Jim Hill:

Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:

And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

Jim Hill:

Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:

Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

Jim Hill:

Ready for the “And” factor?

Holly Wyatt:

Let's dive in.

Jim Hill:

Here we go. This one's going to be fun, I think, Holly.

Holly Wyatt:

Okay.

Jim Hill:

In the news, we're hearing a lot about making America healthy again. So the likely nominee for the U.S. Secretary of Health and Human services, Robert F. Kennedy Jr. has made this a major goal to make America healthy again.

Holly Wyatt:

Well, what does he say? I think it's make America great again, right?

Jim Hill:

No, that's Trump. Kennedy is make America healthy again.

Holly Wyatt:

All right. I'm sorry. Don't follow this very well.

Jim Hill:

No, that's okay. But one of the things to be clear, we're not going into politics.

Holly Wyatt:

Oh, good.

Jim Hill:

You and I may have lots of opinions, but we're not going to force those on our listeners. This isn't about politics. It isn't about RFK Jr. It's the fact that people are talking about making America healthy again. So what you and I are going to talk about today is what would that take? Is it even remotely possible that we could make America healthy again?

Holly Wyatt:

Yeah, I like this topic because we know that America isn't healthy. America is not healthy right now.

Jim Hill:

It's not?

Holly Wyatt:

No, it's not, Jim. Over 75% of U.S. adults are overweight or obese. So that means 25% are at a healthy body weight, right?

Jim Hill:

Some of those are probably below. Some of those are probably an unhealthy low weight.

Holly Wyatt:

Exactly. 60% of Americans have at least one chronic disease. And 40% have two or more.

Jim Hill:

So that's like diabetes and heart disease and kidney disease and cancer?

Holly Wyatt:

Yes, exactly. 20% of deaths are from heart disease.

Jim Hill:

That's still a big one, isn't it? People die of heart disease.

Holly Wyatt:

Yes. And over 10% of adults have type 2 diabetes. And almost 40% have what we call prediabetes, which means they're on that warning track. And we know that a lot of people with prediabetes go on and develop diabetes.

Jim Hill:

So 40 and 10, 50, half the population really is not managing insulin and glucose in a healthy way.

Holly Wyatt:

Yeah. And we have so much data that when you're not in a healthy range for your blood glucose, it does all kinds of things to your body to make it unhealthy, right? It affects your kidneys, your eyes, I mean, just almost every, every single organ system. So diabetes is a big one in terms of our health. 35% of our children are overweight or obese.

Jim Hill:

And one of the things we know is that most of them don't grow out of it. They go on to be obese adults and they're joined by a whole bunch of other people that gain weight after childhood and become obese.

Holly Wyatt:

Right. And it may even be harder. I mean, we can talk about that. But having obesity for a long period of time in your childhood may make the situation even worse.

Jim Hill:

We need an episode on childhood obesity. That's one that we've been talking about. We need to go into depth on that one.

Holly Wyatt:

Yeah. And I think even more depressing than all those numbers, and I don't like to focus on the depressing number, but we're moving in the wrong direction. I wish I could say it's going in the positive direction, but the facts are it looks to be getting worse, not getting better.

Jim Hill:

Okay. Well, you've totally depressed us, Holly.

Holly Wyatt:

I know. I'm sorry.

Jim Hill:

But these chronic diseases like obesity, diabetes, and heart disease, and even cancer are often called lifestyle diseases because their development usually stems from lifestyle behaviors. Now, clearly there's a genetic component, but we think the reason that these are increasing over time, it's not due to genetics, it's due to basically our lifestyle.

Holly Wyatt:

It's lifestyle combined with those genetics, right? Our genes have stayed the same. The lifestyle's changed and made the genes come out, right? Show what they can do. Yeah.

Jim Hill:

So if we look at how Americans are behaving, we have dietary guidelines for Americans. We have physical activity guidelines. Very few Americans meet either. For example, only 10% of adults get the recommended amounts of vegetables, and only about 20% meet the physical activity guidelines. And these are not vigorous guidelines. These are pretty reasonable, and the vast majority of people aren't even meeting these guidelines. So with our eating and exercising patterns, it may not be too surprising that more and more of us are overweight and developing these chronic diseases.

Holly Wyatt:

All right. You are depressing too, Jim. You can't just point the finger at me, but let's ask the big question now. What can we do to turn this around? What can we do to truly improve the health of Americans?

Jim Hill:

So how do we make America healthy again, Holly?

Holly Wyatt:

There we are back on the subject. I love it.

Jim Hill:

All right. Let's dive in. And again, just to clue you in, we don't have the answers. We're asking a lot of questions. But we really want to look and say, not the quick fix. What would this really take? And I see this in the news. I've been following this because I'm very interested. I love the idea of make America healthy again, but it may be a little bit more complex than a lot of people believe. I hear a lot about focusing on food. Now, I don't have a problem in focusing on food, but we've said over and over again, diet without some other things probably isn't enough. So the two things that I'm hearing, and again, this is hearsay looking, my reading of the news, so you may disagree, but reduced consumption of processed foods and getting chemicals out of foods. Now, those are reasonable strategies, but diving deeper into those.

Holly Wyatt:

And that's what I'm hearing too. We like to point fingers. We like to come up with simple solutions or a solution that solves the problem. But I think just like we talk about this when it comes to weight management, I think it's a fallacy that there's going to be one thing or even two things that we can do that are going to fix the problem. And I think that's where we've failed in the past is actually doing that, going in that direction. Our unhealthiness, is it due to poor diets or is it more complicated? There's a lot of data out there that diets can improve chronic diseases. There's diets like the Mediterranean and the DASH diet. But we also know that it's more than that, right? People with different body weights need different diets and have different chronic diseases and we know that there's not just one solution. Diets do help and diets that focus on whole foods or fewer processed foods, but those diets do more than that, right? So just saying it's about the processed food is I think a problem.

Jim Hill:

I remember we had a podcast with Rick Mattes about processed foods and he talked about, it's not simple. There are all kinds of processed foods and you wouldn't want to get rid of all processed foods. There are good processed foods and bad processed foods. And I remember one of Rick's conclusion was focusing on processing foods. Is that going to be any different than what we've done by focusing on reducing foods high in fat, sugar, and salt?

Holly Wyatt:

Right. A single solution.

Jim Hill:

And so even if you said processed foods are a problem, well, they're such a big part of our diet. What do you do with them? And I'm not saying don't take it on, but I'm thinking that's a little bit more complex. And then we need to figure out how to really do that. Now, taking chemicals out of food, again, I'm not opposed to that. The FDA looks at different chemical additives and everything, and there's a whole science range of that. And so I think it's totally fair to look at things for which there isn't science or the science isn't clear and bring some science into it. And this is the theme, Holly, is it's easy to say, let's go and do this and this and this. But if we really are going to be successful, shouldn't we make it science-based? We have so much nutrition information. So as we're looking at changing diet, let's look at, and I grant you, we don't have all the data, we need much more research. But we have a great deal of research and let's make sure as we're developing these strategies to make America healthy again, where possible, we use science-based strategies.

Holly Wyatt:

And I think we also have to be careful about how we interpret the data we have. So like I just said, we do have good data that the Mediterranean diet can improve chronic disease, right? It can cause weight loss. But then people go in and take that, say, oh, okay, the Mediterranean diet has a lot of whole food. It has a lot of less processed food. That is why it works. When in reality, when you look at the Mediterranean diet, it promotes fruits and vegetables, whole grains, healthy fats. It limits sweets. It's not just about whole foods or removing chemicals.

Jim Hill:

So I want to come back to the Mediterranean diet, but I want to make one point here before we lose the behavioral stuff. People always mention increasing physical activity, but it's often an aside of something. Let's get processed foods out of the diet. Let's get chemicals out of the diet. And oh yeah, we want to increase physical activity. It bothers me that oftentimes we give far less attention to the value of increasing movement than to changing diet.

Holly Wyatt:

Now, Jim, I'm going to push back for just a little bit. We do have physical activity guidelines. I would say that Americans are somewhat aware of them. I'm not saying we're hitting them, but we do have physical activity guidelines.

Jim Hill:

I agree, Holly. We're out there talking about all these regulatory things and so forth on the food intake side and on the exercise side. We're saying just get people to go out and exercise more. I think we're not giving it the kind of real attention we need. And again, I'm not complaining on the food side. America eats terribly. There's so much we can do to increase healthy eating, but without also increasing physical activity, healthy eating alone isn't going to do it. And now back to the Mediterranean diet. A lot of evidence showing, boy, the Mediterranean diet can improve health. It can improve health in people of all weights, even people with obesity. It produces a little bit of weight loss, but the Mediterranean diet, while it can improve health, probably isn't going to do as much as we need to do about weight loss. And you and I have talked about this before. You can maintain your weight with healthy eating and activity, but to lose weight, you're going to have to do food restriction. So even if we put everybody on a Mediterranean diet, those 65% of people that are overweight or obese may lose a little weight, but you still have the negative effects of obesity countering the positive effects of the diet. Does that make sense?

Holly Wyatt:

Yeah, no. So whenever I have someone who likes the Mediterranean diet, that's the way they want to eat. If they want to lose weight, they've got to restrict their calories. It's got to be a calorie-restricted Mediterranean diet. You got to figure out a way where you can control calories because we say over and over again, to have a negative energy balance, to burn fat, to lose weight, there's some way you're keeping the calories low and forcing your body into fat burning.

Jim Hill:

So again, I think what we can conclude is there is really solid research about the benefits of diets like the Mediterranean diet and the DASH diet. These diets can greatly improve health. They alone aren't going to solve obesity. They may be a part of that, but we're still going to need some way to get the weight off. And we're going to come back to this, Holly, because there might be such ways. But on the other side, there's so much good evidence from research studies showing that increasing physical activity can reduce the risk of chronic disease. Just like diet can do it, physical activity can do it, and it can do it in people with all different body weights. A couple of studies that are well known in the physical activity field, the Harvard alumni study showed that men who engaged in regular physical activity over a long period of time had reduced risk of coronary heart disease, regardless of their weight. So again, it's improving health in everybody. The aerobic center longitudinal study, and this was done by my great good friend, the late Steve Blair, showed that higher cardio-respiratory fitness, in other words, the more fit you were, it was associated with a 50% reduction in the risk of cardiovascular disease mortality regardless of BMI. But there again, while physical activity can greatly improve health, it doesn't always produce a lot of weight loss.

Holly Wyatt:

This is why I was ready. You knew I was coming for you on this one. I was going to say, but Jim, just like healthy eating and the Mediterranean diet in its true form, physical activity can produce a little bit of weight loss, but alone, it is not sufficient to greatly reduce obesity. So it's no different there, Jim. It's the same.

Jim Hill:

No, no, I agree. So here's what I conclude. If we had a population with very low rates of obesity, healthy eating and increasing physical activity would greatly improve health. No question. But we don't. We have populations where less than 25% of people are healthy. So just doing diet or even just doing diet and physical activity is going to improve health, but it's still not going to get that big elephant in the room obesity.

So my point here is we need a third leg on the stool. We need to improve diet. We need to increase physical activity, and we need to produce weight loss. And simply eating healthy and being physically active isn't always going to produce enough weight loss to really dramatically reduce obesity. I think we've got to do all three to make America healthy again.

Holly Wyatt:

I like this because it's some people that don't need to lose weight. That doesn't mean they can just put their hands up either. To be healthy they may need to work on their diet and their physical activity independent of their weight, right?

Jim Hill:

Absolutely. If we were talking about prevention, and let's do this, Holly. Let's forget adults. Adults, who cares? Let them go. Let's look at our kids. If you're taking our kids where obesity rates are still low, this is a place where healthy eating and physical activity might be particularly important to prevent obesity. But if you're taking the adult population, in many ways, we've missed the opportunity for prevention. We've already lost that battle. If we're going to make adults healthier, we've got to do all three. We've got to improve diet, we've got to increase physical activity, and we've got to reduce obesity.

Holly Wyatt:

And I would say we've got to do it with the adults if we're going to impact the kids. It's going to be hard to impact the kids without changing some of this for the adults that are raising the children.

Jim Hill:

I agree in general, although we'll save this topic for another time. But I still think there are things you can do in schools and so forth with kids to help. But you're right. Parents have such an important influence on kids and provide a lot of their eating and exercise opportunities. So I'll give you that.

Holly Wyatt:

Well, and even the epigenetic piece of this. Right?

Jim Hill:

Oh, gosh. That's another one we could do a whole study on.

Holly Wyatt:

But Jim, hear what I really like about this is because I think so many times people think, okay, let's just solve the obesity problem and everything is fine. Or they say, let's just solve the diet problem and everything will be fine. And in reality, it's going to take, I think you're right, all three. And some people are going to say, okay, I'm at a healthy body weight, but I get zero physical activity.

Jim Hill:

Good genetics, I would say.

Holly Wyatt:

Good genetics, great genetics, and good for you, but are they healthy?

Jim Hill:

Yeah, I agree.

Holly Wyatt:

Does that mean they shouldn't do anything in terms of helping with preventing chronic disease? You can definitely have chronic disease even at a healthy body weight.

Jim Hill:

All right, so we've agreed. You've got to do all three, okay?

Holly Wyatt:

Okay.

Jim Hill:

Now, the devil's in the details. We have not been very successful at doing any of the three.

Holly Wyatt:

True.

Jim Hill:

We have made very little change in what people eat. We've made very little change in physical activity levels, and we've made very little change in obesity. But, Holly, let's start with obesity. We now have these new medications that can actually produce a lot of weight loss. And for many people, you can actually reverse the obesity. How can we use those in combination with the other two?

Holly Wyatt:

Okay, I see where you're going with this. You're saying the new thing we have that we haven't had before.

Jim Hill:

That's right.

Holly Wyatt:

And you're saying we've not been successful at this in any area. Now we're saying, well, let's go for all three. And I get that. Okay. Now you're saying we have a new tool that could actually help reduce body weight, the weight loss piece.

Jim Hill:

Best tool we've ever had other than bariatric surgery.

Holly Wyatt:

I agree. And we're in agreement here.

Jim Hill:

One simple way, Holly, is let's put all the overweight and obese people on the medications, get the weight off, and then we promote healthy eating and physical activity. You think that would work?

Holly Wyatt:

Yeah, no, I'm not sure that's the solution Jim.

Jim Hill:

It's not that simple?

Holly Wyatt:

No, that sounds good, I guess, but I'm not sure.

Jim Hill:

Is the solution to say, forget healthy eating and physical activity. Let's just put people on the drugs and keep the weight off. When we get rid of obesity, we know that just reducing obesity is going to improve health.

Holly Wyatt:

I do think just reducing obesity would improve health, but I don't think that's the solution. And I don't think it's what most people want necessarily. I think it's way bigger than that.

Jim Hill:

So back to the three, it doesn't work to do just one. If we got everybody to a healthy weight with drugs, probably isn't success. If we got everybody to eat the Mediterranean diet, it's probably not success. If we got everybody to engage in more physical activity, probably not success. I think what we're getting at is you have to do all three.

Holly Wyatt:

Yeah, you do have to do all three. And like we've said, Jim, we haven't been successful in any one of them yet. So maybe we should brainstorm. What do we do?

Jim Hill:

Let's do that. Let's take these three and let's look at maybe what we've done or what we haven't done. Let's start with diet. One of the things we've done ad nauseum is to try to educate people around diet. I think probably people out there know a lot about nutrition.

Holly Wyatt:

I agree. The educators are going to push back against this because they always push out. I think it's necessary.

Jim Hill:

Exactly.

Holly Wyatt:

But not sufficient.

Jim Hill:

If you don't know what a healthy diet is, you're not going to do it. Necessary, but not sufficient. If you know it, you still have to do it. And I think what we've seen is despite dietary guidelines and messages and even programs in schools, a lot of people know what to do, but they aren't doing it.

Holly Wyatt:

I think a perfect example is if I think you went out to almost anybody on the street and say, should you be eating vegetables?

Jim Hill:

Everybody's going to say yes. And yet only 10% of people actually meet the guidelines.

Holly Wyatt:

And yet it doesn't happen. And so I think that's the perfect example, because I think everybody, I think the message that vegetables are a good thing and we need them is out there.

Jim Hill:

All right. So let's look at a second thing that's often talked about, and that's access to healthy food. Can we make it easier to get healthy foods or alternatively, can we make it harder to get unhealthy foods? How have we done with that?

Holly Wyatt:

So it's either the stick or the carrot, right?

Jim Hill:

Stick or the carrot, yeah.

Holly Wyatt:

Stick or the carrot. Personally, I'm way big on the carrot and less on the stick. I think when you punish people, that's just my personal opinion, taxation and punishment doesn't, to me, produce a situation that I like to live in. So I think it's more about the carrot, but at the same time, that doesn't seem to work completely either. But access to foods is something people always say, I would eat more vegetables if they were easier to get, if they were less expensive, those types of things.

Jim Hill:

Yeah, a few years ago was this concept of food deserts. It's like they're places where people live and they just don't have access to healthy food. And I think as more and more data has come out about that, just providing healthy food alone is not the answer. Just putting a grocery store in an underserved area, it makes it easier for people to get the bad stuff. That alone doesn't seem to have worked. Taxing food is one. A lot of people want to tax bad food or label bad food. And again, there's still a lot of studies going on, but my reading of the literature is that's been a lot less successful than people would like it to be. That alone has not made a huge improvement in diet, and it certainly has not had any impact on obesity. So it may be good, just like education. You can't eat a healthy food unless it's available. But knowing and having it available is still not the behavior change we need to eat the good stuff.

Holly Wyatt:

Yeah. And then given a stick like taxation or some kind of negative consequence of eating it, I don't think is going to move us in that direction either. You know, like marketing restrictions, what you're allowed to market. I mean, there's so many things, but we kind of live in a society where I think, God, I feel like, you know, we have choices. I like having choices, Jim.

Jim Hill:

You don't want somebody to restrict your choices?

Holly Wyatt:

No, it irritates me.

Jim Hill:

But it's hard to do that. We can't go back. It's like, you know, you're not going to take away these foods that people have learned to like. Somebody's going to provide them.

Holly Wyatt:

Sometimes they try to, or they, you know, they want to punish.

Jim Hill:

Well, let's turn it around a little bit. Do you think we could actually leverage food product innovation? Could part of the solution be with the companies that provide food? And one of the things that I've always felt was not optimum is there is this antagonism between the food industry and the public health community. And again, the food industry, they want to make money. So they want to give you good tasting food. And too often, good tasting food is fat, sugar, and salt. But at the end of the day, somebody is going to provide our food. And can we figure out a way to work with the food industry to innovate, to make it more attractive, to make more attractive, healthier products? It would seem like that would be something that we should at least try to promote.

Holly Wyatt:

Yeah, I like that better. I think that finding a solution instead of restriction. The companies have lots of money to spend in research. And if we wanted that, I think if we as a society said that's what we want, I think they would do it. I think they would innovate.

Jim Hill:

Well, I think it's something to continue to pursue. I think these companies have a terrific ability to contribute positively. They also have a contributed ability to contribute negatively. And they've done that in the past. So I'm not giving the food industry a pass here. But I'm saying that somebody is going to provide our food in the future. And it seems like they at least need a seat at the table as we're figuring out solutions.

Holly Wyatt:

I agree with that. And should it all be about rules and regulations or should it also maybe have more about innovation and where we're moving and what we can do? To tax my chips, Jim, gets me irritated, right? They're going to put a tax on my chips.

Jim Hill:

Even though you shouldn't eat them, you don't want them to be taxed.

Holly Wyatt:

I don't. I don't want them to be taxed. But I love it when they come out and they try to make a truly healthier version of a good tasting chip. That, I do like.

Jim Hill:

All right. So what about technology? Is technology going to get us out of this? Is AI going to tell us what to eat? We're talking about personalized nutrition. We're talking about now doing telehealth to help people change their behavior. Interventions that are tailored to you, Holly, not to everybody. Is this something that's going to help us eat more healthy?

Holly Wyatt:

Well, I do like the idea of tailoring interventions. Being able to say, this plan will work potentially better for you for these reasons. I don't think we've got that figured out, and I don't know when we'll have that all figured out. I mean, we're studying that. That's one of our studies that we have going on, that the NIH has going on, that personalized nutrition. So I think we're gathering more data, and maybe, maybe AI will help. I don't know.

Jim Hill:

Yeah, and I want to move on to physical activity. But at the end of the day, it seems like food is so complex that I think oftentimes we develop solutions without bringing all the right people to the table. I mean, we've got farmers. We've got government regulatory people. We've got the FDA. We've got the food industry. We've got restaurants. We've got grocery stores. We've got dietitians. It just seems like we need more efforts to bring these people together to brainstorm solutions. I think what we've decided here, education is important, but not sufficient. Access is important, but not sufficient. So if you understand what to eat and it's available, the big challenge is actually getting people to eat those foods.

Holly Wyatt:

And I think I agree with you. We need a lot of people at the table to figure that out, to see if we can move the needle there.

Jim Hill:

So that's a big one. And the barriers here are, if you ask people what influences their food intake, the three big ones are still taste, cost, and convenience. Health is probably fourth, but it's got to taste good. It's got to be at a reasonable cost. It's got to be convenient. So this is a tough thing. We've got to put health in there. So the healthy foods taste good. They're reasonably priced and they're convenient. So the Make America Healthy Again people, big challenges here. But boy, it'd be fun to take this on.

Holly Wyatt:

And I think this shows the complexity in just doing one thing, like taking out the chemicals, I'm not sure it's going to move the needle.

Jim Hill:

It's not bad as a strategy, but it's not the only strategy.

Holly Wyatt:

Okay.

Jim Hill:

All right. Physical activity. Holly, how do we increase physical activity?

Holly Wyatt:

I have a feeling you have some ideas about this, Jim.

Jim Hill:

I have some ideas.

Holly Wyatt:

I thought you would.

Jim Hill:

So what we've tried to do is to look at the environment. Can the environment make us more active? Can we design our urban areas so that they're more walkable? Can we put in bike paths and walking paths and make them more attractive? Can we encourage people to take public transport? You know, people always note that when they go on vacation in Europe, they end up walking so much more because, you know, take public transportation, there's walking involved. So there are efforts to do that. And I'll have to say that on average, they've been fairly modest. Again, it's the idea of making it available. It's available. We still have to do it. There's a public transport available. You still have to get people to do it. There's a bike path available. You still have to get people to go out and do it.

Holly Wyatt:

You need it. If you don't have it, you can't use it.

Jim Hill:

Right. And also the education. I mean, again, I don't know that there's anybody on the planet that doesn't know that more physical activity is good. So again, knowledge and opportunity, but you still have to do it. We've tried incentives. We've tried in the workplace or even health insurance companies are trying to give people hats and t-shirts if they get the number of steps and those kinds of things.

Holly Wyatt:

Even we'll give them money back or money off their insurance in some way. It's really interesting to watch what happens a lot of times. Guess who does that?

Jim Hill:

The people that are already doing it.

Holly Wyatt:

Yeah, the people who are already doing it. The active people take advantage of it or do it, but it really hasn't, I don't think, made a huge difference in terms of getting people who weren't active to move more. It's interesting how that kind of has played out a little bit.

Jim Hill:

So can we integrate it into our health system? And I actually want to go back to one thing we missed on the food side. One of the new sort of initiatives is Food is Medicine. You actually prescribe healthy meals for people. You can do this through primary care, et cetera. The analogy on the exercise side is exercise is medicine. So your primary care doc gives you a prescription for a gym or the YMCA or something. Can we integrate food and exercise into our health care system? And there are efforts underway to do that. And I think it's too soon to know yet if that's going to work, but that certainly seems like one strategy to pursue.

Holly Wyatt:

I think it gives it even more easier to get to, more important, but you still have to do it, Jim.

Jim Hill:

See, that's the issue. You can know you need to do it and you can have an opportunity to do it, but you still have to do it.

Holly Wyatt:

You can have a really sweet opportunity to do it and you still might not do it. That's the key.

Jim Hill:

So what about social support and peer networks? There are more and more community groups, walking group, wellness programs, etc. Is that one potential way to use social networks to increase physical activity?

Holly Wyatt:

I think it is. That's one of the area. I don't think there's one solution to this like we're talking about. But one of the areas that I think when I do see people who really start to put themselves in a group that's more active, they become more active without them even knowing it. Right? So this is kind of like a stealth way of getting more physical activity. If you're hanging around people and you're doing something you love and it just gets that activity in there because of that group dynamic, I think that's a kind of a sneaky way. But I don't think it's going to work for everybody and it's the only thing. But I like that as a possibility. I like that as a brainstorming idea.

Jim Hill:

Okay. What about technology? Man, apps are going crazy. You've got fitness apps, you can track movement, you can track your steps or minutes or other things. You've got wearables. You've got virtual exercise programs. Is technology going to help us?

Holly Wyatt:

It's helpful. And we've said this many times. Once again, you can have something that tracks your activity. But then if you don't use that awareness, awareness is key. "Oh, my steps are low. My activity is low." But if you don't have a plan or a strategy then to say, "Okay, my steps are low. What am I going to do about it?" I don't know that it moves the needle very much. So once again, I think they're helpful. I think they're positive. And once again, with other things, but alone, I'm not sure just wearables are going to do it either.

Jim Hill:

So for both food and activity, we have awareness. People know they need to eat better and move. We have opportunities. There are plenty of healthy food in the grocery store, plenty of ways to increase exercise. The key is getting people to do it. And the barriers, what's the number one barrier to physical activity, Holly? You know this.

Holly Wyatt:

Time.

Jim Hill:

Time. I don't have time to be active. I got to watch six hours of TV a day, but I don't have time to be active.

Holly Wyatt:

Well, they don't say that. They don't say that. I know. But they do show me their calendar. And they're busy people. We are all busy, busy, busy people. I get it. But there is time for 60 minutes of movement a day. It's a mind state that we've gotten ourselves into.

Jim Hill:

The other thing is people say, Holly, I don't really like exercise.

Holly Wyatt:

Yeah. I hear that one too. And once again, it's about figuring out something that you can like. I think sometimes they think about the sweating and the gym. They have one idea. But it's figuring out what that is. What movement can you get in during your day?

Jim Hill:

All right. Let's take the third of the stool, the third leg, weight loss.

Holly Wyatt:

Well, we talk about that all the time.

Jim Hill:

We have been fairly successful at producing modest weight loss with lifestyle, but totally unsuccessful in people keeping it off. And you and I followed some of the people that are successful long-term, and they're the rare individuals who can both lose weight and keep it off. But the game changer here are the medications that can actually produce an amount of weight loss that is satisfying to many people.

Holly Wyatt:

Well, and I'm backing up one second because I don't like what you said. I don't like you saying it's the rare bird. Now, we know, I know you're going to do some statistics on me or something, but I think that's negative. I do think there are a lot of people out there who do maintain their weight, Jim, and I'm going to give them credit.

Jim Hill:

Yes, Holly, but they're the minority. I wish there were more.

Holly Wyatt:

All right, they're the minority, but okay.

Jim Hill:

Most of our listeners have had that experience many times of losing weight and regaining it.

Holly Wyatt:

Yeah, and regain it, and then some lose it and maintain it. And we talk about that all the time. All right, I'll give it to you.

Jim Hill:

So the medications work for weight loss. What are your concerns?

Holly Wyatt:

Well, are they going to be on them for the rest of their lives? And is it safe to be on them for the rest of their lives? And so far, it looks like it may be, but we don't know for sure.

Jim Hill:

So you and I, just to clarify, are generally positive about the new weight loss medications. We think they are wonderful tools. I think we also think we haven't quite figured out how to use them yet. One model is you go on these meds and you stay on them for a lifetime. And we don't have longer term data, but the data we have up to three, four years suggests that they are effective. If you stay on them, you can lose weight and you can keep it up.

Holly Wyatt:

And they're safe. The data that we have thus far shows that they're safe.

Jim Hill:

And they're safe. But for whatever reason, it seems like most people don't stay with them over the long term. And there are various reasons for that. So the medications are a great way to lose weight. I think we still have to figure out how to help people keep it off with or without the meds or with a combination of meds and lifestyle.

Holly Wyatt:

I totally agree with that. I think we need options. Let's get the weight off. Recognize what we've been saying for a very long time. Getting the weight off is different than maintaining it. Let's then have options for maintaining it that are very different and don't get all bogged down in the weight loss piece. Right? The weight loss can be separate from the weight loss maintenance.

Jim Hill:

All right, Holly, we've gone through diet and physical activity and weight loss. I'm going to give you a couple of minutes here at the end and tell us why the mind is important in this. We've talked about behavior.

And I know this is an area you and I have really done a lot of thinking about and a lot of work on lately. What's the role of the mind in all this?

Holly Wyatt:

Well, I think the mind is the critical piece. It's really the foundation for making behavioral change and being successful and living a good life, which is really what you're wanting. It's not just about being healthy. It's how that health is going to impact your life and so much of that I think comes down to that mind state. That missing piece that very few programs talk about or they just do lip service, and very few people really get or want to work on. We can get people that want to work on diet and physical activity but when I say, "Hey let's work on your mind." They don't just jump up and say, "Sure, let's do that." So I think it's very important. We talk about a Voyager mind state. I don't know if we've ever brought that up on the podcast, but it's something we talk about.

Jim Hill:

We should talk about that because I actually believe that mind state is probably the thing that most separates successes and failures. If you don't have the right mind state, you're not going to sustain the behavior changes that you're undertaking. So I think it may be the most critical part.

Holly Wyatt:

Right. But it makes sense when we talk about weight loss and weight loss maintenance. Weight loss is a short period of time in the scheme of your life, right? You're not going to lose weight for years and years and years and years. Weight loss maintenance is years and years and years and years. And that's when having that right mind state is so important. If you think this is going to be terrible, your lifestyle, what you're going to eat and how you're going to have to move is going to be painful and going to be terrible. And it means I never get to have anything good to eat and I'm going to be constantly having to do all these things and not go out with my friends, you're never going to make it. It isn't going to work, right? You can have what we've talked about. You can be educated. You can have opportunities. But the mind has already got you not succeeding, basically. And I think it's way more powerful than we think. And so to be successful long-term, which is what weight loss maintenance takes, and to enjoy your life, not just be waiting to one event. "Okay, I'm healthy. I went to the doctor, I'm healthy, but I don't like my life." I don't think that's going to work.

Jim Hill:

All right, Holly, I'm going to wrap up here because we're about out of time. So we agree, America's not healthy and it would be great if we could make it healthy again. But as we've talked about, this won't be easy. An effective campaign would need to focus on identifying and promoting healthy eating, promoting more physical activity, and encouraging weight loss in those with excess body weight. It also involves creating a mind state for sustainability of behaviors.

Holly Wyatt:

Yes.

Jim Hill:

Wouldn't it be great if we actually decided as a nation to take this on? It would take commitment of significant resources. It would take collaboration from many sectors of society, government, industry, nonprofit communities, almost like a moonshot. Could we really say we're not just going to get lip service, we're actually going to take it on, and we're going to put the resources and the time to do it the right way?

Holly Wyatt:

So do you think that that's feasible? I mean, it would be like deciding to go to the moon like in the 1960s, right? It seemed impossible. And didn't we accomplish it in like eight years or something? It seemed impossible. And yet we did it.

Jim Hill:

You know, Americans are wonderful at putting off problems until it gets to be really, really serious and then doing what it takes to solve the problem. So RFK, if you're listening.

Holly Wyatt:

Oh, I'm sure he is.

Jim Hill:

We love the idea of making America healthy again. Just know that it won't be easy and it won't be as simple as focusing on one thing like diet. However, if we could achieve this, it would be, I think, a game changer for the future of our species.

Holly Wyatt:

Love it.

Jim Hill:

Wow.

Holly Wyatt:

There you go, Jim.

Jim Hill:

We didn't get many answers, but we elucidated some of the problems.

Holly Wyatt:

We asked a lot of questions.

Jim Hill:

We asked a lot of questions and we had fun.

Holly Wyatt:

That's it.

Jim Hill:

[41:12] So thanks, everybody, for listening. This was a fun episode for us. I would love it if we really did get serious about making America healthy again. It would take everybody playing a role, but I'd love it if we really took it on like a moonshot. So thanks, everybody. See you next time on Weight Loss And.

Holly Wyatt:

Bye.

Jim Hill:

And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:

If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

Jim Hill:

We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

Holly Wyatt:

And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.