but just to help people maybe appreciate it uh the most you started this segment out by mentioning how we've seen these weight loss drugs rise and fall what's so interesting about the gp1 agonists is that the fall appears to be patient induced even within the UK the statistics find that after 24 months of use of glp1 agonists over 65% of people have got have chosen to stop taking it they get so tired of feeling sick yeah what we say is the food noise is quieted down I don't crave as much that's a nice way of saying I constantly feel like I'm going to vomit yeah and they'll have what they call OIC burps it's kind of a joke where you have food sitting in your stomach for so long that it starts to fester and creating these noxious fumes that are bubbling up your esophagus now your breath is horrific you're burping all of these gases up and the person just says I don't want to take this anymore I'd rather be a little chubby or fat than feel like this all the time not to the reports the document how they find that everything just turns gray not that they're depressed it's almost as if life becomes very flat that's what I mean to convey what used to drive them what they used to find be very passionate about they're not anymore so there are these reports of people who they like to go on Hikes now they don't really care about hiking anymore they're taking everything they really cared a lot about including eating yeah so that one addiction somewhat addressed one passion addressed which is a passion for eating food and they're sort of driving everything down to this flat level where they just don't they're apathetic rather than maybe being depressed I don't want I want you try to be precise with my wording apathy is probably the more apt word here that they just don't care as much about the things they Ed to care about as body weight changes so too does metabolic rate that's a known phenomenon usually a person loses weight metabolic rate comes down they start to gain it metabolic rate will come back up mind you it it lags a little which is why so is so easy to gain the weight back however the NIH in the US published a paper finding that in people who experience dramatic weight loss through eat less exercise more specifically it was based on a set of people who had participated in that game show The Biggest Loser which I think you guys have seen here in the UK or you may have your own version just I've never seen the reunion party yet exactly and you never will because they gain it all back but what they found in that study was that as they gain the weight back metabolic doesn't follow they've uncoupled these two it it is like they broke it I hate to use such an imprecise word but it's like they have broken that metabolic response and and interestingly a study just published a very big metaanalysis from a high kind of biological computational lab looked at every available study that was ever published that looked at low carb or high carb diets that had lost weight and then looked at what happened to the metabolic rate and they found that on the low low fat high carb version calorie matched always low calorie which again I'm not totally in favor of let calories take care of themselves they found that that was a group whose metabolic weight went down the most with their weight loss so low carb versus low fat they both lost weight y this group had a substantial reduction in their metabolic rate this group didn't y their metabolic rate stayed the same it was not a statistically significant drop that is profound yeah don't tell me so that's part of my frustration with these studies that last for two weeks yeah and it's calorie controlled every meal's coming out of the lab yeah what happens the next two weeks then what about the next two weeks or the next two months or the next two years yeah don't tell don't try to fool me with this kind of word smithing and and confusing of the data if your metabolic rate even with the weight loss has stayed as high as it was before you've you've broken the system but in a highly advant advantageous way yeah you've uncoupled the metabolic rate from body weight but now in your favor rather than against you like what's happening in the other group one of those groups is going to gain their weight back very quickly in part because they fail because they're facing hunger the other group who's learning to rely on their own fat for fuel will not be left facing hunger they find that they can go times without eating and indeed the food noise is a little quieter because the brain is sensing I got all the energy I need because of this low insulin State glucose levels are are normal free fatty acids are higher because of the fat burning ketones are high I got all the energy I need