Show Notes
The Chorus of “Just Eat Less” Spend a few minutes on social media, and you will hear it. On Bill Maher's podcast the other day, I heard it. Two people who know less about GLP-1 drugs than almost anyone, opining about how GLP-1s are horrific. Bill Maher says, “Just eat less.” Jillian Michaels warns that GLP-1 medications are dangerous. Did she even graduate from college? Meanwhile, a rotating cast of gym bros, coaches, and influencers insists that anyone using these medications is taking the easy way out. At first glance, these seem like different voices. A comedian, a fitness personality, a group of online trainers. However, they are all saying the same thing. If you are overweight, this is your fault. If you need help, you are weak. If you use medication, you are cheating. That message travels well. It is simple. It fits into a tweet. It sounds like common sense. Science shows us that fat shaming doesn't work (reference). It is also wrong.
Who Is Doing the Shaming—and Why The fitness industry has something to lose here, and that part is easy to understand. Entire businesses are built on the idea that weight loss is a matter of discipline. Follow the plan, buy the program, track the macros, and success will follow. If it doesn’t, the explanation is built in. You didn’t try hard enough. However, the criticism does not stop there. When someone like Bill Maher reduces obesity to “just eat less,” it is not about selling a diet plan. Instead, it reflects something else entirely. A kind of cultural impatience with complexity. A belief that if a problem can be described simply, it must also be solved simply. And when that belief meets a condition like obesity, the result is dismissal. If I don’t struggle with this, then it must not be real. If you do struggle, then you must be doing something wrong. That is not analysis. That is a failure of imagination.
The Problem with Simple Answers Medicine has a long history of being wrong in simple ways. We once believed ulcers were caused by stress alone. Then came Helicobacter pylori and antibiotic treatment. We once thought hypertension was simply a matter of salt intake and personality. Then we developed therapies that addressed the underlying physiology. Obesity has followed a similar path, except we have been slower to let go of the old explanation. “Eat less, move more” is not incorrect. It is incomplete. Because it ignores the system that determines how much you want to eat, how often you think about food, and how your body responds when you try to lose weight.
The Part I Didn’t Admit For years, I saw the damage this thinking caused. I ran support groups for patients struggling with weight. I watched them come in carrying not just pounds, but shame. They believed they were weak, that they lacked discipline, that something about them was broken. We worked to change that. We talked about biology. About appetite regulation. About how the body defends weight. We tried to replace blame with understanding. And yet, I quietly held myself to a different standard. I didn’t blame my patients. I blamed myself.
The Surgeon Who Thought He Could Outwork Biology If anyone should be able to power through something, it is a surgeon. That is the job. Endure long hours. Stay focused. Push through fatigue. Delay gratification. So I assumed I could do the same with weight. I tried diets. I cleaned things up. I ate vegetables, cut back on certain foods, and experimented with structure. And like many people, I saw results. At first. Weight loss is not the mystery. Weight maintenance is. Because over time, the same thing happened again and again. The body adapted. Hunger increased. Energy dipped. The system pushed back. And eventually, the weight returned.
What the Data Shows (and Why It Matters) When you look beyond personal stories and examine long-term studies, the pattern becomes clear. In the Diabetes Prevention Program, participants lost weight early, then gradually regained some of it. In the Look
More from Fork U with Dr. Terry Simpson
With all the spices we have access to, it is amazing how bland recipes have become. I have many cookbooks, some from great chefs, television personalities, and friends. What I am always surprised by is how bland the food has become. People seem to think a bit of salt, pepper, maybe onions, and garlic provide the spices one needs. Perhaps it is because some associate spice with heat. Mostly because many have never experimented with some of those great warm spices available. A pinch of coriander, some freshly ground cumin, a little cardamom, or a touch of cinnamon can turn an ordinary dish into something remarkable. And the most astonishing part is that these spices financed voyages around the world, built cities, created fortunes, and caused people to kill one another. Without the spice trade, it is safe to say that the United States, as we know it, would be vastly different from what it is now. The money loaned to the United States, when we were a fledgling country, came from the wealthy spice merchants from what was considered one of the great hyperempires of the world, based in Amsterdam. But before we go to the birth of the United States, let me take you to the meatball.
Tea: The Drink That Built an Empire—and Helped Break One China had the tea. Britain had the appetite. John Hancock had a business to protect.
MesoAmerica and Chocolate In our series looking at foods that built civilizations, today we are going to stay in the Americas with chocolate. Chocolate has been used as currency, consumed by kings, incorporated into religious ceremonies, and prescribed as medicine. Today, it is a multibillion-dollar industry that wants you to believe that eating chocolate is an act of preventive cardiology. I mean, why not? They convinced us to give chocolate to people we love, eat it when we are happy, when we are sad, when only the dog understands us. Don’t feed chocolate to your dog. And we have done all this with a bitter seed that most of us would probably spit out if we tasted it straight from the tree.
I’ve been doing a series about foods that built civilizations. In this episode, we are talking about the potato. It is difficult to imagine that thousands of years ago, people constructed large buildings, managed rivers, built monuments, and created art. We have glimpses of these civilizations through stories, archaeology, and the structures they left behind, but much of their history has been lost. Imagine, we don’t even know where Cleopatra or Alexander the Great are buried, yet we know their stories. As European powers conquered Indigenous peoples, their languages, cultures, and oral traditions were suppressed. When a language disappears, so are the stories preserved within it. Our clues come from archaeology when we uncover a monument, a building, or an ancient settlement. In the Andes, the potatoes they cultivated were not the Russets, Yukon Golds, or fingerlings you find in the store today. Different colors, shapes, and textures. Adapted to survive the elevations, temperatures, and growing conditions. Biodiversity protected their food supply against frost, disease, and changing environmental conditions. If one variety failed, another might survive. The ancient wisdom of diversity that Andean farmers developed over thousands of years was lost when the potato eventually reached Ireland.
In our series about foods that built civilization, we talked a lot about grains, from wheat to corn to rice. Today, we are taking you to the ocean, with the civilizations that salmon built. From California to the interior of Alaska, salmon, a staple, allowed people to settle into villages, develop complex social networks, art, and trade routes. Those trade routes are as large as the ones in the Mediterranean. Some tribes built communal homes and developed complex art and language. Some were Seafaring tribes with canoes up to 60 feet long that traveled across oceans. All because there was a fish that would return in large numbers to streams and rivers, reliably, predictably. So predictable, the people could build their lives around salmon runs. So much so that some built a calendar not only with lunar cycles, but also with the return of the salmon. Civilizations have always gathered around food and water. The Mediterranean connected people who grew wheat and olives, giving people time to make wine, mine copper, build ships, trade with their neighbors, and occasionally go to war with them. Asia had rice and grain near the great river systems. The reliable calories from rice and grains allowed villages to become cities and to travel by water to trade. Today we are going to my home, from the Ventura River in California to my home state of Alaska.