For six whole months Dr Jack Mosley couldn’t bear to hear his father’s voice. Dr Michael Mosley was, of course, the much loved doctor and broadcaster, famous for popularising intermittent fasting, who died on holiday in Greece last June.
“It’s only in the past few weeks that I’ve been able to listen to his Just One Thing series,” says 32-year-old Mosley, referring to his father’s BBC show advocating small positive life changes. “And obviously that’s been bittersweet. But the whole reason he is still there on radio, podcasts and on TV is something to be proud of — my dad helped a lot of people lead better lives.”
Michael went missing while on holiday with his wife, Clare, also a doctor, on the Greek island of Symi. Walking in near-40C heat without a mobile phone, he took a wrong turn and, according to a UK inquest, probably succumbed to heatstroke.
He was missing for four days before his body was discovered. Jack Mosley and his siblings (he has two brothers, Alex, 34, Dan, 30, and a sister Kate, 25) had joined the search. Thankfully, it was not one of them who discovered their father’s body on a beach just 150 yards from where they had earlier been looking. It was a tragedy that triggered an extraordinary outpouring of grief, from a whole day’s programming on the BBC to tributes from thousands of people he’d inspired and Rishi Sunak, then the prime minster.
Eight weeks later, Jack was on a train from Austria to Munich with his mother. They’d been on a family trip and the carriage was so packed they sat on the floor. He is also a doctor (he qualified in 2018 and is training to be a GP) and he wrote his master’s thesis on weight loss, specifically: why do some people manage to lose weight and keep it off, while others don’t?
“And of course I’d had many conversations with Dad, who was a passionate advocate for weight loss and improved metabolic health,” he says. Michael’s 2013 book The Fast Diet, written with Mimi Spencer, has sold 1.4 million copies around the world.
Right there and then, on the floor of the carriage Mosley began mapping out the chapters for a possible book. Now I’m holding it in my hand. Food Noise: How Weight Loss Medications & Smart Nutrition Can Silence Your Cravings is a fitting continuation of his father’s work. As Mosley writes, his father left big shoes to fill. And it will give any reader pause before injecting with a weight-loss drug such as Ozempic.
“My dad thought there was huge potential for these drugs, as do I,” he says. “But the more research I did, the more I was convinced it’s like the Wild West out there. People need to know how to use the GLP-1s [glucagon-like peptide 1 is the body’s natural appetite-suppressing hormone, secreted after a meal, making you feel full by suppressing both appetite and slowing the stomach-emptying process] and the significant consequences of misusing them.”
I hear “food noise” regularly, the nagging voice of craving that, according to research, affects 57 per cent of the population. In fact, I hear dainty little arias sung to me by wine, and also sultry “Come hither” ballads from chocolate and cheese.
I’ve been tempted to try Ozempic but reading Food Noise made me think twice.
‘People think weight-loss drugs are a magic bullet’
Mosley cites astonishing figures: in the Sixties 1 per cent of men and 2 per cent of women in the UK were obese. Now it’s around 28 per cent of us. (Slightly less alarming but nonetheless intriguing is his contention that the size of the average dinner plate has expanded from 22cm to 28cm in 50 years.)
“The food landscape has changed so much in the past six decades — wherever you turn, unhealthy eating options are thrust at you, so it’s wrong to blame individuals. The problem now is that so many believe weight-loss drugs are a magic bullet.”
Half a million people in the UK are using weight-loss medication, with 95 per cent of them accessing it privately. (The NHS began prescribing Wegovy, the weight-loss version of the diabetes drug Ozempic, in September 2023, but has reportedly only managed to treat 3,000 people due to shortages.)
Mosley sounds several notes of warning. The first is about the kind of weight that users tend to lose. One study by Novo Nordisk (the Danish company that manufactures Ozempic and Wegovy) showed that after 68 weeks users lost an average of 17.3 per cent of their body weight. Great, but scans showed that 40 per of this was lean body mass (ie muscle) and when people come off these drugs, many regain the weight as fat. A 2011 study of post-menopausal women showed that 26 per of their weight loss was lean body mass, but when they put on weight again, fat mass was regained to a greater degree.
“People thinking about using weight-loss drugs need to know that lifestyle changes are also required,” asserts Mosley. “Because, what you lose and what you later regain can be very different. And even for people living with obesity, that can lead to malnutrition.”
I have to admit, no one has ever accused me of suffering from malnutrition. But that is to confuse weight with nourishment. Those who eat a lot of UPFs (ultraprocessed foods) might be getting just enough essential micronutrients as a result but, factor in sudden weight loss, and there can be serious consequences.
‘Fifty per cent of obese people have a vitamin deficiency’
“Some doctors use the term ‘malnubesity’ — it means people who are obese but also undernourished because UPFs don’t contain enough micronutrients unless you are eating large quantities of them. Fifty per cent of obese people have a deficiency in key vitamins: vitamin A, B1, B9, vitamin D, iron, calcium and magnesium.”
Losing lean body mass and regaining fat isn’t just aesthetically undesirable. Mosley really wants us to understand the important role muscle plays in maintaining good health.
“Muscle is the best predictor of longevity,” he says. “In older people it reduces the chance of falling, allowing them to remain independent. It also burns calories — it’s a glucose sink, sucking up all the sugar in the bloodstream.”
Mosley and I are meeting in a London photo studio. He’s very warm and friendly and when he smiles his eyes go cheeky and twinkly just like his dad’s did. He is also very tall and thin: 6ft 4in and weighing 13st 5lb, to be precise. That’s a bit annoying. At least his dad had a sweet tooth and weight issues we could all relate to.
Food Noise tells the tale of his father sneaking downstairs one night and eating all the children’s Easter eggs. Jack was ten years old. “Yeah, bit of a trauma,” he smiles. “But that was plain addiction. For him, the food noise around chocolate could be unbelievably loud.”
Michael improved, perhaps even saved, many lives by being upfront about his own health struggles and also by self-experimenting. In the early Nineties he developed stomach ulcers for a BBC Horizon programme to prove that they could be cured with antibiotics (he was correct and 20,000 sufferers wrote in to thank him). For the 2014 BBC documentary Infested! Living with Parasites, he purposely ate beef containing Taenia saginata cysts, and then grew a metre-long tapeworm inside him. Michael hoped the parasite would help him lose weight (it didn’t — he gained 2lb).
‘Dad was a maverick, a master self-experimenter’
“He was a maverick and a master self-experimenter,” agrees Mosley. “I remember my brother Alex’s in-laws once meeting dad and asking him what he’d been up to that day. He said, ‘I got myself mustard-gassed to see what it was like.’ ”
Michael’s own father, Bill, suffered from diabetes and died aged 74. Michael’s interest in health was partly driven by the fact that he couldn’t find a single male in his family history who had lived to 75. Poignantly, surpassing that life expectancy was his goal. “He [Bill] hadn’t seen his grandkids grow up. I thought, that’s not a road I want to go down,” Michael Mosley said last April.
“Yes, my dad’s dad inspired him to change his lifestyle, because he could see that he was putting on the kilos as many do in middle age — that is the time to invest in your health,” notes Mosley.
It turns out Mosley has inherited some of his dad’s dietary quirks. He might be looking svelte but he definitely hears food noise too. In his first year as a newly qualified doctor working in a Manchester hospital, it became deafening.
“We know from research that stress means you are much more likely to eat sweet, sugary, fatty, starchy, salty foods — they hit the bliss point. They are designed to be moreish. I am no different. I’d drive an hour to work and eat a big bag of Haribo on the way in. Same on the drive back. And then on the ward I’d help myself to all the sweets and chocolates that kind patients gave staff as presents.”
In that one year Mosley put on 2st 5lb of pure fat and had two fillings.
“My fiancée is a dentist. That did not impress her,” he says.
But it’s startling how the weight-loss drug revolution is now sweeping all before it. In 2015 Oprah Winfrey joined the board of WeightWatchers and the company was valued at $6 billion at the time. Then, in 2023, Winfrey announced she was injecting Ozempic, and the day I meet Mosley, the company announces it is preparing for bankruptcy.
Ozempic has eaten WeightWatchers’ lunch. The irony is that most people using the drug are effectively self-experimenting with a medication invented to treat diabetes.
“For diabetes, they were prescribed at between 0.25mg and 1mg. For weight loss, hundreds of millions are taking them at 2.4mg and the truth is, at that dose, we don’t know what the long-term effects might be.”
In Food Noise Mosley reminds us that the NHS prescribes such drugs for people with a BMI of 27 and a weight-related health problem. For those using it as a lifestyle option, the stories of unintended consequences are legion.
‘They’re not made for people getting beach-body ready’
He cites an example from clinical practice: a 74-year-old man who thought Ozempic gave him licence to indulge his sweet tooth without constraint.
“I was exploding in every direction from every possible orifice,” the man reported. Meanwhile, actor Stephen Fry lost 4st 12lb injecting Ozempic but gave up because he was vomiting four times a day. After a positive start the former PM Boris Johnson also gave up.
“One minute I would be fine, and the next minute I would be talking to Ralph on the big white phone,” Johnson said.
Sharon Osbourne lost 3st but gave up when she couldn’t stop losing weight (she reported not being able to put on the roughly 11lb required to be healthy, regardless of what she ate). Lottie Moss (a model and half-sister of Kate Moss) weighed 9st 6lb when she decided to inject weight-loss medication in order to hit 8st 5lb. She took a dose appropriate for someone weighing 15st or more and suffered a seizure.
“It is very brave and helpful of her to have spoken about the dangers and risks of taking the weight-loss medication at a healthy BMI,” says Mosley. “They are for those living with obesity or poor metabolic health — they are not made for people trying to get beach-body ready.”
Time and again Mosley likens the current weight-loss drug environment to the Wild West. Today it’s like we are chatting as bodies fly through the window in its most rambunctious saloon. A news report flashes up that the singer Robbie Williams has gone down with scurvy (a disease caused by vitamin C deficiency) as a result of taking a weight-loss medication similar to Ozempic. Williams went from 13st 13lb to 12st 1lb before contracting what he calls the “17th-century pirate’s disease”.
“I cannot believe Robbie Williams has got scurvy,” marvels Mosley. “I mean, a small orange a day is all you need to get sufficient vitamin C, so that suggests significant malnutrition.”
The new wave weight-loss drugs
There is a long ignominious history of weight-loss fads. Mosley lists them in his book. In the 19th century, arsenic was thought to induce weight loss and in the early 20th century the tapeworm diet was briefly in vogue. Since the Thirties amphetamines, cigarettes or even having one’s jaw wired shut have also been popular.
By the early Nineties the pharmaceutical industry entered the game. A drug called fen-phen was launched but by 1997 withdrawn when it caused fatal heart and lung issues. In the Noughties, rimonabant arrived: it toyed with the brain’s mood receptors but was pulled when it triggered suicidal thoughts in users. Another drug, sibutramine, failed after it led to an increased risk of heart attack and strokes.
So what to make of the GLP-1s originally derived from the saliva of a giant lizard (the Gila monster’s saliva produces a hormone similar to GLP-1) and other medications on the way? A monthly injection, MariTide, made by the US pharma company Amgen, is undergoing phase 2 trials. Users report shifting 20 per cent of their body weight. What’s more, the weight stayed off for five months after injections ended. Also imminent is orforglipron, a weight-loss tablet taken daily which many believe could prove a major rival to Ozempic (cheaper to produce and with no need for refrigeration or injection). It is due to be licensed in the US next year.
“These medications are not a fad; they aren’t going anywhere any time soon,” says Mosley. “The NHS and the government are inevitably going to have to adapt. Hopefully that means sensible measures, such as access only after a proper consultation, not just being prescribed because someone exaggerates their weight or puts on three baggy jumpers when being assessed.”
Mosley is not against weight-loss medication per se. After all, the title of his book makes clear that, alongside other lifestyle changes, they can work. And though he notes concerns about the drugs’ possible links to conditions such as pancreatitis, blocked bowel, gallstones and even thyroid cancer, he is clear-eyed about some of their extraordinary downstream benefits.
Anecdotally, the GLP-1s not only quell food noise but also reduce other cravings such as for alcohol and drugs (GLP-1 users are 50 per cent less likely to get drunk).
“I know some doctors who believe they reduce other addictive traits like scrolling or biting one’s nails,” he says.
They may also reduce heart disease (a study of 17,000 people on weight-loss medication noted a 20 per cent decrease) and general inflammation (high blood sugar levels can cause inflammation and weight-loss drugs are known to lower these). They may also help those suffering with dementia (by increasing blood flow to the brain) and even reduce colon cancer. And, of course, weight loss can mean knock-on improvements in knee, hip and other osteopathic ailments.
Mosley likens weight loss drugs to wearing noise-cancelling headphones. When in use, you no longer hear “food noise”, so you eat less. Your “hedonic drive” (the desire to seek pleasure from food) is disabled and you can look at, say, a Hobnob biscuit for what it really is: a disc of oats, flour, palm oil and partially inverted sugar syrup with some raising agents and salt thrown in.
‘Too many people are using Ozempic like a sledgehammer’
And that’s got to be good, right? Well, yes, although Mosley warns of one other major possible side-effect: divorce.
“Patients who undergo bariatric surgery [weight-loss surgery such as a gastric bypass] are known to experience higher levels of divorce,” he explains. “If one person loses a lot of weight and the other doesn’t, then that can cause tension in the relationship. Doctors call it ‘bariatric divorce’ and it’s possible something similar will happen with the widespread use of weight-loss drugs.”
But “Ozempic divorce” may actually be something entirely different. There has been much talk about “Ozempic personality”, the change in outlook that turns a former bon viveur into a pleasure-avoidant zombie. With a reduced hedonic drive for food, alcohol and, according to some reports, sex, aren’t we in danger of becoming a bit bland and boring?
“Suppressing appetite so that there is absolutely no desire or pleasure in eating is obviously unsustainable,” says Mosley. “And that tells me there are too many people using Ozempic like a sledgehammer. My hope is that we harness the use of weight-loss drugs properly. They should get you to a place where your metabolic health is good and, without them, your ongoing lifestyle is sustainable.”
Food Noise contains 50 recipes created by his mother, Dr Clare Bailey Mosley. I really liked the salmon and rocket egg muffins and felt virtuous snacking on the savoury curry-flavoured nuts that Michael Mosley liked.
“It was such a shock when my dad vanished,” says Mosley. “Grief is a very difficult thing, but we have all looked after each other and it has brought the whole family together. That’s what I got from that train journey with my mum: my dad loved helping people live better lives and he was fascinated by all the implications of the weight-loss drug revolution. As a family, we feel it’s important to carry his message into the future.”
Food Noise: How Weight Loss Medications & Smart Nutrition Can Silence Your Cravings by Dr Jack Mosley (Short Books, £16.99) is published on April 24. To order a copy go to timesbookshop.co.uk or call 020 3176 2935. Free UK standard P&P on online orders over £25. Special discount available for Times+ members
