This week on The Referral, Personal Trainer James Smith joins Dr Karan in the studio. Described as the ‘Gordon Ramsay’ of the fitness industry, James gets real about fat loss, the weight-loss injection and changing your daily habits to drop weight in a healthy, less stressful way. 



Karan also brings you ‘What The Health’, the latest in health and science in the news, and he answers YOUR questions in ‘Crowd Science’. 



If you have a health-related question and want to get in touch, just head to TheReferralPod.com.



A Sony Music Entertainment production. 



Find more great podcasts from Sony Music Entertainment at sonymusic.com/podcasts and follow us at @sonypodcasts 



To bring your brand to life in this podcast, email podcastadsales@sonymusic.com 
Learn more about your ad choices. Visit podcastchoices.com/adchoices

This is The Referral, with me Dr Curran, and the whole point of this podcast is to debunk myths and have chats with interesting people, world leading experts, scientists, doctors, to give you actionable information that can hopefully improve your life, make you happy, make you healthy and counteract the absolute tidal wave of nonsense misinformation out there from all of these charlatans that, at best, are giving you pseudoscience and, at worst, are actually worsening your lives and making your bank balance a bit lighter.

And today's guest epitomizes exactly what this podcast is about, debunking absolute bullshit and nonsense.

He is 1 of the fastest growing personal trainers online with millions of followers across social media, and actually he's been described as the Gordon Ramsay of the health and fitness world.

Forget Gordon Ramsay, this is the 1 and only James Smith.

He debunks these fake wellness gurus and influencers who tell you treacherous ways to lose fat and lose weight.

People are always asking me random questions, so it's only fair that I allow my guests to do the same.

I knew you knew a lot about bums, so when we were like, ask, ask you a question, I was like, it's got to be bum fun.

And now it's time for you to ask me any questions you'd like.

Now if you'd like to get in touch as well, drop a note at thereferralpod.com.

Also coming up, if it ducks like a quack.

Now, I feel really strongly about this because this is where I bust myths and some of them are going to blow your mind.

Carbs are nothing magical, they're also not demonic, so include them as part of a normal diet.

A quick glimpse at all the latest news in the world of science, medicine and health.

This is groundbreaking stuff, and a world first.

A paralysed man is walking again thanks to Bluetooth.

So when Gert-Jan Oskam broke his neck in a cycling accident in China over 10 years ago, he was told he would never walk again.

So first neurosurgeons implanted electrodes in his brain which registers his neural activity, when he tries to move his legs, his thoughts basically.

Those readings or those thoughts are processed by an algorithm which converts them into pulses which are then fed into electrodes in his spine.

So the device in his brain connects via Bluetooth to the device in his spine.

Those pulses which reach the spine activate nerves, which switches on the muscles which are used for the intended movement, like moving his legs.

Basically, It's a thought-controlled Bluetooth device that connects the brain, which regions of the spine that control movement.

It's a digital bridge which bypasses a spinal cord injury.

When the device was switched off after use, Jan Oskam still had some function in his legs and scientists believe that the connection formed between the spinal cord and the brain helped to regenerate some of those nerves.

Well, science has confirmed that dogs officially need to be employed in the hospital.

This new study makes fur babies evidence-based.

In the Shizuoka Children's Hospital in Japan, they were trained full-time dogs that were used in the children's hospital for a number of duties.

Now these aren't your average puppers, They are fully trained therapy dogs which do a number of things.

They visit patients' bedside, they walk with the children to surgery, they cuddle them when they're stressed to make them fall asleep.

The study surveyed 431 medical professionals and 73% rated the dogs as highly effective at increasing patient cooperation during examinations and procedures.

And if you've ever worked with children in any capacity, you will know how difficult they can sometimes be.

And this is a little bit sad, maybe with a silver lining, but they were also noted to improve palliative care in children with terminal illnesses.

Now dogs aren't going to cure any diseases as far as we know right now, but this model of dog service use in children hospital is potentially a model that we could use as an adjunct to traditional care to improve patients quality of life and symptoms potentially.

And if you're wondering which breeds were employed in the hospital it was golden retrievers, lab retrievers or a mix of both because these dog breeds specifically love to please their owners and patients.

I'm Cameron Esposito and I have a lot of jobs.

I'm an actor, you've seen me on ABC's A Million Little Things.

I'm a stand-up comic, best-selling author, but I am no expert at survival.

On my new podcast, Survivor Die Trying, we're going to learn together From shark attacks to tsunamis and bad breakups, this is your one-stop shop to prepare for the absolute worst case scenario.

Join me and some special guests on Survivor Die Trying, a comedy podcast that prepares you for anything.

Listen and follow wherever you get your podcasts.

Imagine trying to find an undigested seed in a heap of steaming shit.

That is how hard it is to find good, accurate health information online.

But thankfully, there are those online who can sift through the bullshit and come up with the treasure amongst the trash.

James Smith has been a personal trainer for 9 years and he's written 3 books which has seen him become a Sunday Times bestseller.

In addition to his books, he's got a podcast and his own personal training app.

Ever since he started, he's been swimming against the waves and calling out bullshit left, right and centre, which is probably 1 of the reasons why we get along so well.

I mean, you've now been doing social media.

I've been following you since about 2018, I think it was.

You obviously are someone that divides opinion, polarizes people, but actually what you're saying is not a polarizing opinion, it's fact.

For example, 1 of the first things which stood out to me was calorie deficit, calorie fucking deficit.

And he had the t-shirts with the CFD, all of that stuff.

And for me, you were saying that in an era, this is like kind of that 2010s era, where people like V shred were at the peak of their game and they were really subscribing to that somatotype model, you know, people are ectomorphs, endomorphs, mesomorphs, whatever, and AthleanX and all of these people who were ripped and in great shape, flexing their authority bias and people were buying into that.

These are seasoned bodybuilders and fitness professionals almost pushing that dogma even more.

And then you come out of nowhere, you know, someone is a personal trainer in a gym in Australia saying, no, it's not all of that, it's just this.

What kind of reception did you get when you first started you know trying to reverse that traditional bullshit?

Yeah at first it was not a lot of response to answer simply then I remember I didn't have a camera I didn't know how to edit My laptop was like a 2011 MacBook, so my only option was to go live.

So there's a period of like, maybe a year in 2017 where at 3 p.m., I'd be at the gym all day with my clients, I'd walk home, 3 p.m.

In the UK during the summer, you gotta go live, and if you wanna get some engagement from that live, you've got to do it and say it in a certain way.

So I was like, what can I have as a clickbait title?

What could be like almost anti-establishment?

What can I say that's going to be controversial?

What could be something that gets them to tag their friend in.

So I'd think about it and I'd be like, okay, cool, go live, boom.

And it was like a peace to camera assault.

And I was just trying to educate people because there were big periods in my life that I could have done with that information.

I did an insanity workout when I was younger.

And like, it seems insane now, but no 1 told me, and everyone's like, well, you're a fucking idiot.

No 1 was like, eat less food, don't worry so much about the exercise.

Because I was training rugby like 3, 4 times

But then 2 for Tuesday's pizza, I was like, it just never occurred to me.

And if someone had just tapped me on the shoulder when I was

hey mate, maybe don't eat till like 2 p.m.

And with what you're doing with rugby, you'll probably lose a bit of weight.

Try eating better, which I wouldn't have done at uni, or go to 1 meal a day.

Or mate, have a protein shake before rugby training, 1 big meal with your mates after, Domino's pizza, whatever.

I never treated The amount of weight I had is like a currency or a bank balance because all of us, every day we have to think about finances.

That's why rich kids have a distorted reality of the world.

They don't actually have to manage their money.

They never have to worry about it running out.

We have like a polar opposite with composition.

And yeah, for a long time, I just, I never really thought of it like that.

My knowledge and standpoint for so long was all about exercise, do more exercise, run more.

Like, you've just brushed your teeth, you're dehydrated, you're going out and trying to run 3 miles before going to the office.

Like when you can empower people with the knowledge, like, hey, there are so many different ways that we can elicit an energy balance deficit, then people become empowered.

Because when they actually understand it, they're like, what, so I don't have to run before work?

Mate, go for a walk on your lunch break, reduce the amount of calories coming in here, we're gonna give you some more protein at night.

But the problem is, you know, even though you broke that mindset of people of thinking beyond, I need to do intermittent fasting, I need to do keto to lose weight, I need to think about my insulin resistance and starvation mode and all that.

You, Dieron, and a bunch of other creators started to bleed in more science into that fitness space, which is all about just person opinion and anecdotes for a long period of time.

But now there seems to be a new wave of pseudoscientists who blend in misinformation with kernels of truth.

For example, there's a whole spate of people in supermarkets, topless or whatever, looking at, picking up foods and whatever out of the shelves and commenting on them and then quoting studies.

Like there are 5 scientific journals published every minute.

So in, you know, in the kind of universe of like publications, you can find something, whether it's like a cell study or a mouse study, that will suit your point that you're making.

But Now there are all these now doctors, so-called doctor, I don't know if they're doctors, but who have gone rogue, and then promoting all these like really batshit ideas.

I've seen this, there's a lot of people and they just put like a PubMed code.

And you're like, bro, what, you think I'm gonna, that's your way of saying that you're smart.

Like screenshot your fucking video, go onto PubMed and be like 002419, you know?

Then what, I'm gonna read through every single part of it, scroll down to the conclusion.

I've always been banging this drum, like artificial sweeteners, I don't think are bad.

And even if they were bad, or they're bad for gut microbiome, whatever, I'd be like, it's probably still the better of 2 fucking evils, right?

So let's, then people are like, yeah, but this study says that it shows you'll get cancer.

And then I do videos, I'm like, but This is where I like to think that my expertise come in.

I'm like, okay, how can I take this point?

How can I bring the solution, but present it in a way that people enjoy watching it?

So I'm like, hey guys, you know, I just really want to apologize.

Everything, you know, I've been saying artificial sweeteners are safe.

I've been saying that, you know, you can drink Coke 0, but the truth is that you should never, ever, never consume these things if you're a fucking rat.

You know, like, and then people are like, you can take them along with it, have some fun with it, and then their friend who's like, ooh, full sugar's better, they tag them in the comments.

I've been subservient to my audience with something that is gonna benefit their life.

And at the same time, give them a little chuckle because, you know, I said this to you before, nothing makes me more excited than having a content idea about something.

I watched the 3 top videos from the 3 smartest people that I respect, because I can respect someone and completely appreciate how smart they are, whilst at the same time think they're fucking boring.

And that was Probably the biggest breakthrough revelation for me was maybe 2014, 2015, looking at the top dogs in the industry going, more muscular than me, smarter than me, more experienced than me, but all you cunts are boring.

Yeah, they can't get that audience retention to follow along.

There was something very recently, the WHO, World Health Organization, you know, coming out in their report based on, you know, their empirical evidence that sweeteners, the non-nutritive sweeteners, or the artificial sweeteners, are not good for long-term fat loss.

This reminds me of when people in the fitness space, you talk about sweeteners and sweetened beverages, They go, just drink water.

And you're like, fucking no brainer, mate.

But the truth is that person wants a cold, fizzy, refreshing drink that tastes sweet.

They want it because they've always fucking had that.

Then when they go to lunch, the psychological pain of picking up a water just reminds them they're on a diet.

So I've got Coke 0 in my fucking bag right here, just in case I fancy something fizzy.

So what we need to do in so many situations is to do food swaps because we've seen what happens.

Everyone should have anecdotal imperial evidence of what happens when you replace the foods you eat with healthy foods, you don't stick to it.

Instead, we should be looking to swap foods for slightly better versions.

There's something that I did a video on maybe 7 years ago, I called it food intensity scaling, where I said, identify all the foods in your diet instead of swapping out a donut for broccoli or whatever.

I was like try and find something that is lower on that scale So for instance if you said James What's the food you could easily consume a thousand calories of I say ice cream, but you wouldn't just say ice cream You say what is it?

Okay, fish food Ben and Jerry's fish food.

What I'm saying is, if we swap the Ben and Jerry's fish food for a Haagen-Dazs vanilla, would you still enjoy it?

Maybe even, you like pizza on a Saturday.

Cool, Everyone likes pizza on a Saturday.

Why because that's a reduction in calories you still get the hedonic food from a fast-food take away Whatever it is then over time you pick these things people have done this for years when you go from Normal potato fries to sweet potato fries in some respects you might consume less.

So like we're actually doing these kind of like food intensity swaps and 1 of those that may not be easily to spot in a massive study is when you take someone that drinks fucking, I had an Uber driver the other day telling me how much weight he's gained since he started driving Uber.

I said, mate, just, and he was like, oh, so the sweetened ones aren't bad for me.

I said, mate, you swap in those fizzy drinks for a sweetened sugar-free version, couple hundred calories a day.

When I was in med school, I was very near a gym.

I'd skip lectures, go to the gym, I'd have fun, You know, I'd go with my mates.

It's like a kind of almost like a little, you know, an hour or 2 where you hang out with your mates, you do some weights or whatever.

And I didn't necessarily do the gym for weight loss.

And I liked the fact of, you know, getting stronger.

I was swimming and playing cricket then, so it was like, help me bowl faster, you know, if I lifted more weights, I had more kind of strength in my shoulders, etc.

So I did it for functional and fun purposes.

But this kind of fat loss world, almost, the fitness industry with all the supplements, authority bias of random people telling you to do this, this and this of fat loss.

I mean, it's almost now covered the point that there's actually so many other things that prop up your health, not just your weight.

So 1 thing that I used to do when I went to the gym when I was younger, I used to work a 9 to A5I used to work in Oxbridge and I lived in like Ascot.

I'd sit in like fucking 40 minutes of traffic a day.

I realized if I woke up half an hour earlier, I missed all the traffic, but I got to work an hour early so I then was like fuck I'll get gym membership next to where I work Seem kind of counterintuitive so got up half an hour earlier, which wasn't what went to bed half an hour earlier Drove all the way to Oxbridge 0 traffic, and it was a more enjoyable drive.

get to the gym and then it meant when I left the house I was wearing gym gear suddenly my world was nicer getting a suit and leaving the house knowing you're about sitting traffic It's fucking shy.

It didn't matter an hour before I needed to be at work So I train and I'd be so happy I didn't sit in traffic this morning.

I've got half an hour of my flipping life back.

Suddenly I had a place to just escape a job I didn't enjoy.

I now had to sandwich my morning between something I enjoy going to work, something I enjoy going back to work and then I can go home Yeah, I this was the first time in my life.

I had my work I had my home and I had the gym

but not in the sense that your goal was fat loss

I didn't know what I was doing, didn't know how to squat, didn't know how to deadlift.

I know that at 22, I couldn't deadlift my body weight.

And I think that maybe younger listeners need to appreciate that at 30, I was considered 1 of the like nation's most in-demand personal trainers But at

Yeah, didn't know how so going to that place.

I'm in that third place For so many people I talked to about getting into fitness That's what I'm saying have another place you can go to.

Like, just going in there and having some time to yourself is worth it already.

Then we can optimise, then we can give you a programme, then we can give you something to work towards.

I would actually get someone to embrace that before calories, everyone's like, Because I'm the calorie deficit guy, everyone's like, oh, you count calories, my fitness power, I'm like, that's just a really effective tool.

And it doesn't work for everyone, but it worked for me.

Calorie deficit is obviously like a very simple concept to say, but even like the sustainable changes, you know, Like if someone does want to lose weight, not that they need to, if whatever, if there are, you know, normal way to end their training, but, you know, people are now trying to rush that process as being the primary thing they want to achieve.

And that's why more and more people are using things like a Zempick off-label to lose weight.

And I think you said you were about to use it at 1 point but you...

So and again so you've got a semaglutide, you've got a zempic, you've got saccender.

So the semaglutide is the active ingredient in a zempic at a higher dose than what they'd use for diabetics.

So I remember straight away, I was talking about all 3 of these in a YouTube video, and someone was like, they're different.

The point I was saying is we've now got injectables that kill hunger, but this is the interesting thing about this.

First of all, yes, I was gonna do the video I was gonna get Shreddy Kruger then at the end be like guys like gaunt as fuck I tried the injections whatever but I checked out the side effects.

I was like fuck that I'd rather do a video about something else 1 of the key things that I actually quite like about these weight loss injections is, for so long, everyone's saying their metabolism's broken.

Yeah, James, you know, I've yo-yo dieted all the years, my metabolism's broken.

Oh, you know, my thyroid wasn't good 5 years ago, all of this shit.

I go, if I give you this injection, you will lose weight.

This injection doesn't impact your metabolism.

What it does is it stops you fucking eating.

3 weeks later, they're like, I've lost a stone, I've lost 2 stone.

And I'm like, yeah, that broken metabolism of yours just churned through calories and you lost weight.

Because you stopped putting things in your mouth.

I mean, the thing is I deal with bariatric patients.

I've done, you know, surgery on bariatric patients in the past.

And for me, obesity is, it's quite a complex topic, obviously, in the NHS anyway, the criteria for having bariatric surgeries, you need to be above BMI 40 or above 35 with conditions like diabetes or other metabolic conditions which, you know, are not in the best control.

So then they have, you know, various bariatric surgery, Roux-en-Y bypass, gastric bypass, sleeve gastrectomy, you cut a bit of the stomach, all these sort of things.

But actually, those are very difficult to reverse if you do like a surgical operation on someone.

Rewind-wide bypass, you're literally taking the small intestine and re-plumbing it.

You are rewiring the plumbing inside, which is very difficult to reverse and has obviously significant complications if things do go wrong.

So actually having the injection for that subset of people who are very overweight, obese, with metabolic conditions, it's a game changer.

But I'm now seeing, and I saw a patient maybe last year who was using the Ozempic off-license for weight loss.

This person was in pretty good health, actually.

But the reason for taking it was that they wanted a six-pack before their wedding, and they came in with pancreatitis, an inflammation of their pancreas, because that's 1 of the risks of a Zempik.

Not to mention obviously with the dramatic weight loss, if you're doing it in someone like yourself and you took a Zempik, yes, you'd lose weight, but would the body composition change be favourable for you?

Like the amount of muscle you'd lose and the bone density loss, would that pay for the cost of fat that you'd lose?

It would give me like, it would only just increase the amount of problems.

I thought for 30 days I could eat it but like you say I think it's great that we're not having to perform surgery on people but the reason I'm kind of anti these jabs is because right now the listeners I reckon 90% of them don't need it and want it

of them need it can't get it yeah So like the talk into the larger audience here,

you and I have both come across lots of nonsense online What would be the 3?

Worst things or trends fads Thing statements that people have said online in your career online

Any single thing they say promotes health.

I hate it because so many people think they just need to do that thing.

Sleep, sunlight, stress, relationships, nutrition, training, strength, whatever it is.

1, yeah, because you need the, you know, enough cement in all the pillars to hold up

We need to sit back and say, tell me about your life, because most of the time, people tell you the things that need to change.

came back from Bali, I'm in Australia, and I Had a bit of pain around by my kidney So I might need to go to the doctor.

See all The Referral with Dr. Karan transcripts on Applepodcasts

Fat Loss Expert: Diet Myths, Weight-loss & Counting Calories