absolutely.
[00:22:18.880 --> 00:22:27.200] And that's always been an issue and always been a conversation that's happened around kind of, for example, gastric surgery types of weight loss.
[00:22:27.200 --> 00:22:49.760] And I think the ubiquity of people using GLP-1 receptor agonists probably helps us challenge that thinking a little bit as well because it kind of almost desensitizes you to that as a method and hopefully therefore challenges the idea that there's a particularly morally right way to lose weight.
[00:22:49.760 --> 00:22:53.280] Major asterisk on that, which we're going to come back to.
[00:22:53.600 --> 00:23:01.800] However, does it mean then that people will need to continue taking these medications for life in order to maintain their body weight?
[00:23:01.960 --> 00:23:13.480] If this is a change in physiology and it's not about embedding certain practical weight management tools, is there a consequence that people need to stay on the medications for life?
[00:23:13.480 --> 00:23:20.520] We know that yo-yo dieting is likely to actually be much more harmful to health than simply living with a higher body weight.
[00:23:20.520 --> 00:23:32.040] So, is there then also a risk of these medications contributing to weight gain, weight loss, cycling, and extreme fluctuations for some people, which might have an impact on their health in the longer term?
[00:23:32.040 --> 00:23:53.240] These are important, nuanced discussion and research points around the kind of long-term value, long-term safety, and actual kind of long-term consequences of taking these medications, especially if access to those medications changes throughout your lifetime and you might be subject to that kind of fluctuation that is that we know is potentially damaging.
[00:23:53.560 --> 00:24:00.040] I don't have time to do that conversation justice today, but again, it's maybe something we could come back to in the future.
[00:24:00.040 --> 00:24:17.160] But one of the biggest issues that I think we're experiencing right now is that the sudden rise in access, use, and unrestrained media coverage of these medications for the purpose of managing body weight is having a massive impact on our society and potentially, therefore, on individuals within our society.
[00:24:17.480 --> 00:24:21.480] So, let's be clear: I believe in health at any size.
[00:24:21.480 --> 00:24:25.000] I think it is possible to be healthy and exist in a bigger body.
[00:24:25.000 --> 00:24:32.720] That is not to say that some people don't experience detrimental impacts on their individual of their individual body weight on their individual health, yeah.
[00:24:33.000 --> 00:24:35.800] But body weight isn't the be-all and end-all of health.
[00:24:35.800 --> 00:24:39.960] And I also think that health isn't the be-all and end-all full stop.
[00:24:39.960 --> 00:24:42.040] Like, I am not quote-unquote healthy.
[00:24:42.040 --> 00:24:44.440] I have multiple disabilities and conditions that impact on my health.
[00:24:44.440 --> 00:24:46.720] That doesn't mean I'm less valuable as a human being.
[00:24:44.840 --> 00:24:47.600] Yeah, that's not why.
[00:24:49.200 --> 00:24:54.640] If a person does experience health implications of their body weight, so what?
[00:24:54.640 --> 00:25:00.640] Of course, it's not anyone else's business, but even if it were, someone's health does not equate to their worth.
[00:25:00.640 --> 00:25:17.040] If someone is experiencing health impacts due to any circumstances in their life, that is for their consideration, along with the people they choose to include in that journey and their personal medical professionals who hopefully aren't subjecting them to medical bias or weight stigma, although we know that that is often happening.
[00:25:17.040 --> 00:25:23.200] And if that consideration leads them to choose to take GLP-1 receptor agonists to manage their body weight, that is entirely up to them.
[00:25:23.200 --> 00:25:27.440] Medical choices are highly personal and are entirely up to individuals.
[00:25:27.440 --> 00:25:43.200] However, there is a definite issue that we are encountering right now in that the public discourse has become entirely saturated in both subtle and explicit and of course very pervasive ideas of what is considered an appropriate body weight.
[00:25:43.200 --> 00:25:56.080] We know weight stigma is already an issue, but now after years of the body positivity and body neutrality movements growing, we're suddenly in a space where skinny is fashionable again and not just fashionable.
[00:25:56.080 --> 00:26:11.200] On social media, promotion of extreme weight loss is rampant with the rise of hashtag skinny talk, a hashtag which has now been blocked from searches by TikTok because of the potential dangers to people, particularly young women and girls.
[00:26:11.520 --> 00:26:24.080] This content has been likened to the pro-ANA content, which has circulated, long circulated among people living with anorexia on social media, often as a symptom of their illness, but which is believed to contribute to illness progression.
[00:26:24.080 --> 00:26:34.600] We know that this has an impact both on people with eating disorders, but also on people without eating disorders who might be susceptible to those.
[00:26:34.920 --> 00:26:37.720] So, this is one of a few significant risks.
[00:26:37.720 --> 00:26:44.680] Firstly, there is a risk of creating a climate which leads people towards disordered eating, which then might develop into an eating disorder.
[00:26:45.000 --> 00:26:55.560] There's a risk of creating a climate which increases the risk of relapse in people who are managing their eating disorder, and there's a risk of exacerbating an eating disorder in people who are currently struggling with their illness.
[00:26:55.560 --> 00:27:01.160] But it's not just people who have, have had, or will have an illness relating to food intake and body weight.
[00:27:01.480 --> 00:27:07.320] We also know that weight stigma has a negative impact on mental health more broadly.
[00:27:07.640 --> 00:27:11.480] We know that weight stigma has an impact on physical health and mortality.
[00:27:11.480 --> 00:27:19.640] One study even suggests that weight-based discrimination might lead to a 60% increase in mortality among specific individuals.
[00:27:19.640 --> 00:27:28.360] And we know that this shift in the public discussion of weight is really potentially going to have a massive negative impact on weight bias and experience of stigma.
[00:27:28.360 --> 00:27:37.400] And I'm seeing and feeling that already: the amount of people who've talked about these things, but even just the people challenging these ideas to some point.
[00:27:37.400 --> 00:28:02.400] And that's why I've taken my time to actually come and talk about this on the show: I don't want to talk about it to debunk it just flippantly because actually sometimes seeing that debunking content is making you think about it more and is exposing you to it more and is making you more potentially susceptible to the idea that well everybody's losing weight and everybody should be losing weight and all of those kind of potentially damaging ideas that just kind of creep into your brain.
[00:28:02.720 --> 00:28:05.600] Yeah, you can't debunk an idea without stating the idea.
[00:28:05.600 --> 00:28:06.080] Yeah.
[00:28:06.160 --> 00:28:08.320] As you found out the hardware, your flat earth videos.
[00:28:08.480 --> 00:28:08.640] Yeah.
[00:28:08.800 --> 00:28:10.160] Fucking yes.
[00:28:10.800 --> 00:28:15.200] Still, you can still go to Flat Earth antarctica and get those fucking videos reported.
[00:28:15.200 --> 00:28:42.800] And while I said earlier that maybe GLP-1 receptor agonists help us understand that perhaps body weight really doesn't have much, if anything, to do with willpower and motivation, which could in theory help reduce some weight bias, I can also see a world where the conversation shifts towards assuming that anyone who is fat but not taking GLP-1 receptor agonists is therefore choosing to do some sort of harm to their body because we've already got those biases so staunchly ingrained.
[00:28:42.800 --> 00:29:54.760] Yeah, that's one of the things that I worry about is the denial of health care to somebody who is especially overweight or indeed especially underweight on the basis of well you did this to yourself so you deserve it and that's fucking bullshit yeah right you see people make that argument towards smokers yeah happily that's not where the medical profession goes they try to encourage you to give up smoking but there's no suggestion that you should be denied health care because you smoke but there is a suggestion you should be denied health care because you're overweight and that's fucking appalling yeah you know and and that's that's in the british context obviously there are contexts where people are denied medication and healthcare because of the fact that they are overweight or smoke or all these other things yeah when you have a for-profit healthcare and this is it is we all you know when when we say that mortality is higher for people in bigger bodies there's lots of reasons for that and there's that we don't fully understand all of the reasons for that we know some of the reasons for that are likely because people who are fat and having medical problems are going to avoid seeing their doctors because they've experienced weight stigma from doctors before and they don't see the point in trying to to have that conversation.
[00:29:54.760 --> 00:30:17.720] But we also know that there are medical professionals who are so biased against people in bigger bodies that they will inadvertently, I think, but still literally deny healthcare to patients because, well, you know, it's just a weight issue, therefore, lose weight, come back once you've lost some weight, and we can have a conversation if you've still got the symptoms sort of thing.
[00:30:17.960 --> 00:30:19.320] I have had that conversation with my doctor.
[00:30:19.640 --> 00:30:22.840] I'm not an enormous bloke by any stretch of the imagination.
[00:30:22.840 --> 00:30:27.960] I am overweight to the technical BMI, yada, yada, yada, BMI bullshit definition.
[00:30:27.960 --> 00:30:37.240] So I'm not enormous by any stretch of the imagination, but I have had that conversation with my doctor when I've gone in with a health complaint and they've said, but could be a weight, lose weight and come back if it's still there.
[00:30:37.240 --> 00:30:37.640] Yeah.
[00:30:37.640 --> 00:30:38.200] Yeah.
[00:30:38.520 --> 00:30:46.920] I'm actually surprised I haven't had that conversation because my body weight is quite a bit higher than you would expect looking at me because I'm just dense.
[00:30:47.400 --> 00:30:53.560] And so whenever a doctor weighs me, I'm expecting to have the conversation about why my body weight is slightly higher than you would expect it to be.
[00:30:53.560 --> 00:30:56.520] And luckily, it's never come up for me yet, but that's because I look thin.
[00:30:56.520 --> 00:30:58.920] So I've got that additional privilege.
[00:30:58.920 --> 00:31:03.960] But I think there are even more reasons for skeptics to be extra interested in this conversation.
[00:31:03.960 --> 00:31:11.000] GRP1 receptor agonists are expensive and their prescription is and should be regulated.
[00:31:11.000 --> 00:31:16.600] We shouldn't be giving these to just anyone, especially not in the context of eating disorders and disordered eating.
[00:31:16.600 --> 00:31:21.000] There should be a cut-off for who can have access to things that suppress their appetite.
[00:31:21.000 --> 00:31:26.120] Of course, we need to be careful to not cause people serious harm.
[00:31:26.440 --> 00:31:31.640] But given the cultural context, there is a high demand for simple and effective weight loss tools.
[00:31:31.640 --> 00:31:40.600] There's always been a high demand for these sorts of tools, which has led to people taking things like diet teas, which include high doses of laxatives and can cause significant harm to the body, for example.
[00:31:40.600 --> 00:31:44.760] But now we know that there are medications that seem to work like magic.
[00:31:44.960 --> 00:31:51.680] Like it used to be that the wellness industry would sell you things and try and pretend that they were like magic weight loss.
[00:31:51.680 --> 00:31:53.360] Yeah, treatment still does, yeah.
[00:31:53.520 --> 00:32:02.320] But any level of thought, critical thinking would say, well, but there is no magical tool for weight loss, and therefore this can't be true.
[00:32:02.560 --> 00:32:11.520] The exploitative ads on websites are going to have to find something else because all that kind of burns belly fat in seconds, those kinds of stuff.
[00:32:11.760 --> 00:32:18.720] We've got something admittedly as expensive, but there is a solution that actually works rather than those bullshit ads selling you complete bullshit.
[00:32:18.960 --> 00:32:20.400] Let me tell you what it is.
[00:32:20.400 --> 00:32:23.040] Now we know that we have a medication that works.
[00:32:23.040 --> 00:32:27.040] You can just take a GLP1 receptor agonist and your appetite reduces and the weight just falls off.
[00:32:27.040 --> 00:32:31.280] So of course we now have companies providing access to GLP1 receptor agonists, right?
[00:32:31.280 --> 00:32:40.560] So there are now direct-to-consumer companies who will set you up with a private doctor and prescribe you the GL1 receptor agonists.
[00:32:40.560 --> 00:33:01.760] But there are also plenty of companies selling things like Sensi Labs Essentials GLP1 Active High Dose, a herbal supplement which claims to stimulate the satiety hormone GLP1 and support your weight loss with no hormones at a price of £30 for a 30-day supply or Tommy Tox's GLP1 balance Hollywood weight loss formula.
[00:33:01.760 --> 00:33:03.440] Oh god, all those words.
[00:33:04.080 --> 00:33:09.040] Another herbal supplement which claims to boost GLP1 and cost £50 for a 30-day supply.
[00:33:09.040 --> 00:33:23.040] And even the product that kind patches, the patch company that we discussed in episode 389, thanks to Seligman for the Skeptic with a K Transcript Search Cool, which have launched the GLP1 patch, which Skeptic Mag sub-editor Marianne shared.
[00:33:23.040 --> 00:33:34.280] Their post read: When all three cutting-season GLP disruptions are addressed, 92% experience less cravings, while 0% experience side effects.
[00:33:34.680 --> 00:33:35.400] No side effects.
[00:33:29.840 --> 00:33:36.040] No side effects.
[00:33:36.360 --> 00:33:37.960] 0% side effects.
[00:33:37.960 --> 00:33:40.840] This is a difficult to translate post from kind patches.
[00:33:40.840 --> 00:33:41.560] Let me repeat that.
[00:33:41.560 --> 00:33:46.520] When all three cutting season GLP disruptions are addressed.
[00:33:46.520 --> 00:33:48.120] Yeah, it's a mouthful.
[00:33:48.120 --> 00:33:53.720] I think they're borrowing the cut phrase from the gym space where you might have a cut phase to lose weight.
[00:33:54.120 --> 00:33:54.760] I see.
[00:33:54.760 --> 00:34:01.320] A maintenance phase and then a bulking phase where you aim to gain muscle, mass and increase the caloric intake to facilitate that.
[00:34:01.320 --> 00:34:15.000] And then I think they're combining it with the concept of summer ready or beach body to imply that this is the time of the year where we have a season in which we all go on caloric deficits in order to cut and then combine it with the Azempic GLP1.
[00:34:15.480 --> 00:34:19.000] I've also just figured out why the podcast maintenance phase is called that.
[00:34:21.960 --> 00:34:26.680] So these sorts of products are now almost ubiquitous in the wellness space.
[00:34:26.680 --> 00:34:40.040] Every company that is selling wellness stuff is now selling GLP1 supplements to stimulate, naturally stimulate your own GLP-1 so that you can lose weight naturally using their supplements.
[00:34:40.040 --> 00:34:40.920] And they're everywhere.
[00:34:40.920 --> 00:34:43.080] They are absolutely everywhere.
[00:34:43.080 --> 00:34:47.400] So yes, that's what's replaced the belly fat burning stuff.
[00:34:47.400 --> 00:34:48.440] That makes sense now.
[00:34:48.760 --> 00:34:58.600] And in most cases, of course, these are herbal supplements which are going to do absolutely nothing for weight loss unless you're talking about making your wallet a bit lighter.
[00:34:58.600 --> 00:35:05.320] Obviously, this is a massive topic, and I've barely scratched the surface, but I think I've talked for quite a while.
[00:35:05.320 --> 00:35:12.440] So, hopefully, I've provided listeners who might be hearing a lot about Azempic a bit of non-sensational context on the discussion.
[00:35:12.440 --> 00:35:19.680] But I'm sure this is a topic we'll come back to again in the future, especially if listeners want us to expand on any relevant parts of the discussion.
[00:35:23.520 --> 00:35:30.160] So, a couple of weeks ago, well, a little bit longer than that, we had Hamilton playing in Liverpool.
[00:35:30.160 --> 00:35:31.280] And I know you went to see it, Alex.
[00:35:32.000 --> 00:35:32.640] It was really good.
[00:35:32.640 --> 00:35:33.360] I really enjoyed it.
[00:35:33.360 --> 00:35:33.680] Did you?
[00:35:34.000 --> 00:35:35.280] Was that your first time seeing it live?
[00:35:35.520 --> 00:35:39.600] My first time seeing it live because so I really like musicals.
[00:35:39.600 --> 00:35:40.000] Yes.
[00:35:40.000 --> 00:35:41.840] And I really like Hamilton.
[00:35:41.840 --> 00:35:44.160] And I saw it when it came out on Disney Plus.
[00:35:44.160 --> 00:35:44.560] Yes.
[00:35:44.560 --> 00:35:52.480] And I've watched it a few times, not quite as many times as Emma has, but I have watched it a few times and listened to the soundtrack a few times.
[00:35:52.480 --> 00:35:55.760] But I have a real aversion to spending money.
[00:35:55.760 --> 00:35:57.120] Yeah, that's reasonable.
[00:35:57.280 --> 00:36:07.440] So, like, going down to London to pay, obviously, it's quite expensive to go and see a musical, to see musical theatre anyway for the tickets, and then the travel to London and the accommodations.
[00:36:08.000 --> 00:36:12.560] London hotel prices and so that had never drawn to me.
[00:36:12.560 --> 00:36:19.360] And then it was showing in Manchester, I think, last year, and I was tempted, but Warren's not that into music.
[00:36:19.360 --> 00:36:21.120] Like, I haven't got people to go to things like this.
[00:36:21.120 --> 00:36:23.600] It's like I'm going to spend all this money to go on my own.
[00:36:23.600 --> 00:36:26.400] Yeah, so you could have definitely got Emma to go with you.
[00:36:27.440 --> 00:36:29.920] Emma's already going a million times with everybody else.
[00:36:30.160 --> 00:36:30.960] She'd go a million away.
[00:36:32.320 --> 00:36:40.880] So when it was playing in Liverpool, I was like, well, this is my opportunity to go because I can go on my own and not have to pay a fortune in travel.
[00:36:40.880 --> 00:36:42.800] And actually, the tickets were really reasonable.
[00:36:42.800 --> 00:36:43.760] They were very reasonable.
[00:36:44.240 --> 00:36:46.880] So I went to see it and it was amazing.
[00:36:46.880 --> 00:36:47.600] It was really good.
[00:36:47.600 --> 00:36:48.400] I really enjoyed it.
[00:36:48.400 --> 00:36:51.360] Bob from the Said Skeptic Society also, he's also on the board.
[00:36:51.360 --> 00:36:52.560] He also went to see it.
[00:36:52.560 --> 00:36:53.200] Hated it.
[00:36:53.200 --> 00:36:53.760] I know he did.
[00:36:53.840 --> 00:36:55.760] Only person who's ever properly hated it.
[00:36:56.400 --> 00:36:57.200] He's got no taste.
[00:36:57.200 --> 00:36:57.760] That's fine.
[00:36:59.040 --> 00:36:59.440] He's alright.
[00:36:59.440 --> 00:37:00.520] He's allowed to have no taste.
[00:37:01.160 --> 00:37:02.920] I'm not going to judge him for it very much.
[00:37:02.920 --> 00:37:04.760] We have balance on the board.
[00:37:05.400 --> 00:37:09.240] But yeah, so I've been to London a couple of times to see Hamilton.
[00:37:09.240 --> 00:37:11.400] I didn't go and see it in Manchester.
[00:37:11.400 --> 00:37:14.520] I considered it, but it's like, it's Manchester, though, isn't it?
[00:37:14.520 --> 00:37:20.360] But when we heard it was coming to Liverpool, I bought tickets to go with Emma as a surprise.
[00:37:20.360 --> 00:37:22.840] And I text Emma and said, I've got a ticket to go to Hamilton.
[00:37:22.840 --> 00:37:25.480] She texts me back saying, yeah, I've got his tickets to go to Hamilton.
[00:37:26.120 --> 00:37:28.600] All right, well, I guess we're going to Hamilton twice then.
[00:37:29.080 --> 00:37:29.720] Fair enough.
[00:37:29.720 --> 00:37:31.000] I guess that's what we're doing.
[00:37:31.000 --> 00:37:32.680] So we went to see it.
[00:37:32.680 --> 00:37:34.120] We went to see it a week apart.
[00:37:34.120 --> 00:37:37.800] And it was what was interesting to me, because obviously I've seen it live before.
[00:37:37.800 --> 00:37:39.320] I really enjoyed it.
[00:37:39.320 --> 00:37:42.760] Seeing the differences between the two performances was really interesting.
[00:37:43.000 --> 00:37:51.560] So the first night that we went, I don't know how it compared for your performance you saw, Alice, but the King got a huge round of applause when he first appeared on stage.
[00:37:51.720 --> 00:37:53.560] Do you know what it was?
[00:37:53.720 --> 00:37:56.840] Annoyed me how much the audience loved the King.
[00:37:56.840 --> 00:37:57.800] In Liverpool.
[00:37:58.120 --> 00:38:00.040] Because, like, boo him, you're in Liverpool.
[00:38:00.280 --> 00:38:01.560] He's a well-written character.
[00:38:02.040 --> 00:38:03.560] It was well performed.
[00:38:03.560 --> 00:38:04.760] Great comedy.
[00:38:04.760 --> 00:38:05.160] Yes.
[00:38:05.240 --> 00:38:05.880] Lovely.
[00:38:05.880 --> 00:38:12.040] But also, like, it's a bit part that he's just a comedic relief.
[00:38:12.040 --> 00:38:12.360] Yeah.
[00:38:12.360 --> 00:38:15.160] Like, I don't understand why people love him so much.
[00:38:15.720 --> 00:38:20.600] I think it's largely actually because of Jonathan Groff's performance as the king, is what.
[00:38:20.920 --> 00:38:22.040] Because they've not seen.
[00:38:22.280 --> 00:38:23.320] I say they've not.
[00:38:23.320 --> 00:38:25.480] I had several times at this point.
[00:38:25.480 --> 00:38:31.000] But most people in the audience hadn't seen that portrayal of the king before, but they will have seen the Disney Plus version.
[00:38:31.000 --> 00:38:38.200] But I think he did a good job, like, and made it his own a little bit while still having all the nods to the other performance.
[00:38:38.160 --> 00:38:42.600] So, the other person who got a massive cheer when they came out on stage was Thomas Jefferson.
[00:38:42.600 --> 00:38:45.120] I don't know if you saw that in your performance.
[00:38:45.600 --> 00:38:46.960] But Thomas Jefferson got a massive.
[00:38:47.600 --> 00:38:49.120] I don't think that happened when I went.
[00:38:44.920 --> 00:38:52.000] Whooping cheer, which was really bizarre.
[00:38:54.160 --> 00:38:58.800] Yeah, do we only cheer the villains in this performance?
[00:38:58.800 --> 00:38:59.760] What's going on here?
[00:39:00.080 --> 00:39:06.480] No one whooped and cheered when Hamilton fucking came on stage for the first time, but only when the bad guys turned up for the first time.
[00:39:06.480 --> 00:39:12.080] But watching between the two performances, the second performance, the King, fucking silence.
[00:39:12.400 --> 00:39:14.800] No reaction to the King the second time I saw it.
[00:39:14.800 --> 00:39:15.360] Wow.
[00:39:15.360 --> 00:39:17.600] But still, big whooping cheers for Jefferson.
[00:39:17.600 --> 00:39:23.520] But also, the guy who was playing Jefferson was really egging the crowd on, going, come on, give me a.
[00:39:23.680 --> 00:39:25.680] No, no, no, no, that's enough, that's enough.
[00:39:25.680 --> 00:39:31.520] No, come on, give me another one, give me another one, and really working the crowd to really get the crowd.
[00:39:31.920 --> 00:39:38.240] To be fair, there was a little bit of that in the debating scenes that worked quite well.
[00:39:38.240 --> 00:39:43.520] And yeah, so there probably was a little bit of cheering for Jefferson, partly because of that egging on.
[00:39:43.840 --> 00:39:48.080] But it wasn't like, it wasn't noteworthy to the point that I was like, that's a bit weird.
[00:39:48.080 --> 00:39:51.520] But also, the cast was massively different between the two performances.
[00:39:51.520 --> 00:39:55.440] It was the same King, it was the same Hamilton, but like it was a totally different George Washington.
[00:39:55.440 --> 00:39:57.280] It was a different Eliza.
[00:39:57.280 --> 00:40:01.280] It was, and I was surprised that the cast was changing.
[00:40:01.280 --> 00:40:04.800] I don't think we saw it because we went to see it more times than I've mentioned.
[00:40:05.120 --> 00:40:10.960] Did you just manage to see them on their break day and see all the understudies then?
[00:40:10.960 --> 00:40:17.920] Because they did, like, there's a listing for who's in which role, and there's only one name for all of the roles.
[00:40:17.960 --> 00:40:20.800] Yeah, but if it's running every day for two weeks, then they must have.
[00:40:20.880 --> 00:40:22.080] I thought they might just have a day off.
[00:40:22.640 --> 00:40:23.760] A day off, yeah, exactly.
[00:40:23.760 --> 00:40:29.880] So maybe the understudies just do one performance, a couple of performances a week or something.
[00:40:29.440 --> 00:40:35.640] Well, we ended up, so I say, I got tickets and Emma and I went, and then Emma got tickets and Emma and I went.
[00:40:35.960 --> 00:40:39.720] And then Emma's sister Karen said, I'd like to see Hamilton, and I'll see Hamilton live.
[00:40:39.720 --> 00:40:42.440] So it's like, all right, well, we'll go a third time.
[00:40:42.440 --> 00:40:45.000] So we went and we went with Karen as well.
[00:40:45.000 --> 00:40:48.120] Because Karen is a mum, she can't be staying out late.
[00:40:48.120 --> 00:40:51.960] So we went to the matinee performance of a Saturday afternoon, which makes sense, right?
[00:40:51.960 --> 00:40:53.160] So we went out to that.
[00:40:53.160 --> 00:40:54.360] Different cast again.
[00:40:55.720 --> 00:40:59.800] A third different person for some of the big names, or just a different mix and match.
[00:40:59.800 --> 00:41:00.200] Oh, okay.
[00:41:01.960 --> 00:41:03.800] Yeah, so a third set.
[00:41:03.800 --> 00:41:09.480] And it was really, you know, we were coming out going, well, Eliza wasn't as good this time as she was last time.
[00:41:10.280 --> 00:41:11.400] It was terrible.
[00:41:11.400 --> 00:41:18.760] There was one time the guy who kind of understudied George Washington was just in the chorus for the rest of his channel.
[00:41:18.920 --> 00:41:19.720] So he wash.
[00:41:19.800 --> 00:41:23.480] He was George Washington for one performance and then was in the chorus the rest of the time.
[00:41:23.720 --> 00:41:25.000] One minute you're watching him the next.
[00:41:25.320 --> 00:41:26.760] You can make use of your understudies.
[00:41:26.760 --> 00:41:30.920] You can't just have them sitting and watching for the whole two weeks or whatever.
[00:41:31.080 --> 00:41:33.480] That means he's an understudy for his chorus part.
[00:41:34.120 --> 00:41:38.280] No, it means he's an understudy for the main part and then is in the chorus when he's not.
[00:41:38.600 --> 00:41:41.080] That means he has an understudy for his chorus part.
[00:41:41.240 --> 00:41:44.040] Well, I bet all the chorus just like chop and change anyway.
[00:41:44.040 --> 00:41:46.360] There's a lot of chopping and changing in the chorus.
[00:41:46.360 --> 00:41:52.760] But we came out of watching it on the Saturday afternoon and we thought that was, you know, it was a great performance and really enjoyed it.
[00:41:52.760 --> 00:41:56.840] We saw Karen off to the bus and Emma and I went off to get something to eat.
[00:41:56.840 --> 00:42:01.160] And just as we're sitting there eating, it was like, should we go again?
[00:42:01.640 --> 00:42:05.320] So we went back and watched it again that evening.
[00:42:05.560 --> 00:42:06.120] Ridiculous.
[00:42:06.120 --> 00:42:09.160] For a fourth time, having seen it twice in a day.
[00:42:09.160 --> 00:42:11.160] I'm not convinced it was the same cast.
[00:42:11.480 --> 00:42:12.960] Emma thinks it was the same cast.
[00:42:12.960 --> 00:42:16.880] The final when we went to see it twice in one day, Emma thinks it was the same cast.
[00:42:16.880 --> 00:42:18.640] I'm not persuaded it was the same cast.
[00:42:14.920 --> 00:42:21.040] I think there were some different people in there.
[00:42:21.280 --> 00:42:22.880] You are ridiculous, human beings.
[00:42:23.200 --> 00:42:27.920] I turned down the chance to go and see one of my favourite brands in the world, Bright Eyes.
[00:42:28.320 --> 00:42:29.280] We went to see them.
[00:42:29.280 --> 00:42:30.000] We booked for tickets.
[00:42:30.000 --> 00:42:35.520] Alice and I booked tickets to go and see two years ago and they were delayed and then it was postponed for a year.
[00:42:35.520 --> 00:42:37.520] And it was in Wolverhampton because they were only doing Wolverhampton.
[00:42:38.240 --> 00:42:39.600] That time they were only doing Wolverhampton.
[00:42:39.680 --> 00:42:45.840] And then after you bought the tickets, they announced other shows around the UK, including one in Manchester and Leeds and very including one in Nottingham.
[00:42:45.840 --> 00:42:51.680] And that night, there were so many gigs on because I went to see Tim Minchin in Nottingham on the 16th of June.
[00:42:51.680 --> 00:42:56.320] Yeah, I went to see the AES, which I had to turn down because I had tickets to see Tim Minchin.
[00:42:56.640 --> 00:43:01.600] And then we couldn't go and see Bright Eyes in Nottingham on the 16th of June because we were both on the gigs.
[00:43:01.600 --> 00:43:03.520] And I looked at, I could have gone to see them in Leeds.
[00:43:03.600 --> 00:43:04.560] We went to the Manchester.
[00:43:04.560 --> 00:43:05.680] Sorry, went to the one in Wolverad.
[00:43:05.760 --> 00:43:07.200] We already had tickets to the one in Wolverhampton.
[00:43:07.360 --> 00:43:08.480] I could have gone to see them in Leeds.
[00:43:08.480 --> 00:43:09.520] And I thought, oh, it's a bit ridiculous.
[00:43:09.600 --> 00:43:14.080] Drive all the way to Leeds to see a band that I'm going to see the week after in Wolverhampton.
[00:43:14.080 --> 00:43:20.720] And then I saw they were playing in Manchester, and I got an email saying there's two free tickets if you want to answer a question.
[00:43:20.720 --> 00:43:21.840] And I knew the answer to the question.
[00:43:21.840 --> 00:43:24.480] So I emailed her, like, immediately, here's the answer to the question.
[00:43:24.480 --> 00:43:27.200] The email back said, congratulations, you've won the two tickets.
[00:43:27.200 --> 00:43:32.400] And then I remembered the reason we weren't going to Manchester because it was the same night we were in Manchester seeing Pulp.
[00:43:33.360 --> 00:43:35.440] So I was already at a gig in Manchester that night.
[00:43:35.440 --> 00:43:36.320] I was like, great.
[00:43:36.320 --> 00:43:38.160] Thanks for the two free tickets.
[00:43:38.160 --> 00:43:38.960] No, thank you.
[00:43:38.960 --> 00:43:40.160] I can't, I can't come.
[00:43:40.160 --> 00:43:41.200] You give them to someone else.
[00:43:41.200 --> 00:43:42.800] So, yeah, ridiculous.
[00:43:42.800 --> 00:43:46.880] So it's just a ridiculous, like, two days, five gigs.
[00:43:46.880 --> 00:43:47.280] Yeah.
[00:43:48.240 --> 00:43:50.240] We kind of wanted to be at all of them.
[00:43:50.240 --> 00:43:51.920] I mean, you didn't want to go and see Tim Minchin.
[00:43:52.000 --> 00:43:53.280] I didn't want to go and see Tim Minshin.
[00:43:53.280 --> 00:43:53.520] No.
[00:43:53.520 --> 00:43:55.440] Well, you can smell his feet, can't you?
[00:43:58.560 --> 00:43:59.280] We'll leave it there.
[00:43:59.480 --> 00:44:00.040] We'll leave it there.
[00:44:00.040 --> 00:44:00.520] It's fine.
[00:43:59.920 --> 00:44:03.160] The 2010s were a long time ago.
[00:44:08.840 --> 00:44:14.360] So, Mercy Side Skeptic Society have our annual summer picnic coming up.
[00:44:14.360 --> 00:44:20.360] That's going to be this Sunday, which is the 13th of July, in Sefton Park from 2 p.m.
[00:44:20.600 --> 00:44:22.760] And if you're in the Liverpool area, you should definitely come along to that.
[00:44:22.760 --> 00:44:23.720] It's going to be a fantastic time.
[00:44:24.680 --> 00:44:31.880] It's our family-friendly event, so you can bring any kiddies, pets, as long as they're not going to bite or attack anybody.
[00:44:31.880 --> 00:44:33.640] That's why I don't bring Micah.
[00:44:35.720 --> 00:44:37.800] And she doesn't bite, really.
[00:44:37.800 --> 00:44:41.240] She definitely doesn't attack kids, but she's not predictable to bring people.
[00:44:41.320 --> 00:44:42.200] She would attack adults.
[00:44:43.000 --> 00:44:43.800] No, she does.
[00:44:43.800 --> 00:44:47.160] She wouldn't, especially not adults that she knows that are my.
[00:44:48.120 --> 00:44:55.480] She does do a little bit of redirection if somebody's walking directly at her who is a complete stranger, but that's the extent of it.
[00:44:56.440 --> 00:44:59.320] I mean, I do muzzle her if I'm going to be in close contact with people just in case.
[00:44:59.480 --> 00:45:00.520] You're a very responsible dog.
[00:45:01.160 --> 00:45:01.880] But she's not going to be there.
[00:45:02.200 --> 00:45:04.280] She's not going to be there because she can't be trusted.
[00:45:04.600 --> 00:45:10.840] Because although she won't be any danger to the people there, she will just bark incessantly, constantly.
[00:45:10.840 --> 00:45:14.600] And if there are any other dogs there, she might well get a bit aggro at them.
[00:45:14.920 --> 00:45:18.600] And Lupin can't be there because he can't be trusted because he tries and steal everything.
[00:45:18.920 --> 00:45:22.040] Try and eat all the food, try and escape.
[00:45:22.040 --> 00:45:22.760] Try and lick everybody.
[00:45:23.000 --> 00:45:24.520] Try and lick everybody.
[00:45:24.520 --> 00:45:27.320] Just generally need me to keep hold of him the whole time.
[00:45:27.320 --> 00:45:30.440] And he is really strong and it is really exhausting.
[00:45:30.440 --> 00:45:35.160] So he also can't trust us because he just can't chill.
[00:45:35.160 --> 00:45:35.880] He can't chill.
[00:45:35.880 --> 00:45:42.600] But it will be a fun day, assuming the weather is fine, which we can't predict because we're recording this two weeks in advance.
[00:45:42.600 --> 00:45:45.000] Yeah, I'm sure it'll be fine, though, given the way the weather has been.
[00:45:45.200 --> 00:45:46.400] We'll get the chemtrails out.
[00:45:46.560 --> 00:45:47.200] It's all fantastic.
[00:45:48.240 --> 00:45:49.440] Yeah, so we will be catering that.
[00:45:49.440 --> 00:45:53.120] So there will be free food available if you would like to come along, you know, which you're more than welcome to.
[00:45:53.120 --> 00:45:55.040] There will also be soft drinks available.
[00:45:55.520 --> 00:46:02.800] And if you would like alcoholic drinks, you're welcome to bring your own to the extent that you're allowed to consume such things in a public space.
[00:46:02.800 --> 00:46:05.360] Yeah, you'll be able to spot us because we'll have our flag up.
[00:46:05.360 --> 00:46:09.360] We've got a Mercy Sound Skeptics flag that's got our logo on, which you'll be able to spot.
[00:46:09.360 --> 00:46:13.040] But we're going to be heading towards the north end of the palmhouse.
[00:46:13.520 --> 00:46:14.320] Off the road by the palmhouse.
[00:46:14.400 --> 00:46:15.600] We're usually near the palmhouse.
[00:46:15.600 --> 00:46:18.800] Yeah, I always think of it as the north end of the park by the palmhouse.
[00:46:18.800 --> 00:46:19.600] I don't know that it is.
[00:46:19.600 --> 00:46:20.880] I don't know the Lark Lane end.
[00:46:20.880 --> 00:46:21.360] It's the south.
[00:46:21.520 --> 00:46:21.760] No.
[00:46:21.760 --> 00:46:24.960] I've never actually got a fucking compass out, but it's the bit by the palm house.
[00:46:25.840 --> 00:46:27.200] On the big field near the palmhouse.
[00:46:27.280 --> 00:46:28.640] Yeah, by the road by the palmhouse.
[00:46:28.640 --> 00:46:32.320] People who are going, check up our meetup, you'll see details of where to find us there.
[00:46:32.320 --> 00:46:33.840] We'll drop it in there when it comes to it.
[00:46:33.840 --> 00:46:37.280] Yeah, so that's going to be from two o'clock, and you should definitely come along to that.
[00:46:37.280 --> 00:46:38.480] It's going to be a brilliant time.
[00:46:38.480 --> 00:46:39.040] I'm going to be there.
[00:46:39.040 --> 00:46:39.760] You're going to be there.
[00:46:39.840 --> 00:46:40.400] I'll probably be there.
[00:46:40.720 --> 00:46:40.880] Yeah.
[00:46:41.040 --> 00:46:42.160] Going to be a cracking time.
[00:46:42.160 --> 00:46:42.560] It will.
[00:46:42.560 --> 00:46:49.120] I'll also mention that obviously I've mentioned a couple of times on the show over the last couple of months that I do another show with Cecil Cicarello from Cognitive Distance.
[00:46:49.120 --> 00:46:50.880] I do the No Rogan experience.
[00:46:50.880 --> 00:46:53.520] We finished our first series a couple of weeks ago.
[00:46:53.520 --> 00:46:55.120] We're in a mid-series break.
[00:46:55.120 --> 00:46:59.280] I think we did like 27 episodes and then some bonus episodes and things.
[00:46:59.280 --> 00:47:21.520] So if people haven't checked that out, if you want to know what is happening on the largest podcast platform in the world, which is the Joe Rogan experience, but you don't want to listen to Joe Rogan, you want to listen to essentially Cecil and I explaining what is happening and pointing out where he's wrong and bringing the context and the evidence and putting together a larger picture, by all means, check out norogan.com.
[00:47:21.520 --> 00:47:23.760] I'm really happy with how we've done the first series.
[00:47:23.760 --> 00:47:31.160] I think we've done some interesting stuff being able to put together the pieces of what's going to have been happening in America when it was recorded.
[00:47:31.240 --> 00:47:40.280] You can hear like this times that he's interviewing someone who is going to go on to become quite important in the Trump administration, and you can hear what they have planned.
[00:47:40.280 --> 00:47:42.760] And it's all right there on Joe Rogan's shore.
[00:47:42.760 --> 00:47:46.440] And the reason none of us knew it was happening is because none of us listened to Joe Rogan.
[00:47:46.440 --> 00:47:50.200] And so we went ahead and did that in order to do the skeptical service on it.
[00:47:50.200 --> 00:47:52.840] So yeah, if you want to check it out, go to noorogan.com.
[00:47:52.840 --> 00:47:55.960] And we should also give a quick plug for our Patreon as well.
[00:47:56.280 --> 00:48:05.480] So if you like the show, if you enjoy what we do, you can support the show by going to patreon.com forward slash skeptics with a K, where you can donate as little as a pound a month.
[00:48:05.480 --> 00:48:06.680] That helps support the show.
[00:48:06.680 --> 00:48:09.480] It helps us keep things going, helps us keep things running.
[00:48:09.480 --> 00:48:12.840] And in exchange for that, you also get an ad-free version of the show.
[00:48:12.840 --> 00:48:15.000] So no ads, nice and clean.
[00:48:15.000 --> 00:48:17.000] It just gets straight into it.
[00:48:17.000 --> 00:48:19.640] And you'll be able to get that from Patreon.
[00:48:19.640 --> 00:48:20.120] Yes.
[00:48:20.120 --> 00:48:27.560] We don't have any bonus material there, but what your money does do is say to us that you appreciate the work that Mike and I and Alice do on the show.
[00:48:27.560 --> 00:48:28.200] Yeah.
[00:48:28.200 --> 00:48:36.280] You can also support the Mercy Skeptic Society by going to their Patreon, which is patreon.com forward slash Merseyskeptics, which does things like catering the picnic.
[00:48:36.280 --> 00:48:42.280] In fact, it's exactly what that kind of money goes for: for supporting the Mersey Science Skeptics, support the work that we're doing.
[00:48:42.280 --> 00:48:44.040] It also supports this show.
[00:48:44.040 --> 00:48:47.800] And you also get an ad-free version of the show from that venue as well.
[00:48:47.800 --> 00:48:53.560] But if you're not feeling like you financially are in a position where you want to contribute to a podcast, and that's totally fine.
[00:48:53.960 --> 00:48:56.920] No one's saying you're a bad person because you can't pay for a podcast.
[00:48:56.920 --> 00:48:57.480] What you can do.
[00:48:57.800 --> 00:49:00.600] Alice was saying that off air, but she hasn't said it on air.
[00:49:00.840 --> 00:49:03.800] The abuse that Alice gives to our listeners who don't go on Patreon.
[00:49:04.440 --> 00:49:06.240] It's fucking astonishing, to be honest.
[00:49:06.200 --> 00:49:07.040] Morgan gets to hear it.
[00:49:09.000 --> 00:49:11.320] It is only our editor Morgan who gets to hear this.
[00:49:11.800 --> 00:49:13.880] But yeah, and she always does it on a hot mic.
[00:49:13.880 --> 00:49:15.200] Never, never in the drivers.
[00:49:14.840 --> 00:49:16.720] Always on a hot mic.
[00:49:17.040 --> 00:49:26.160] But if you're the sort of person Alice despises, what you can do to help us if you're not willing to pay or not able to pay, which is a totally reasonable thing to do, is you can leave a review.
[00:49:26.160 --> 00:49:26.480] Yeah.
[00:49:26.480 --> 00:49:30.160] Leave a review on whatever podcasting platform is of your choice.
[00:49:30.160 --> 00:49:32.960] Tell a friend, you know, try and get the show out there.
[00:49:32.960 --> 00:49:35.440] Try and help us spread skepticism.
[00:49:35.440 --> 00:49:38.080] And that's going to, hopefully we'll win.
[00:49:38.080 --> 00:49:38.800] We're going to win this.
[00:49:38.880 --> 00:49:39.360] We're going to win.
[00:49:39.360 --> 00:49:39.920] It's fine.
[00:49:39.920 --> 00:49:40.560] It's going to be good.
[00:49:40.560 --> 00:49:41.280] It's going to be fine.
[00:49:41.280 --> 00:49:41.760] Trust us.
[00:49:41.760 --> 00:49:42.560] We've got this.
[00:49:42.560 --> 00:49:43.520] We've got this.
[00:49:43.520 --> 00:49:46.080] You just need to leave us reviews.
[00:49:46.400 --> 00:49:48.800] Aside from that, then, I think that's all we have time for.
[00:49:48.800 --> 00:49:49.360] I think it is.
[00:49:49.360 --> 00:49:52.000] All that remains then is for me to thank Marsh for coming along today.
[00:49:52.000 --> 00:49:52.480] Cheers.
[00:49:52.480 --> 00:49:53.520] Thank you to Alice.
[00:49:53.520 --> 00:49:53.920] Thank you.
[00:49:54.160 --> 00:49:56.160] Alice, I'm going to have to cut that out.
[00:49:56.160 --> 00:49:58.320] You can't say that on a hot mic.
[00:49:58.400 --> 00:50:00.480] It's a fucking disgrace.
[00:50:00.480 --> 00:50:03.280] We'll beat Skeptics with a K, and we will see you next time.
[00:50:03.280 --> 00:50:03.920] Bye now.
[00:50:03.920 --> 00:50:04.880] Bye.
[00:50:09.680 --> 00:50:14.800] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society.
[00:50:14.800 --> 00:50:24.160] For questions or comments, email podcast at skepticswithakay.org and you can find out more about Merseyside Skeptics at merseyside skeptics.org.uk.