If You Want To REVERSE Chronic Disease & End Inflammation, WATCH THIS! | James Maskell

James Maskell 0:00 There's this one resource that's inexhaustible, and it's ridiculously powerful, and it's being used to 0% of its potential, and I believe that it's a critical part of the future of reversing chronic illness.

Dr. Rangan Chatterjee 0:11 [upbeat music] James, good to see you, mate.

James Maskell 0:17 Mate, great to be here.

Dr. Rangan Chatterjee 0:18 Also, we had a great dinner last night. And over dinner, you said to me that for a lot of people, their friends are getting in the way of them being healthy.

James Maskell 0:32 Yeah.

Dr. Rangan Chatterjee 0:32 They've either got to choose their friends or their health.

James Maskell 0:35 Yeah.

Dr. Rangan Chatterjee 0:36 What do you mean by that?

James Maskell 0:38 Yeah, so, you know, we've been running, um, group medicine for the last two years all online. So getting groups of people together and taking them through a lifestyle enhancement process. And in the first month, we asked the question, "Who out of all of your friends and your family is gonna be supportive of this transformation?" Right? And what we found is that very few people had friendships that actually reinforced healthy behaviors.

Dr. Rangan Chatterjee 1:06 Mm.

James Maskell 1:06 And in fact, a lot of friendships were built on really unhealthy behaviors. In England, going to the pub. In America, tailgating. You know, there's all these different things that are built around these really unhealthy behaviors. And so when people are faced with the fact, like, do I want to have... Do I want to reject these friendships, right? And loneliness is the biggest driver of all-cause mortality. A targeted rejection from a social group can increase your chances of depression by 20 times. So that's one path, right? Leaving that group behind. And on the other side, you know, if you've got an autoimmune disease and you're going to pizza and beer night every Friday, it's very difficult, you know, to get improvement in an autoimmune disease with that consistent, uh, diet. And so many people who are at the beginning of thinking, "Can I actually reverse my chronic illness?" Which is sort of the journey that they're starting with, are faced with this really, really impossible choice.

Dr. Rangan Chatterjee 2:03 This is just so powerful. And, um, I'm pretty sure, James, that every single person listening to this or watching this right now, if they really think about that question, "Who in your life is gonna be supportive of these changes?" I kind of feel that will bring up a whole load of emotions for different people because as a doctor, that's something I've seen time and time again, is that, you know, often it's in January when they've got the motivation, they can, you know, follow the plan for a few weeks, and they're feeling better. But the life around them, the environment around them, the people around them are not swimming in the same direction, so that change becomes almost impossible to turn into, like, a long-term transformation.

James Maskell 2:52 Yeah, um, and other people could actually almost actively sabotage it because they have their own shame and guilt about not making those changes, and so it's like, "Come on, have another drink," or, you know, whatever that is, because they want to feel better about themselves, too, and there's these subtle psychological things that are happening inside friendships. And, you know, ultimately, what we've seen is that when people can build new, healthy relationships that support these new healthy behaviors, it's not only transformational to people's sort of mental state, but actually it gives them the right sort of accountability and support structures to make really profound changes-

Dr. Rangan Chatterjee 3:28 Yeah

James Maskell 3:28 ... in their health that, as you know, turn into really profound changes in their diagnosis, health status.

Dr. Rangan Chatterjee 3:35 Yeah, something I've been pondering a lot over the last few years is this idea that, you know, aren't we fundamentally getting something wrong as doctors? Not intentionally, but as a result of the way that we practice, which is that we're fundamentally... If we, if we go from the starting point that 80 to 90% of what we're seeing now as medical doctors is in some way related to our collective modern lifestyles-

James Maskell 3:59 Yeah

Dr. Rangan Chatterjee 3:59 ... okay, again, I'm not putting blame on people. I get it that life's tough and, and it's difficult for people. But if that's the starting point, then the, the s- the next step is that a lot of what we're asking our patients to do is make changes to their lifestyle.

James Maskell 4:13 Yeah.

Dr. Rangan Chatterjee 4:14 Right? And our patients want help in making changes to their lifestyle.

James Maskell 4:19 Mm-hmm.

Dr. Rangan Chatterjee 4:20 But a lot of what we do, the way the system is set up, is to see an individual by themselves-

James Maskell 4:27 Yeah

Dr. Rangan Chatterjee 4:27 ... talk to them about their health, and actually ask them to make changes in isolation. And this is, of course, why things like parkrun-

James Maskell 4:39 Yeah

Dr. Rangan Chatterjee 4:39 ... are proving so transformative because, you know, parkrun, you know, these kind of events where people do a 5K walking or running or walk-running, whatever, and people, whether they're attending or they're volunteering, are having their lives transformed because it's the power of the group and the community. Now, you mentioned a term, group medicine.

James Maskell 4:58 Yeah.

Dr. Rangan Chatterjee 4:58 I reckon a lot of people listening at the moment would not be familiar with that term.

James Maskell 5:04 Yeah.

Dr. Rangan Chatterjee 5:04 So what do you mean when you say the term group medicine?

James Maskell 5:08 Well, it, the reason why they're unfamiliar with it is because it hasn't really existed, right? This is a new area that I've been working in and pioneering in and trying to really understand. Um, you know, something that most people will be familiar with is Alcoholics Anonymous, right? Where if you went back 100 years and you asked the average doctor, "Is alcoholism treatable, reversible?" They would say, "Absolutely not. You can't reverse it." That's because doctors and drugs can't reverse it. But a supportive community of mentorship, support, and accountability is actually very effective at getting people to no longer be addicted to alcohol. And as I looked at these chronic illnesses like Type 2 diabetes, heart disease, Alzheimer's, mental health issues, like the big chronic illnesses that affect the majority of the population, even things like chronic pain, they're actually a lot more similar to alcoholism than they are to being hit by a car. And yet we sort of use the medicine of, uh... We use acute-style medicine to- with these chronic illnesses, and essentially that was the beginning of a thinking process of, like, could we take some of the ideas from Alcoholics Anonymous? Like, the most obvious one is- Knowing someone who got sober, right? So if you have a chronic illness, maybe the most important person that you need, not a doctor, is actually knowing someone who reversed that chronic illness. And what if we could introduce those people to each other in a supportive container where other people... Where it was just a norm and, uh, and all these people had made progress on it, what would happen if we did that? And as we've innovated in that, both in person before the pandemic, and now online since the pandemic, what we've seen is that that person is really missing in healthcare, that mentor, that support, that sponsor, and I believe that it's an im- a critical part of the future of reversing chronic illness.

Dr. Rangan Chatterjee 6:59 It's a peaceful analogy, that. It, it really is. That we use this acute care model that works very well for the car crash and the heart attack-

James Maskell 7:09 Mm-hmm

Dr. Rangan Chatterjee 7:09 ... to, in that moment, treat it and, and, and help someone get out of that emergency state or that, that acute illness, whatever it might be. One of the things I've said many times in, on this podcast, and you've been talking about for years in America, is this idea that that acute medical model that, that works well for acute conditions is not translating very well to chronic illness.

James Maskell 7:34 Mm-hmm.

Dr. Rangan Chatterjee 7:34 You know, anxiety, depression, chronic pain, type 2 diabetes, obesity. Um, even things like gut problems and-

James Maskell 7:42 Yeah

Dr. Rangan Chatterjee 7:42 ... I think even low libido I'd put in this category. You know, these-

James Maskell 7:45 100%

Dr. Rangan Chatterjee 7:46 ... these are all these kind of chronic conditions that are bothering us and affecting us, but we still see these things as medical issues.

James Maskell 7:54 Yeah.

Dr. Rangan Chatterjee 7:55 And I think that's what's really interesting about your work to me. Are these medical issues or are they actually social issues?

James Maskell 8:04 Yeah. Well, it's really interesting. As I started researching, uh, my book, and I, I did a TEDx talk on this topic, started to really see that many things that are now medicalized were actually just a part of community, right? Um, before technology, you know, if you look at technology through the Industrial Revolution, and then, um, now into the Information Technology Revolution, all that, um, so many of the things that used to happen, um, as part of community, uh, are now sort of outsourced to the medical system. So, you know, Grandma, um, had a lot of knowledge about how to keep you healthy. Um, you had, you know, people in your life like, uh, what we now are like babysitters and grief counselors. Like, this was just things that were provided because a group of people knew each other and supported each other through those kind of things. And as, uh, technology has dissipated community, there's this sort of missing layer, and everyone's just on their own, me against the world. And ultimately, the need for all these services just goes up and up and up and up. And ultimately, you know, community is something that, um, is a such an elegant solution to so many of those things, but it's been lost. And ultimately, you know, my, my thesis is essentially that we need to recreate that community. Now, that can happen in many different ways, but ultimately, if the issue is chronic illness, and people are coming into the medical system because that's where lonely, sick people end up, then the medical system is the place to re-energize community.

Dr. Rangan Chatterjee 9:34 Yeah. I, I don't think it's an over-exaggeration to say that you are someone who is transforming healthcare in America. Um, what you're doing, yes, with your books, but more in terms of the stuff you're doing now in terms of helping clinics, doctors, healthcare systems utilize group medicine in a way that's effective and working and improving health and reducing costs, is transformative, right? I, I wanna get to that. But I think you just made a really powerful point that the lack of community that we have now is ending up as medical problems that never were medical problems. You know, I, I remember chatting to Tim Spector on the show a few months ago, and I think I said to Tim, "You know, one of the big problems I, I, I think in, around the nutrition topic-

James Maskell 10:27 Yeah

Dr. Rangan Chatterjee 10:27 ... is that we need nutrition experts," right? Fundamentally, I think that is problematic, that we are now... We need a guru. We need an expert to tell us what we should be eating.

James Maskell 10:41 Yeah.

Dr. Rangan Chatterjee 10:41 When have we ever had that before? It's, it, it... We would've learnt it from our parents and our tribe.

James Maskell 10:46 Yeah.

Dr. Rangan Chatterjee 10:46 You know, "This is what you eat. This is what you avoid. This is the kind of things you eat. This is the time in which you eat."

James Maskell 10:50 Yeah, absolutely.

Dr. Rangan Chatterjee 10:51 And that we now need books and podcasts and all kinds of things to teach people what their community would've given.

James Maskell 10:56 Yeah.

Dr. Rangan Chatterjee 10:56 But this goes beyond health, doesn't it? Because one of the reasons I think so many relationships, marriages are struggling is because, again, we don't have that community. We've moved away from our homes, our friends, our tribe, basically-

James Maskell 11:14 Yeah

Dr. Rangan Chatterjee 11:14 ... for work, for better opportunity. And I appreciate everyone has lots of different ways of bringing up kids, but let's say there's a romantic couple-

James Maskell 11:21 Yeah

Dr. Rangan Chatterjee 11:21 ... who've got kids. Usually now, it's not unusual for them to be hundreds of miles away from their parents-

James Maskell 11:29 Yeah

Dr. Rangan Chatterjee 11:29 ... from their childhood friends, from whatever. And, and there can be pros of that, for sure.

James Maskell 11:34 Yeah.

Dr. Rangan Chatterjee 11:35 But, but it means then that no wonder so many relationships are under strain because they're expecting their other half or, or their partner to be everything.

James Maskell 11:44 Yeah.

Dr. Rangan Chatterjee 11:44 You know, the grief counselor, the, the lover, the, um, supportive friend, the whatever it might be.

James Maskell 11:50 Yeah.

Dr. Rangan Chatterjee 11:51 As someone from an immigrant family-

James Maskell 11:53 Yeah

Dr. Rangan Chatterjee 11:54 ... I, I've been thinking, I, I wonder what you think about this, but I think a lot of immigrants l- let's say an Indian immigrant, let's say, let's talk about my family and my parents' friends, they left India in search of a better life.

James Maskell 12:09 Yeah.

Dr. Rangan Chatterjee 12:10 But then the question is, what does a better life mean?

James Maskell 12:13 Yeah.

Dr. Rangan Chatterjee 12:14 Because they literally leave all their family, all their friends, all their community, all their culture-

James Maskell 12:20 Yeah

Dr. Rangan Chatterjee 12:20 ... to go to somewhere completely different. Yes, on paper, they may be earning more money.

James Maskell 12:25 Yeah.

Dr. Rangan Chatterjee 12:25 But I've really come to the conclusion that I think many families now are actually regretting the trade that they made. They, they got more money- More material wealth, but I think they lost a whole lot more in that process

James Maskell 12:42 100%, man. I mean, I'm, I'm living proof of that too. So, you know, I've lived in America for 17 years. I grew up here in the UK. I had the American passport. For 17 years I moved away, met a girl, got married, had kids. My first daughter was born in New York. Extremely isolating. The first year we were there was Snowmageddon. You couldn't [laughs] go outside-

Dr. Rangan Chatterjee 13:01 Yeah

James Maskell 13:01 ... for four months, right? And no one else I knew had kids, 'cause we were 32 when we had kids. People in New York have kids when they're 45, [laughs] right? So then we moved to LA, really good weather, but, you know, better for bringing up the kids, but still isolated in the fact that we didn't really know anyone else when we moved there and who had kids. And eventually in 2018, we actually ended up moving back to the Sacramento area where my wife's family's from because ultimately we realized, like, am I really gonna entrust, um, uh... What proportion of my kid's life do I wanna entrust to a random babysitter that's trying to be an actress, right? I would hear my daughter say things and I was like, "Where did you hear that?" And I was like, "It's the babysitter's." So then there was a real moment where I was like, hang on a minute, it's really important to have family around. My wife's family is from the Sacramento area. And so it was really important to me to, um, you know, give my daughter, now two daughters, the opportunity to be around people who genuinely cared for them for reasons of, you know, altruistic-

Dr. Rangan Chatterjee 13:59 Mm

James Maskell 14:00 ... and, and real love, right? So that was the first thing. And I will say, um, I could visibly see the, my daughter's nervous system shift when she, when we moved there, and she kind of realized that she knew and trusted everyone around her, and that there was no, you know, sort of random new characters coming into her life every day. There was a serious moment of, like, that I saw, okay, we've done the right thing. Beyond that, you know, when I moved there, I realized, like, I don't know anyone here.

Dr. Rangan Chatterjee 14:29 Yeah

James Maskell 14:29 You know? So who, who's gonna be my new friends, and how am I gonna... As someone who's interested in community, what sort of community do I want? And, you know, ultimately, one of the best decisions that I ever made in my, in my life, in the last three years I've been part of a men's group. So every week, uh, for three hours a week, there's a group of anywhere between, you know, four and nine of us. There's nine of us in the group, but not everyone can make it every week. Sit in a circle for three hours and get into it. Right? Get into what's going on in our lives, get into, um, really understanding each other and supporting each other through the ups and downs of life. And, and I realized until I had that group, I was kind of dumping all of that on my wife, right? And it's very difficult to have, um, a nourishing relationship when, you know, uh, being an entrepreneur, being a dad, um, you know, just being in the world, uh, you, you know, it was, it was... There's something really powerful to be able to have a group of emotionally mature men to spend time with so that not all of that stuff is just being sort of dumped on, um, your significant other. It's been really transformative for me.

Dr. Rangan Chatterjee 15:39 You said to me last night that these men's groups have had a massive impact not only on you, but also your marriage.

James Maskell 15:47 Yeah. Yeah, absolutely. I mean, I'm, I'm grounded. I'm in integrity with my word. Um, I show up as a much better father. Um, I don't bring the frustration of whatever's going on in my day, you know, to my wife, unless there's something that we need to connect about. If there are things that I need to connect about with my wife, I have other emotionally mature men in that group. Part of the men's group is actually building a capacity to feel, right? What I realized is my capacity to feel, feel emotions, had been blunted somehow. Um, drinking, um, whatever other things that, you know, I had, I've done there. That was... It was, I realized, like, I had a sort of a, sort of a deadness inside and that I couldn't feel the emotions that I could see that other people felt. And through this process, you know, the, the process that I'm in, the group that I'm in, has a number of different factors to it. But each week, the first thing we do after we sort of share, okay, what's going on in our lives and what do we need to get out in order to be really fully, fully present for the group, is about just sitting there and thinking like, "How am I feeling?" Right? "And how am I feeling today, right now in the present?" And ultimately, like, that's a practice, and if you do it every week for three years, you start to realize, like, actually, I am feeling a little bit of tension, or I am feeling... You know, I feel it in different parts of my body. I'm feeling, you know, joyful or anxious or whatever that might be, but it's a practice.

Dr. Rangan Chatterjee 17:24 So it sounds like having a, a community around you, this men's group-

James Maskell 17:28 Yeah

Dr. Rangan Chatterjee 17:30 ... not only is it great 'cause it enables you to bounce things around with other people-

James Maskell 17:35 Yeah

Dr. Rangan Chatterjee 17:36 ... who have committed to saying, "Yeah, we're here to support you," but it also strikes me as though you're getting to know yourself better through this tight community. Because I guess before that, because without the structure, it's too easy for you to get caught up in emails and work and booze or whatever it might be-

James Maskell 18:00 Yeah

Dr. Rangan Chatterjee 18:00 ... so you never have to ask yourself the question, how am I actually feeling? It, it's something so simple, James, to me, yet it feels like... It feels totally profound. 'Cause I, I genuinely feel that one of the big problems these days for many people is that they're not in touch with their own emotions, feelings. One of the big reasons for that is that they're constantly distracting with other things. It's never been easier to distract ourselves.

James Maskell 18:23 100%.

Dr. Rangan Chatterjee 18:24 Yeah. That... It- so it isn't just the community's helping you. With that community, it's impacting your relationship with your wife. It's also impacting your relationship with yourself.

James Maskell 18:34 100%. Yeah, I mean, there's that. Uh, the next round that we go through after feeling is really about accountability. And I realized, like, I was very professionally accountable, right, where I had employees and team and mentors, and I'd be like, "Have I done my work this week?" And you know, I was accountable in that way, but I wasn't really personally accountable. I'm an only child, right? So I think part of it was like I could just get away with whatever I want because it's only in here, and if, if no one else saw it, then it didn't happen. But it resided in here-

Dr. Rangan Chatterjee 19:06 Yeah

James Maskell 19:06 ... and it was blocking that feeling. And then ultimately, you know, being in integrity with my word, right, and being accountable to my word. If I say I'm gonna do it, then I do it. That has been transformational for me. I mean, I don't drink anymore. Um, you know, I... And you know, I, I would, when I was younger, I would sort of laugh at people who had made that kind of transition, but ultimately the way that that's showing up for myself, you know, for my business, for my family, for my kids, you know, these are the most important things. This is why I'm here. I'm here for the mission. I'm here for my family. Everything else, you know, can just fade away a little bit.

Dr. Rangan Chatterjee 19:45 What I'm hearing is it's very much about waking up to a more intentional life, about a life where in the past maybe you're reacting, you're living on autopilot.

James Maskell 20:00 Yeah.

Dr. Rangan Chatterjee 20:00 You're just doing things 'cause people around you do them, and you think that's what you're meant to do. But actually, for a variety of reasons, through the power of community, the accountability that you have to have for these guys, you're making much more intentional choices. You know, you're not giving up alcohol because someone's told you you should do it, or, "Oh, it's good for my health if I do it." Actually, you're, from what I can tell, you're giving it up, at least for the time being, because you've realized it's not actually helping you be the person you want to be.

James Maskell 20:37 Yeah.

Dr. Rangan Chatterjee 20:38 That's very, very different. And again, coming back to one of the things I think about in terms of healthcare, a lot of the time people are trying to follow someone else's plan. "Okay, what should I do? Okay, how long do I do that for? What benefits am, am I gonna get?"

James Maskell 20:52 The doctor's plan.

Dr. Rangan Chatterjee 20:53 The doctor's plan, exactly.

James Maskell 20:55 Yeah.

Dr. Rangan Chatterjee 20:55 And [laughs] as I wrote in the conclusion in my last book on, um... So my fourth book on, on sustainable weight loss, I, I put, "At some point, this plan has to stop being my plan-

James Maskell 21:06 Yeah

Dr. Rangan Chatterjee 21:06 ... has to become your plan."

James Maskell 21:07 100%.

Dr. Rangan Chatterjee 21:08 'Cause you're the architect of your health and happiness. You understand what works and what doesn't. So-

James Maskell 21:14 The locus of control has to shift from the doctor to the patient. That's the key thing of the transformation of healthcare. Is the doctor in charge, or is the patient in charge? And the group is the structure by which that locus can be transferred and tran- and the, the patient can actually participate.

Dr. Rangan Chatterjee 21:32 So let's get into that. People currently think medicine is, "I have a problem with my health." Whatever country you live in, then it could well be, "I phone to make an appointment with a healthcare professional," maybe a doctor, maybe someone else, but, "because then I can tell that person about my problems-

James Maskell 21:50 Yep

Dr. Rangan Chatterjee 21:51 ... and they with their training and expertise can actually tell me what's wrong and what I need to do."

James Maskell 21:57 Yep.

Dr. Rangan Chatterjee 22:00 And the benefits of that for me are... Or the, the, the sold benefits are I'm gonna get expert advice-

James Maskell 22:08 Yep

Dr. Rangan Chatterjee 22:09 ... from a professional. My healthcare is private. I don't have to share it with anyone. This is a private thing. I've got a one-on-one consultation. Yet what you're doing with groups is showing that this [laughs] model that we're used to, that all healthcare systems that I'm aware of are currently set up around-

James Maskell 22:27 Yeah

Dr. Rangan Chatterjee 22:27 ... are fundamentally problematic for many of the conditions that we see.

James Maskell 22:33 Yeah. Let me give you my favorite example.

Dr. Rangan Chatterjee 22:35 Yeah, please.

James Maskell 22:35 And it's actually here in the UK. So Dr. David Unwin, 2016 NHS Innovator of the Year, what is he doing in his practice? So the first thing he works out is that Type 2 diabetes is reversible with diet, and you know this better than anyone 'cause you did it on the TV show like four times, [laughs] right?

Dr. Rangan Chatterjee 22:51 Yeah.

James Maskell 22:52 So he, he realizes that. But it's quite, like, labor-intensive to do that in a one-on-one GP visit when you've got a million other things to do. So Dr. David Unwin starts these Type 2 diabetes groups, which is essentially community support plus a low-carb diet. That's pretty much what it is. So he implements it into his GP clinic, and over the next five years reverses Type 2 diabetes in the majority of the patients who have Type 2 diabetes in his clinic. The savings on medication alone from doing that is 70- almost 70,000 pounds in that clinic, and they've shown that, and this was in the BMJ, that if you extrapolated that out to the whole NHS, that would save 270 million pounds, a quarter of a billion pounds. One chronic condition, right, just being done a little bit differently in a group, supported in that way. So you know, if we're here, if we wanna talk about the transformation of the NHS and you're looking at, you know, what sort of examples do we need to lead out of the pandemic to the future, look at that and say, "Look, is there, is there an example? Is that a good example of what we look?" Lower cost, more access, more love, more accountability, more support, more professional satisfaction for Dr. Rangan Chatterjee.

Dr. Rangan Chatterjee 24:04 Patients getting better as well.

James Maskell 24:05 Patients getting better and not reliant on the healthcare system.

Dr. Rangan Chatterjee 24:09 I mean, that's incredible, and you think those savings should have anyone in any healthcare system, their ears should be pricking up, going-

James Maskell 24:18 Yeah

Dr. Rangan Chatterjee 24:18 ... "Okay, [laughs] how do we do that?"

James Maskell 24:20 Yeah.

Dr. Rangan Chatterjee 24:20 And you obviously know how to do it 'cause you're doing it, right?

James Maskell 24:23 Right.

Dr. Rangan Chatterjee 24:23 And I'm very hopeful that what you're doing in America you're gonna be able to bring to the UK very, very soon, 'cause you, you're, you're figuring out what the obstacles are, what the problems are. We'll come to that, right? But what is it about a group then, right? What is it... You said earlier- The most powerful thing for someone who struggles with their alcohol intake and, you know, wants to reduce it and ultimately get off it-

James Maskell 24:51 Yeah

Dr. Rangan Chatterjee 24:51 ... is to know another alcoholic who no longer drinks.

James Maskell 24:56 Absolutely.

Dr. Rangan Chatterjee 24:57 What is the magic in the group that they're not getting from the experts?

James Maskell 25:01 Yeah. There's a, there's a key person that I would sort of... The term that I would use is a health coach, right? And that's the term that we use in America. And essentially, the health coach, it's not a health professional, it's not a dietician, it's not a nutritionist. It's really sort of this... It's the equivalent, in my estimation, it's the equivalent of the mentor in Alcoholics Anonymous, the sponsor. It's someone who's overcome a chronic illness, has learnt a ridiculous amount through that process. They have the lived experience of the disease, they have the lived experience of the reversal, and now they can be this sort of peer leader where you now know someone. You know, you, you're able to essentially hold space for someone else to come to their own conclusion, right? To support people in, in coming to that. So in the groups that we run, we have this health coach. In Dr. Dun- Dr. Unwin's model, what he realized is the first couple people that he helped reverse their Type 2 diabetes in the clinic, put them in the group, right? So it's not just Unwin saying, "Hey, the science says this. This is the most optimal thing. Look at the science." It's like, "Here's Jane, and Jane did it. Jane, tell us about your experience." You know, when we run these groups... I'll tell you something else. So now we're doing it virtually. I... You'll love this. Think about when you come on the first Zoom with a bunch of people you've never met. Most people have their camera off on the Zoom because, "What is this? I don't even know what I'm getting onto," you know, getting into and doing that. So what does the first... What does the coach who host these groups, what are the first thing they do? They share their story of their own chronic illness, how painful it was, how traumatic it was, the effect on their whole family. Then finding this new operating system of care, lifestyle medicine, starting to take care of themselves, learning, and then their journey back to being... not having the chronic illness, right? That journey. Bing, bing, bing. It just... The Zoom cameras turn on because people feel safe to be seen, because they're like, "That's me."

Dr. Rangan Chatterjee 27:06 This reminds me of one of the biggest things people complain to me about, whether it's in person or on DMs, on social media, is, "I don't feel seen and heard by my doctor." You know? "I don't feel they got me. They didn't really take it seriously."

James Maskell 27:20 Yeah.

Dr. Rangan Chatterjee 27:20 "I don't feel they really cared." Now, let me just defend the medical profession for a moment. I understand that the system makes it very hard sometimes, you know, if you are working in a model where there's 10-minute consultations. But even if you can do that as a doctor, it's not as good as someone who has had the same experience as you've had, is it?

James Maskell 27:40 No.

Dr. Rangan Chatterjee 27:41 And I can just see how that would be so powerful, where suddenly that person is like, "Yeah, I, I, I get it. It's hard. You know, I get it. It, it has an impact on your relationship. Sometimes, um, you don't want to get out of bed. Your kids need taking to school. You've got no energy." That's what connects you to someone else. Now suddenly that has more resonance. It's more, it's more like, "Oh, and you know those struggles, you know what that feels like, and you've got through them onto the other side. Okay, tell me more. I'm really engaged now." Rather than the, the, the more distant, the less engaged approach it might be in a more conventional, um, sort of appointment system, one-on-one with a doctor.

James Maskell 28:21 Yeah. I mean, the question I would just ask anyone who's listening to this is, like, if you have a chronic condition, how many other people do you know who had that chronic, chronic condition and reversed it? And if the answer's zero, you need to find those people. And they're out there. They have their own podcasts and books and other kind of things, in almost every condition, right? But ultimately, there's something super critical to learn from someone who's been in your shoes, and most people who have a chronic illness feel extremely isolated because they don't know anyone else that's going through the same thing. If you're addicted to psychotropic medication or pain medication, you don't know anyone that is, and ultimately those relationships may not be, you know, empowering. And ultimately what we've seen is that if you can find other people that have gone on the journey that you're trying to go through, you, you, there's a, there's a shared resonance, there's a shared experience. People feel safe, right? That's the big... It sends... Community sends the signal of safety, right? You're safe here. This is a safe environment where you're able to share because I'm starting off

James Maskell 29:21 by sharing my experience, and now it's safe for you to share. And look, some people feel safe straightaway. They're like, "Oh, great, I've been waiting to, like, tell my story." But other people, it takes weeks or months, and that's why the episodes of care that we've made is a six-month group, right? Because it's-

Dr. Rangan Chatterjee 29:38 What does that mean, episode of care?

James Maskell 29:39 So, like, you know, when in our model, when a doctor prescribes you into the group, the group is six months long, and the goal is each month we focus on one of the pillars of health. So the first pillar is community and connection.

Dr. Rangan Chatterjee 29:52 Yeah.

James Maskell 29:52 The first month is really about, can I create trust in this collective, right?

Dr. Rangan Chatterjee 29:56 Hence the first question.

James Maskell 29:58 Yeah.

Dr. Rangan Chatterjee 29:58 Who... Which of your friends, which of your community, which of your family are gonna support you in this change, right?

James Maskell 30:04 Exactly.

Dr. Rangan Chatterjee 30:04 So that all feeds into this first pillar, community.

James Maskell 30:06 Yeah. Other things that we do in that first month, SMART goals, right? Everyone who's ever made any sort of changes in business or otherwise in coaching, you know the SMART goals, right? So how do... What is your goal for this next six months? You've got enough time to do something really transformational. What do you want to do? And to- it to come from you. It's no longer the doctor saying, "You should reverse your chronic disease in the next six months." It's like, "I'm gonna reverse my chronic disease in the six months. That's what I'm gonna do," and that's like an internal motivation that's coming from them. The other thing is, how did I get here, right? How did I end up with a chronic illness, right? One of the things that... I think people hate this the most, is that in their mind, the doctor's kind of telling them it was like healthy, healthy, healthy, healthy, healthy, lupus. It didn't go down like that, right?

Dr. Rangan Chatterjee 30:50 Yeah.

James Maskell 30:50 The body was breaking down over time. That eventually leads one marker to be at a point where you have lupus, but it was a slow-

Dr. Rangan Chatterjee 30:57 Yeah

James Maskell 30:57 ... you know, dysfunction, right? Over time, you got more and more dysfunctional, and then at a certain time, your hemoglobin A1c goes over seven, and you've got Type 2 diabetes. But you had... Something was going on before.

Dr. Rangan Chatterjee 31:08 Yeah.

James Maskell 31:08 You weren't just healthy. It didn't just happen, right? So really understanding sort of like the, the where the illness came from. So that's, like, month one. And then also, we pr- we, we pair people with what we call a progress partner. When we started out, it was an accountability buddy. Turns out accountability's not that sexy, and people don't want it. But you just call it a progress partner, and everyone's like, "Oh, I want progress. That's cool."

Dr. Rangan Chatterjee 31:30 So it's the same thing, but-

James Maskell 31:31 It's the same thing. It's just the same thing

Dr. Rangan Chatterjee 31:32 ... you've rebranded it-

James Maskell 31:32 We rebranded for-

Dr. Rangan Chatterjee 31:33 ... to be something, something people want [laughs]

James Maskell 31:34 [laughs] So then, um, month two, what do we do in month two? What is the... What is the one thing that you can do that will make the biggest shift in your potential for chronic disease? What's the answer?

Dr. Rangan Chatterjee 31:48 Change of diet.

James Maskell 31:49 Food, right? So in that month, the goal of this program with each month is can I make one permanent change to what I eat? Now, the reason why you need a month is because you need time to fail, right? To try do something, fail, come back into the collective, share why it didn't work for you, and then sort of re- reshift that, you know, the, the, the, the plan. Whatever the plan was, if it didn't work, why didn't it work? Deal with that, and then come up with something that's gonna be real, and that's why we have challenges. And the challenges are really simple. In week three of the, each month, the challenge is, like, eat a few new vegetables, like, as an example. What is the impact of someone eating a few new vegetables on their physiology, right? If then you do it for the next five months, it can be transformational, right?

Dr. Rangan Chatterjee 32:34 Mm.

James Maskell 32:34 So there's that. So that's, you know, month two. Month three, stress, right? How do you deal with stress? How do you... You know, what are your... What are the ways that you deal with stress? Can you try some new stress reduction techniques? Month four, sleep. You know, I've heard you say a million times that a good night's sleep starts in the morning, so we really focus on what is your morning routine. The sunlight, having, um, good sleep hygiene-

Dr. Rangan Chatterjee 32:56 Yeah

James Maskell 32:56 ... not having the phone in the room. You know, we've had some people who've come through the group who are doing all of these perfectly, but their smart goal is, "I wanna change my relationship with social media," right? It can be that kind of thing. Like, people have their own goals, and that's the whole point. It's not like the doctor is saying, you know, "You need to do this." It's like people are coming up with their own one. The fifth month is all around movement, so it's like creating regular movement and structures where you can move every day. And then the sixth one is your environment. And so what you see, if you make one permanent change in each of those things, you are a dramatically different person-

Dr. Rangan Chatterjee 33:29 Yeah

James Maskell 33:29 ... by the end. And the outcomes prove it out, so anxiety, depression, pain, fatigue, sleep struggles. In our groups, the vast majority of everyone who has those issues in the groups have a remarkable transformation in that six months, a clinically significant reduction in those areas.

Dr. Rangan Chatterjee 33:50 I- it's just, you know, like a lot of the best ideas, they're just so simple at their core.

James Maskell 33:59 Yeah.

Dr. Rangan Chatterjee 34:00 It... You know, it, it, it makes so much sense. I'm sure everyone gets that straightaway. If you're doing this with people, other people who are trying to do it at the same time, you've got the support. "Hey, I tried to do that, guys. I fell off the wagon. You know, this happened." Someone else is like, "You know, I get it. I did that, but th- this is what I've tried. This is what I have."

James Maskell 34:17 Yeah.

Dr. Rangan Chatterjee 34:18 So it's, um... And, and the fact that you have a month on each pillar, and the request is you just make one permanent change in that month, it makes it very manageable.

James Maskell 34:28 Yeah.

Dr. Rangan Chatterjee 34:29 You know, reminding me, before March 2020-

James Maskell 34:33 Yeah

Dr. Rangan Chatterjee 34:33 ... um, this podcast was having lots of podcast clubs around the world. Certainly in the UK, there were, I think, at least 60 or 70 in the UK around the country where people were getting together. They were getting together with other Feel Better, Live More listeners and going for walks together and discussing what changes they were making from the last episode. And actually, I was about to attend one near to my house. They invited me. I thought, "I'd love to go."

James Maskell 34:59 Yeah.

Dr. Rangan Chatterjee 35:00 So whoever that was, if you get back in touch again-

James Maskell 35:02 Yeah, yeah

Dr. Rangan Chatterjee 35:02 ... I would love to start coming. But again, I think it's, even if you take a podcast, right? People listen to the podcast often while going out for a walk, or they're going for a drive somewhere by themselves.

James Maskell 35:17 Yeah.

Dr. Rangan Chatterjee 35:17 And they, they might get inspired by the conversation, think about their lives differently, go, "Yeah, I wanna make that change."

James Maskell 35:22 Yeah.

Dr. Rangan Chatterjee 35:23 But then they have to go back into their regular life with their friends and their community. And often it's a life that the reason they've ended up with the help in the, in the first place, their life actually, in some ways, it's not supporting the health outcome they want. It's actually supporting the health outcome they've currently got.

James Maskell 35:43 Yeah.

Dr. Rangan Chatterjee 35:44 I know it's, it's so obvious when you say it like that, but then the onus is very much on how do I make this change? How do I make this change myself? And it is this power of the group. I think... I wanna come back to your example in just a minute, but if you take it outside medicine for a minute-

James Maskell 36:00 Yeah

Dr. Rangan Chatterjee 36:03 ... think about practices people like to do, let's say yoga. A lot of people like to practice yoga. And because of busyness in life and, um, how many things people feel that they have to do these days, it clearly saves you time if you do a yoga class online or from a YouTube video, right? You don't have to go. You don't have to travel to it. You don't have to find a parking space or whatever you might do.

James Maskell 36:32 Yeah.

Dr. Rangan Chatterjee 36:33 So yes, it may be more efficient time-wise to do it at home. But actually, again, we miss out a big piece. There's something if you are in person with another 20 people who also want to practice yoga, and the interactions you get beforehand, the struggles other people may have, and then you see what the teacher says to them, you go, "Oh, you know, maybe that's what I'm..." You know, there's something about being together. I'm not-

James Maskell 36:58 Yeah

Dr. Rangan Chatterjee 36:58 ... of course, it's not either/or. But I, I often say to my patients, "If you like doing this at home, and you do 10, 15 minutes a day on Zoom or on a YouTube thing-" If you can, go to a real life club as well or a class-

James Maskell 37:11 Yeah

Dr. Rangan Chatterjee 37:11 ... where you're surrounded by other humans, and it really is transformative, isn't it, when we engage with these groups?

James Maskell 37:16 Yeah, super transformative. There's another amazing example from the UK that I'd love to share with you-

Dr. Rangan Chatterjee 37:22 Yeah, yeah, yeah. Go for it

James Maskell 37:22 ... because I guess the question might have people like, "What does this look at s- like at scale?" Like, could this really be a transformative agent for the world, like if it was done? And right in the UK, there's another great example, actually quite near where I grew up, and it's a town called Frome.

Dr. Rangan Chatterjee 37:34 Yeah.

James Maskell 37:34 And you've actually had, uh-

Dr. Rangan Chatterjee 37:35 Julian Abel

James Maskell 37:36 ... Julian, yeah, on the podcast here, so-

Dr. Rangan Chatterjee 37:37 A couple years ago

James Maskell 37:38 ... you know, their thesis was exactly this: people are lonely, and that's driving, you know, th- these, um, health outcomes. So in Frome, which is 115,000 people, um, what they thought is, could we make... Could we solve loneliness? Could we cure loneliness in the town of Frome, and how are we gonna do that? There's five medical practices, so they hired a coach for each of these practices. The coaches spend half their time in the clinic speaking to people, and half the time in what they call these talking cafes, right, where people, um, they sit in cafes and actually just meet with people. But the key thing that they did is they, they took an inventory of every group that was happening, not just health groups, but all kinds of groups, church groups, sports groups, men's groups. They took a whole inventory. There were 2,000 groups. They whittled it down to, I thou- 400 that were regular, anyone could join, had a s- you know, constant location, consistent location. And so essentially, this was a website where you could see, and essentially what, what the, what people would do if they came in and they saw that the- these people were lonely, especially older people, they would sit with a coach, and the coach would say, "What do you like doing? What do you wanna be part of, what, you know, do?" And then say, "Hey, look, here are the different options. Which one are you gonna... Meets this time per week at this location. Go get 'em." The other thing that happened is they recruited 1,500 just people in the community that walk around with this green lanyard, right, to let them know that they're a community, uh, connector, and they would just send people to the website. They had no role apart from say, "Hey, here's the website. Go to it. Find something for yourself." So in a time where, you know, the healthcare costs and, you know, everything was going up in Somerset, which is in the town, emergency room admissions went down, recidivism on drugs went down, and loneliness was essentially solved by one small town in the UK. So on one end, you have the David Unwin example of reversing chronic illness in il- in small groups. On the other end, you have sort of like a societal, um, shift driven by medicine again, and ultimately, you know, the, the solution in my estimation to... The, the super elegant solution to so much of healthcare is sort of at the th- at the nexus of those two things. And Julian has said it himself since I've had a chance to know him, is that he realized the first thing was to get people in these groups. But if you can potentiate that, that connection with some sort of other healthy behavior, it's sort of almost exponentially more healthy. So like, you know, it... Like you said, going to yoga and doing a yoga class. Um, so rather than just meeting and sitting around, uh, what if we spend our time, you know, doing a mindfulness exercise, or we actually do movement together, or we actually eat as a community?

Dr. Rangan Chatterjee 40:16 So this goes back to the, the first question you guys asked people in the groups.

James Maskell 40:20 Yeah.

Dr. Rangan Chatterjee 40:20 Who in your life is gonna support this transformation?

James Maskell 40:24 It's a critical question.

Dr. Rangan Chatterjee 40:25 'Cause for many people, of course, in their current life, there is no one.

James Maskell 40:30 Yeah.

Dr. Rangan Chatterjee 40:32 But by having these groups, suddenly you now, um, you're part of a new community, a new tribe-

James Maskell 40:39 Mm-hmm

Dr. Rangan Chatterjee 40:39 ... where actually these people will support it. And I think this also... I, I wonder what, what the experience has been for people who've gone through these six-month groups, um, what it's done to their friendships because, uh, it's not necessarily either/or, like, you know, "Oh, I'm gonna become healthy now, so my current friends no longer serve my life," because that can be very, um, very scary for people.

James Maskell 41:08 Yeah.

Dr. Rangan Chatterjee 41:09 I don't think it has to be that extreme.

James Maskell 41:11 No.

Dr. Rangan Chatterjee 41:11 It's be, you know, these friends can still serve me. I can still enjoy hanging out with them, but actually, the... It s- speaks down to... It, it, it speaks to this idea about relationships, right?

James Maskell 41:22 Mm-hmm.

Dr. Rangan Chatterjee 41:22 It takes a village, right? We, we can't expect our partner to be everything.

James Maskell 41:27 Yeah.

Dr. Rangan Chatterjee 41:28 And therefore, maybe our romantic partner plays certain roles in our life. Maybe our friends play certain roles in our life, and maybe our health goals might be done by another group. It depends on who you are, of course.

James Maskell 41:44 Yeah.

Dr. Rangan Chatterjee 41:45 A lot of people have got friends they like to go walking with or yoga with or whatever. Do you know what I mean? It doesn't have to be one formula for everyone. It's like-

James Maskell 41:51 Totally

Dr. Rangan Chatterjee 41:51 ... different people in your life are gonna help you with different needs. But have you actually intentionally thought about it?

James Maskell 41:58 Right.

Dr. Rangan Chatterjee 41:58 Have you thought about who is helping these needs that I have?

James Maskell 42:02 Yeah. And, you know, you need time to work all that out.

Dr. Rangan Chatterjee 42:05 Yeah.

James Maskell 42:05 Right? You need time and space and a proven process that does that. My men's group did that for me, and honestly, being in the men's group and being a guy that's making a group medicine business and, you know, trying to get the whole world to do group medicine has actually been extremely instructive, 'cause the men's group's not a health group, right? The men's group is really, uh, an emotional maturity group. There's many different things that it is, but ultimately, in my group, I've seen people give up drinking, give up smoking, um, you know, uh, transform their relationship with their, their, their significant others. You know, I've seen, you know, business success, all of that.

Dr. Rangan Chatterjee 42:47 This is the key thing, James, to me, right? I'm sorry to kind of keep hammering home this point, but I think this is the key point for me as I hear what you're saying. This is not a health group. Right? It's not a health group.

James Maskell 43:01 Yeah.

Dr. Rangan Chatterjee 43:02 Yet people are having health outcomes. They're having amazing health outcomes-

James Maskell 43:06 Yeah

Dr. Rangan Chatterjee 43:06 ... giving up smoking, giving up alcohol, whatever. Business success, improving their relationships, right? It's not a health group- Yet they're having health benefits. And this speaks to this wider idea that a lot of the problems we're now seeing, we talk about them being lifestyle related, and of course they are to a certain degree, but maybe actually, as you say, going upstream even more, they're a consequence of the lack of community that we all have-

James Maskell 43:38 Yeah

Dr. Rangan Chatterjee 43:38 ... or many of us have in our lives. Couple things I wanna say about these men's groups. They've had a transformative effect on you. A really, really close mate of mine joined one about three years ago and said, you know, he raves about it, says it's completely changed his life, his relationship, his ability to be a good father, his ability to be a good husband, his work, all sorts of things. Now, I've heard that. I've heard it from him.

James Maskell 44:07 Mm-hmm.

Dr. Rangan Chatterjee 44:08 I've just heard it from you.

James Maskell 44:09 Yeah.

Dr. Rangan Chatterjee 44:09 I'm not a part of a men's group, okay? And honestly, you know, I spend a lot of time with my wife and my kids. Um, I spend a lot of time working. I love my work, but I, I, I have often thought that, you know what, you don't really have really good quality close friends, talking to myself, near where I live.

James Maskell 44:38 Yeah.

Dr. Rangan Chatterjee 44:39 You know, I, I, I don't. And I've got really good friends from uni that I speak to a lot, but they're all like hundreds of miles away.

James Maskell 44:48 Yeah.

Dr. Rangan Chatterjee 44:49 And last night was a really great example for me. So I'm in London, right? Meet you for dinner. Ian comes along, Rupy comes along. We're having a laugh, and I knew in my head, part of me was like, "I'm not gonna stay long. Get back to the hotel room, do a bit more prep for the podcast tomorrow with the guests." You know, I had a chat with Satchel Panda beforehand. But I realized as I was there, man, this is awesome. I am able to really be myself and just, you know... I'm not, I'm not Dr. Chatterjee-

James Maskell 45:24 Yeah

Dr. Rangan Chatterjee 45:24 ... with, with you, with Ian, with Rupy. I'm just me.

James Maskell 45:28 Yeah.

Dr. Rangan Chatterjee 45:28 Do you know what I mean? And I know it's... Of course, it is me who shows up as Dr. Chatterjee on the podcast more and more than it ever has done, but still, there's something about just being open and honest, sharing the things you're struggling with, sharing the things that are going well. Then I realize, actually, for me at this moment in time, I'd rather spend another two hours with these guys, even if it means I get less sleep tonight. That is gonna nourish my soul much more than sleep will nourish my physical body tonight. Sorry to interrupt. If you are enjoying this content, there's loads more just like it on my channel, so please do take a moment to press subscribe, hit the notification bell, and now back to the conversation. Do you know what I mean?

James Maskell 46:09 Absolutely. Yeah, I mean, to think that I would give, as a, as an entrepreneur and a father and whatever, give three hours of my week to be with a group of strangers, like at the beginning, it doesn't seem like that's a good use of time, 'cause there's millions of other things I could be doing.

Dr. Rangan Chatterjee 46:22 Yeah.

James Maskell 46:22 And I could justify it a lot of different ways. But it really, um, adds quality to everything else, in a, in a, in a very interesting way, and it's nourishing and it's, uh, and, and it creates like safety and nourishment in a way that other things just can't.

Dr. Rangan Chatterjee 46:40 Why are men's groups on the rise so much? And why... Or in your view-

James Maskell 46:45 Yeah

Dr. Rangan Chatterjee 46:45 ... why do we not hear as much about female groups? Is there something fundamentally different in how we're wired? Is it something to do with society? Have you seen any gender differences in this, I guess wider across society, but then also within the groups that you're doing for chronic, uh, chronic disease?

James Maskell 47:07 Well, in our chronic disease groups, the, the vast majority of people that sign up are women, which is interesting. So, you know, I think they, they're, uh... You know, I, I, I don't feel, um, that I know enough about those dynamics to like really understand it, but I would say in general, the kind of, uh, the people that show up for lifestyle medicine are majority women. The numbers, you know, the doctors that practice it are, you know, it's a lot of women too, 'cause I think they understand it at a sort of a fundamental level. Um, uh, nourishment and empowerment, support is just, you know, something that's, um, you know, part of-

Dr. Rangan Chatterjee 47:44 Yeah

James Maskell 47:44 ... uh, you know, part of them. I think men are needing it more and more because I think a lot of men realize that the sort of like competitive side of, of men and the sort of like emotionally dysfunctional part of men that is sort of celebrated in society in a weird way, um, ends up being like quite detrimental to their relationships, their ability to, um, lead, uh, manage people, work with people-

Dr. Rangan Chatterjee 48:11 Yeah

James Maskell 48:11 ... have good long-term relationships with people. And I think that there's just sort of a new generation of men who realize like, you know, "If I wanna be able to feel feelings and have a truly human experience-

Dr. Rangan Chatterjee 48:22 Yeah

James Maskell 48:22 ... on my time here, it's gonna take work, and I don't know what to do, so I'm gonna go and find some people who do."

Dr. Rangan Chatterjee 48:29 Yeah.

James Maskell 48:29 Right? The pe- the aver- you know, the other people in my men's group, there's a guy who's 65, there's a guy who's 60. You know, that I'm, I'm one of the younger people in the group, and these are people that in some cases for 20 years have been doing this work. They still have their own stuff, but they're working through it.

Dr. Rangan Chatterjee 48:42 Yeah.

James Maskell 48:42 But their advice is so powerful, and it's the same energy of what we're talking about with the health coach. It's just like a kind of a, an unpaid life coach. You know, the whole thing's free, right? There's no cost for me to be in the men group. It's just the only cost is that we meet in this random room at a church, and we pay them, you know, a tiny amount to be part of it.

Dr. Rangan Chatterjee 48:59 Like, like you said last night, people helping people-

James Maskell 49:03 Yeah

Dr. Rangan Chatterjee 49:03 ... is the only inexhaustible resource we have.

James Maskell 49:06 100%.

Dr. Rangan Chatterjee 49:07 Like, I couldn't stop thinking about that last night.

James Maskell 49:09 Yeah, I mean, look, if you look at, say, we wanna save the NHS, and then it's like, well, there's not enough resources. There's this one resource that's inexhaustible, and it's ridiculously powerful, and it's being used to 0% of its potential. We need to... That's what to build around.

Dr. Rangan Chatterjee 49:26 Yeah. Just speaking to men- And women. And again, these aren't gross generalizations-

James Maskell 49:34 Yeah

Dr. Rangan Chatterjee 49:34 ... but, you know, one thing I've noticed when I go for walks around my neighborhood is you often see women walking with other women.

James Maskell 49:45 Mm.

Dr. Rangan Chatterjee 49:46 I, I don't know. Look, you live in Sacramento, I live in the northwest of England, right?

James Maskell 49:49 Yeah.

Dr. Rangan Chatterjee 49:50 I have observed, this is not a scientific experiment.

James Maskell 49:54 [laughs]

Dr. Rangan Chatterjee 49:54 This is, you know, just to be clear, this is just my observation where I live, what I've seen. Well, you know, take my wife, my wife will often go for her walk with her friends.

James Maskell 50:03 Yeah.

Dr. Rangan Chatterjee 50:03 They arrange to meet. I never do that. My walk is always by myself, always. Um, whereas hers, I would say 80% of the time is with someone else. So you'll catch up with someone, connect with them, and you'll walk together. I see that around me, so I find that quite interesting. And there could be a whole variety of societal reasons why that is, of course, but whatever, that's what I've, what I've observed. We talk about loneliness and how harmful that is for our health way more... You know, I, I'm really at the stage, James, where I actually genuinely believe that not having a tribe around us, feeling lonely, and correcting that is possibly more important than the food that you eat.

James Maskell 50:53 Yeah.

Dr. Rangan Chatterjee 50:54 I, I really, I think-

James Maskell 50:55 I mean, it is. There's science to show that it is.

Dr. Rangan Chatterjee 50:57 And that's huge because when we think about loneliness, a lot of people think about the elderly stuck by themselves-

James Maskell 51:03 Yeah

Dr. Rangan Chatterjee 51:03 ... or in homes. Yes, that's a big issue. In the UK, and I suspect it's the same in America, the loneliest group in society, I think, are men between the age of 30 and 50, and that is a group where there is a very, very high rate of suicide. This is, this is massive. And again, so that's really interesting. And then you talk about these, these groups that you are, um, helping set up in America which-

James Maskell 51:33 Can I just say one thing onto that?

Dr. Rangan Chatterjee 51:34 Please.

James Maskell 51:35 Because I've actually seen research that's saying that younger people are infinitely more affected by this than everyone because of the society that's been created, social media, way people connect. I saw research saying that one in f- one in four British teenagers didn't have one friend. Right? And you know there's a s- there's a, there's an epidemic of mental illness in the teens, right? Think about how these teens connect. Like if your friendship group is in a chat in Fortnite, that is not a healthy behavior. That is not a supportive community. That is people, you know, that's a chat stream inside a video game. That is unhealthy-

Dr. Rangan Chatterjee 52:15 Yeah

James Maskell 52:15 ... in its own right. Like where, where are kids getting together to be with each other and not be on their technology? There's sport. There used to be church. There's no church. You know, it's, it's like there's, there's these structures that used to exist where kids would come together and play, and ultimately, you know, we, we are creating a, a seriously mentally ill, you know, younger population. I'm seriously concerned about it, and yet it's pretty exciting to see, you know, what's going on with, with kids when they get access to these kind of tools. Like in the, in the work that we're doing now, you know, we're selling our program to pediatricians because the pediatricians are dealing with 13 to 18-year-old kids who, um, the highest ever rates of, um, mental illness. And those kids, because grandma isn't around in the community, are not getting the training that we once got on how to be healthy, right? The community is not reinforcing healthy behaviors. So you need to go through a six-month program to learn healthy behaviors, how to deal with stress. You need to be in a community of other people who are doing it. So I actually feel this is sort of just like a, a fundamental training in how to be a human-

Dr. Rangan Chatterjee 53:20 Yeah

James Maskell 53:20 ... that is missing from society that is only reasonable that we need to put back in, and the only place where there's like budget assigned to do it is in the medical system. And so that's why it has to come from there-

Dr. Rangan Chatterjee 53:30 Yeah

James Maskell 53:30 ... even though it should just be a societal gift.

Dr. Rangan Chatterjee 53:33 The pediatric thing's interesting. Ian said last night, of course, over dinner that... And for people who don't know, Ian's been on the, the show a few times. He's, uh, a brilliant, uh, NHS GP. And he knows, 'cause we, we run a course together, as you know, called Prescribing Lifestyle Medicine, and we've trained thousands of healthcare professionals and doctors all over the globe now in terms of some of these principles. And a lot of these people we train are very interested in group medicine. They get it. They can see it. But they don't know how to do it.

James Maskell 54:04 Mm-hmm.

Dr. Rangan Chatterjee 54:05 They're like, the system is not set up, which is where I think you can come in. But Ian said some- a really good friend of his has used an element of this group medicine with, um, pediatric respiratory patients.

James Maskell 54:16 Yeah, that was amazing.

Dr. Rangan Chatterjee 54:17 Right? And when sh- he shared that actually their, their, their admission rates to hospital and their how many times they're having to go to A&E now, I think it was with, with asthma, he said, gone right down 'cause these families and kids and their mum and their dad are helping each other. So what's interesting to me, a lot of these doctors we train up, um, they want to do this, but they don't know how.

James Maskell 54:42 Yeah.

Dr. Rangan Chatterjee 54:42 Right? So what is it you've learnt? 'Cause you are, as I say, you're transforming healthcare in America. You're putting this into practice. What do people try and do? What do they get wrong when they try and do this? What do they not get? What are, what are some of these key things that you've learnt?

James Maskell 55:00 One, doctors should definitely not be doing it.

Dr. Rangan Chatterjee 55:03 Okay, let's-

James Maskell 55:03 That's the key thing.

Dr. Rangan Chatterjee 55:05 Why?

James Maskell 55:05 Because the doctor is an expert, and the doctor has spent their last however long their career is, probably since they were 10 years old, being validated for their expertise, their retention of knowledge, their ability to regurgitate that knowledge. And ultimately, when you're in a group and someone asks a question, the most important thing to do is not answer the question. The most important thing to do is to let someone else in the group answer the question because then you're building trust in the collective. And all the doctors that I know that are amazing at this, and I know the best ones 'cause I interviewed them for my book and I've spent time with them, they actually had to go through a deconstruction of their own ego to be able to actually hold a group because it's so tempting to answer the question 'cause they're an expert. And we're moving out of this era, like the- there's definitely room for experts. 100% we need experts, but not in group medicine. We need peers, we need support, we need, you know, mentorship, and that is not being done by a doctor. When we f- we, when we first started running these virtual groups, we had some doctors say, "Oh, I've, I've done a weekend in coaching. I can do it. I'll run the groups." It was a disaster. There's also still this, like, there's this thing where the doctor has the white coat, right? And there's this inbuilt relationship that sort of patients have with what they assume doctors are gonna be like, and that can be actually, you know, that, that can be, um, unhelpful in creating trust in a group. So the first thing is, I, you know, look, we've worked together for a long time. I think getting doctors trained in lifestyle medicine, um, getting trained in this sort of like lifestyle first, root cause approach to health is amazing, and I did it for 10 years, and I'm still involved in it. But what I've come to see is that the quickest way to facilitate the transformation is for the doctor to prescribe it, because there's something about the prescription, like doctor- patients still will follow the prescription of the doctor.

Dr. Rangan Chatterjee 56:50 So I prescribe that group for you.

James Maskell 56:51 You prescribe you're, you're going into this group, but then the doctor doesn't run the group, right? The only reason why you need the doctor in the group is to de-prescribe the medication. That's what we're seeing in America right now. The most exciting is chronic pain, right? Before COVID came along, opiates was the biggest issue in America, right? Um, you know, overuse of opiates, chronic pain. So in our groups, the doctor actually comes in once a month, and their only reason why they're there... Well, there's many reasons for them to be there, but the biggest thing that they're hopefully doing is allowing patients, telling patients, "Yeah, you could probably come down a little bit on your prescription now." De-prescribing, the doctor has to be there because there's a lot of factors, and the doctors have to know it. But ultimately, what the first thing we see is that doctors shouldn't be running the groups. The coach, this peer piece is a part of it.

Dr. Rangan Chatterjee 57:36 That- that's empowering on two levels. Even the doctors who want to see group medicine implemented, who've seen some of the research go, "Oh, and this, this course makes sense." You know, "AM last night. What are you saying?"

James Maskell 57:50 Yeah.

Dr. Rangan Chatterjee 57:50 "I'd love to. I just don't have time."

James Maskell 57:52 Yeah.

Dr. Rangan Chatterjee 57:52 Right? So doctors are overworked anyway, so actually it helps that because they're not having to do one more thing. And I love that, that actually I can totally see why ego and the way that fundamentally to be at medical school, there is a certain type of personality, right? And I, I can say this c- I, and you know, and this is not in a derogatory way, but, you know, a lot of people are super competitive. And, you know, a lot of people have been validated for their... A lot of them get their self-worth, this used to be me-

James Maskell 58:25 Mm-hmm

Dr. Rangan Chatterjee 58:25 ... get your self-worth from success or external validation. Now, you know, how I've got rid of those things and why I feel happier and more content is something [laughs] I've spoken about a lot recently. But that's a separate issue. The point is, is that I can totally see how doctors would not be the right person, and actually their expertise and knowledge it- can be downright harmful-

James Maskell 58:46 Yeah

Dr. Rangan Chatterjee 58:46 ... in this setting. So I think that's really, really powerful. You mentioned chronic pain. Why do you think this is so powerful for chronic pain? 'Cause chronic pain is a big issue.

James Maskell 58:58 Yeah.

Dr. Rangan Chatterjee 58:59 And the medical profession are not doing that well at dealing with this. [laughs]

James Maskell 59:03 Yeah. Number one, lonely people have higher pain scores. The science on chronic pain shows that it is, and this is a big word that I'm gonna use here, it's a biopsychosocial disease. There are biological parts of it. There's, you know, the, the physical body is dysfunctioning that's causing to it. There are psychological parts of it.

Dr. Rangan Chatterjee 59:23 Yeah.

James Maskell 59:23 Right? And then there's also social parts. And so you can't solve, uh, you can't solve a biopsychosocial problem with a biological input, a drug. It just, it's a not, it's not a match.

Dr. Rangan Chatterjee 59:34 Mm.

James Maskell 59:34 Right? So lonely people have higher pain scores. The structure of actually now working to improve your physiology is, is, is what leads to the, you know, the, the, um, you know, the, you wouldn't need the medication anymore. You've gotta change your physiology. If your ph- if your current physiology is causing ongoing chronic pain, you gotta change your physiology, and that's what the power of the group can do, and the lifestyle medicine. And then, you know, ultimately to have it then be prescribed by a doctor gives the validation of the medical piece. So the doctors, it's, it's important for them to prescribe it, but ultimately the action is happening with the group.

Dr. Rangan Chatterjee 1:00:08 Okay, so first thing we get wrong, and we think the doctors need to run it.

James Maskell 1:00:12 Yeah.

Dr. Rangan Chatterjee 1:00:12 So they don't.

James Maskell 1:00:13 Yeah.

Dr. Rangan Chatterjee 1:00:14 Okay, great. What's that next hurdle that we fall at when trying to implement this?

James Maskell 1:00:19 I mean, most of the rest of it comes down to, like, the boring, annoying details of rejigging a health system to do group medicine. So, like, one of those is, you know, we've had doctors that try to run this, and they do it in person, right? 'Cause getting in a group together in person is, is better than being online. But, like, if your clinic only has four parking spots and there's 20 people coming to the group, you can't run it. If there's no room where people can sit around together, you can't run it. You know, and so what we found, even though the, even though there might be more value in having the group meeting in person, w- with a completely virtual experience, like what are the benef- why, what are the reasons why people love telemedicine? Why do people love telemedicine? One, it respects your time, right? You can come in from wherever you are. You can use your phone. You can chat to the doctor directly. You don't have to wait in the waiting room. You don't have to do- deal with your kids. You know, all those other things. It's very respectful of patients' time. That's why they like it. You know, so you get to come in from wherever you are. In America, there's a big conversation about the social determinants of health. How do you get to the office, right? W- whose car-

Dr. Rangan Chatterjee 1:01:25 The doctor's office

James Maskell 1:01:26 ... yeah, who are you gonna, how are you getting there? And if you have to go there every week, then, you know, that can be tricky. But here's the biggest thing. Health is happening outside of those sessions.

Dr. Rangan Chatterjee 1:01:35 Yeah.

James Maskell 1:01:36 That's where health is actually happening. That's when you're making the decision of what you're gonna eat tonight, or whether you're gonna go for a walk after dinner, or what your movement for the day is gonna be, or whether you're gonna have the, the, the morning routine that you want. To be connected to the other people in the group at that moment- ... is the critical moment. That's high-touch care. It's, it's, you're, you're able to touch with your people all the time. People know what this is like, Rangan, because most people have had the experience of being in a Facebook group.

Dr. Rangan Chatterjee 1:02:01 Yeah.

James Maskell 1:02:01 Right? Where you see that there's, like, asynchronous communication. Not everyone's there at the same time.

Dr. Rangan Chatterjee 1:02:06 Yeah.

James Maskell 1:02:07 Right? So I can put something in and say, "Hey, I really struggled with this today. Um, but, you know, I did this and I did that." Put it in, and then you go off to work, and then you see a minute later someone said, "Oh, I had that same experience," you know? Or they said, "This thing really helped me. Here's an episode of Dr. Chatterjee's podcast."

Dr. Rangan Chatterjee 1:02:24 Yeah.

James Maskell 1:02:24 You know, that kind of communication's happening the whole time, and people are helping each other in the time that they're not in the office, and that's what we found to be the most-

Dr. Rangan Chatterjee 1:02:32 Yeah

James Maskell 1:02:32 ... valuable. And look, I think everyone would aspire that wouldn't it be great if every patient could have that kind of access to their doctor? It's just the resources don't add up.

Dr. Rangan Chatterjee 1:02:41 Yeah.

James Maskell 1:02:41 I'm an economist first and foremost. I'm a health economist, and so I come to this problem from a resource constraint, um, uh, you know, perspective. I'm not a doctor, but I... what I recognize is, like, this is the path that people have to go to, and I spent the last 17 years trying to work out what is a way that can do it in a s- in a way that is using the right resources in the right way to create the right transformation? And ultimately, you can see in that, in that process that allowing people who are inside, they already have an agreement of what they're doing together. They've set their SMART goals. They've set their collective intention. Another thing that we do at the beginning is help them to sort of define as a group what this group is, like, what the name of it is, what it's gonna be about for them, so they're, like, bought into it. And then they're just supporting each other-

Dr. Rangan Chatterjee 1:03:26 Yeah

James Maskell 1:03:26 ... throughout the process. And ideally forever. I mean, in the, in the book I spoke about some of the original group visits. It starts off as a type 2 diabetes reversal group, but what do you do once everyone's reversed their diabetes?

Dr. Rangan Chatterjee 1:03:37 [laughs]

James Maskell 1:03:38 You know, in this case it became a salsa dancing club and a gardening club. Salsa dancing in the winter because it was rainy in Massachusetts, and they can't go outside, so they meet once a week for salsa dancing. And in the summer, it was a gardening club. Both really healthy behaviors, when done as a group even healthier, and th- some of these groups have gone for 20 years.

Dr. Rangan Chatterjee 1:03:57 Yeah. That, that Facebook group example I think is... I think pe- a lot of people will, will get that straight away.

James Maskell 1:04:05 Yeah.

Dr. Rangan Chatterjee 1:04:06 Um, I've got my own kind of, um, Facebook group. I think it's called Dr. Chatterjee's Four Pillar Tribe, and, you know, I, I rarely go on it, but what's interesting, as you say, people are helping each other in there. It's, it's, it's just something I've created, right? But-

James Maskell 1:04:23 Mm-hmm. Yep

Dr. Rangan Chatterjee 1:04:23 ... I'm not in there to answer questions. It's people in there who are helping. People post things like, "Oh, I'm really struggling with this in my health," you know? And then everyone's jumping on to help people. And it's, it's really wonderful 'cause also for that person who's helping someone else, that is a real kind of boost, a feel-good into their arm, and that helps their health, and it's kind of who we are. You know, you mentioned men before and competition. I've been reading a lot recently on tribes, and, um, uh, there, there was something I was reading recently, and they were talking about running in tribes and how running in a lot of modern hunter-gatherer tribes is not competitive.

James Maskell 1:05:04 Mm.

Dr. Rangan Chatterjee 1:05:04 People aren't racing with each other. It, it's really interesting. Like, running is a, is a group thing. It's often to hunt. It's of- you know, it's not about who's the fastest runner, which is quite interesting-

James Maskell 1:05:15 Yeah

Dr. Rangan Chatterjee 1:05:15 ... in itself. There's also, I was reading about some other tribes whereby if anyone's ego is getting a bit too, um, elevated or they think they're better than the people around them, there are certain practices that happen to sort of bring them back down to size. And, and more and more, I think, oh, actually, being competitive is not who we are.

James Maskell 1:05:37 Yeah.

Dr. Rangan Chatterjee 1:05:37 It's who we become-

James Maskell 1:05:38 Yeah

Dr. Rangan Chatterjee 1:05:38 ... as a way, uh, as a, as a consequence of the way we're living life. And structure, and I've, I think particularly with a lot of men, we end up thinking the way we are, being competitive, you know, trying to do more or be more is kind of, um, it- it's the male way to do things, where we're realizing more and more it's leaving a lot of us incredibly isolated, lonely. Um, you know, we're drawn to what I call junk happiness habits, like booze, you know, gambling, you know, whatever it might be. And actually, it's... that's why these men's groups, I think, are, are being so effective for so many people. Jason, in terms of what you're doing for healthcare-

James Maskell 1:06:15 Yeah

Dr. Rangan Chatterjee 1:06:15 ... um, so far in the group medicines, uh, clinics, or not... Sorry, not clinics. The clinics you've helped, you've brought in this infrastructure of group medicine. You've said to them, "Guys, you don't have to do anything."

James Maskell 1:06:30 Mm-hmm.

Dr. Rangan Chatterjee 1:06:30 "We'll do all that stuff for you-

James Maskell 1:06:32 Yeah

Dr. Rangan Chatterjee 1:06:32 ... all the boring stuff."

James Maskell 1:06:33 Yeah.

Dr. Rangan Chatterjee 1:06:33 Which I think is powerful because then they're like, "Okay, really?" You know? So I know you've done a, a very clever model, uh, in America-

James Maskell 1:06:40 Yeah

Dr. Rangan Chatterjee 1:06:41 ... which has really, really helped. Be really specific. What conditions-

James Maskell 1:06:46 Yeah

Dr. Rangan Chatterjee 1:06:46 ... have you done it with so far?

James Maskell 1:06:49 Um, the first one was in a primary care clinic, so it was a range of conditions. It was the summer of 2020. Immune health was hot for some reason. I can't remember why. But that was, like, a range of, um, immune issues, so digestive deci- digestive issues, um, autoimmune kind of conditions. That was the first group. We've run metabolic groups, which is, like, type 2 diabetes, um, heart disease, uh, metabolic syndrome, those groups. We've done chronic pain groups. Um, we've done mental health groups. Uh, we've done, you know, really neat niche stuff, like, uh, um, urinary incontinence groups. You know? There's no drug for urinary incontinence, so how are you gonna do? What are you gonna do? You're gonna get women together w- and work together. There's, there's history of, um, incredible success in actually all areas of group medicine, even pregnancy. Um, you know what the most successful group program in America, um, pre-pandemic is called Centering Pregnancy. It's literally just getting women who are pregnant, putting them in a cohort. I know this happens actually in the NHS-

Dr. Rangan Chatterjee 1:07:46 Mm

James Maskell 1:07:46 ... because some of my friends who still live here, you know, had that. But in America, Centering Pregnancy leads to a 35% reduction in preterm birth only by getting women into a circle. There's no other thi- you know, it's just them connecting over a period of time. So yeah, we've, we've focused on, um... You know, we've seen success in, in, in all of those areas, uh, fatigue, anxiety, depression, um, you know, chronic pain. Digestive disorders are really well helped. If you've got a food-first approach, obviously, you know, digestive disorders, um, can be really helped with food. You've seen that-

Dr. Rangan Chatterjee 1:08:18 Yeah

James Maskell 1:08:18 ... you know, yourself. So I actually think there's really no limit to where this-

Dr. Rangan Chatterjee 1:08:22 Yeah

James Maskell 1:08:22 ... can be, can be applied. And part of what we've been doing for the last year is working out where are all the places where this can be deployed, and it's taken us some pretty, you know, weird and wonderful-

Dr. Rangan Chatterjee 1:08:31 Yeah

James Maskell 1:08:31 ... corners of medicine.

Dr. Rangan Chatterjee 1:08:33 I mean, I think you're doing just, just incredible work that, that really has the potential to transform healthcare globally. I really believe that. Um, a lot of people, James, who are very influential in healthcare listen to this show. I know in the UK certainly influential health leaders in the NHS, in politics listen, 'cause I've, I've, I've, I've got it on good authority. I've heard, people have got in touch. What you're doing, you are showing cost savings, resource savings. You're showing huge benefits for patients. That is literally the tick tick for everyone.

James Maskell 1:09:09 Yeah.

Dr. Rangan Chatterjee 1:09:10 Patients getting better, uh, costs coming down. Yet, it's not being implemented. You've mentioned in the UK we've got some, uh, s- science. You know, David Unwin's work has been absolutely incredible in what it's doing.

James Maskell 1:09:23 Yeah.

Dr. Rangan Chatterjee 1:09:23 And just for that one condition, if we have those savings across every GP practice, you know, the, the savings are just staggering amounts of money, yet it's not happening.

James Maskell 1:09:32 Yeah.

Dr. Rangan Chatterjee 1:09:32 You, with your company, um, with, with the framework that you've developed, literally have s- the potential to help the NHS with immediate effects.

James Maskell 1:09:42 Yeah.

Dr. Rangan Chatterjee 1:09:42 Right? So if someone in those influential places is listening or watching right now, and it's like, "Okay, okay, James Maskell, I'm, I'm hearing you. I'm, I'm interested," what should they do?

James Maskell 1:09:54 Get in touch. Healcommunity.com, that's the name of the business. Um, you know, I'm, I'm coming more and more back to the UK. This is like a pet project of mine, because I left 17 years ago to go to America and try and work out what was going on with chronic disease. Like, my degree was in health economics. I saw that in our lifetime, you know, we were gonna bankrupt ourselves with the cost of chronic disease, and it's been 17 years to try and work out, first, is chronic disease reversible? And then second, how can we do it in a resource, um, efficient manner so that it could be deployed? And then how can we scale the deployment? So yeah, healcommunity.com is the name of the business. And you know, I would love to find a way that it could create a more equitable, sustainable, healthful, and human NHS, because living in America, I want the NHS to survive and thrive. It took great care of my mother for years, right? And that's why I'm really committed to it. But coming to America, you realize what a shambles is going on over there. There's something really beautiful about the social contract to take care of each other through medicine, and my concern is that that contract is breaking down as we speak, and m- I would love that my efforts would reinforce-

Dr. Rangan Chatterjee 1:11:10 Yeah

James Maskell 1:11:10 ... that social contract.

Dr. Rangan Chatterjee 1:11:12 Yeah, I hope so. Uh, I think it is going to, mate. I really do. Of course, in our Prescribing Lifestyle Medicine course, we talk about you, your work. You know, we, we're gonna showcase more and more what this is doing because, again, the people who are coming on are already thinking differently.

James Maskell 1:11:27 Yeah.

Dr. Rangan Chatterjee 1:11:27 They're already going, "There's something not working with the current system." You know, and that's another piece I just wanna mention here, because one thing we find when doctors from all around the world do our Prescribing Lifestyle Medicine course, which is online now, so they don't need to fly anymore-

James Maskell 1:11:40 Yeah

Dr. Rangan Chatterjee 1:11:40 ... to London to do it, is they're getting more enjoyment out of their job.

James Maskell 1:11:46 Yeah.

Dr. Rangan Chatterjee 1:11:46 There's less burnouts. They, they, they re-fall in love with medicine.

James Maskell 1:11:51 Yeah.

Dr. Rangan Chatterjee 1:11:51 And for many physicians, it's something that, over time, they're just like, "Man, it's just a s- it's just a slog, this job."

James Maskell 1:11:58 Yeah.

Dr. Rangan Chatterjee 1:11:58 Is that something you're also seeing?

James Maskell 1:12:00 Yeah, 100%. I mean, you know, even just now in the, in the pandemic, right, you see a 400% increase in demand for mental health services. There's no more doctors. There's no more providers. There's no more therapists, right? That's an equation that just doesn't add up. And so what that ends up doing is putting way more pressure on the doctors, and they feel that pressure because the, the pain of transformation of the patients, the pain of the patients sits squarely on their shoulders. The beauty of this is it takes that pressure, and it redistributes it over a group of 20 people. And so with that, w- if doctors know that that group can take care of that, they can really focus on spending time with the people that they can really help.

Dr. Rangan Chatterjee 1:12:42 Yeah.

James Maskell 1:12:43 And just to give you an example of, of this whole thing working, so at the Cleveland Clinic Center for Functional Medicine in America, everyone goes through this kind of group structure first, right? Half the people, this was in the BMJ, half the people get better without any doctor, because all they really needed was support, accountability, and working together in groups. And that now means that half the people are better. They don't need the doctor. That gives the doctor... you know, could either see twice as many people or can spend more time with them. The army of doctors that you've-

Dr. Rangan Chatterjee 1:13:14 Yeah

James Maskell 1:13:14 ... created is necessary, but it's not sufficient to solve the problem.

Dr. Rangan Chatterjee 1:13:18 Yeah.

James Maskell 1:13:18 And that's why I think the work that you've done, you know, we've been friends for eight years now.

Dr. Rangan Chatterjee 1:13:22 Yeah.

James Maskell 1:13:23 You know, we're all tackling our own little bit of it.

Dr. Rangan Chatterjee 1:13:25 Yeah.

James Maskell 1:13:25 And we're all here to try and, you know, create something that's more healthful, more equitable, and more effective.

Dr. Rangan Chatterjee 1:13:30 Yeah.

James Maskell 1:13:30 And I'm super excited for the future.

Dr. Rangan Chatterjee 1:13:33 Taking it away from healthcare systems-

James Maskell 1:13:35 Yeah

Dr. Rangan Chatterjee 1:13:35 ... for a minute, just to finish off, um, this podcast is called Feel Better, Live More. When we feel better, we get more out of our lives. You've given us the big picture. You've shown us how healthcare across the world can be transformed with a relatively simple intervention, right?

James Maskell 1:13:54 Mm-hmm.

Dr. Rangan Chatterjee 1:13:54 But for that individual who's not involved with healthcare systems, who's not involved with healthcare, who listens to this show, watches this show to help them with their own life, given what we've just spoken about, what would you say to them?

James Maskell 1:14:12 Find your healthy community. It might take a little bit of effort upfront, but there's so many non- new tools with the internet to be able to identify people in your local community who have similar ideas, goals, um, than you do, and I think you'll see, you're already seeing, you know, those kind of things pop up. But the value of those relationships to you over a lifetime, it's the key to long-lasting, transformational health.

Dr. Rangan Chatterjee 1:14:37 Yeah. Love it. James, you're doing incredible work.

James Maskell 1:14:39 Thanks, mate.

Dr. Rangan Chatterjee 1:14:40 Thank you for coming on the show, mate. It's, uh... Good to have dinner last night.

James Maskell 1:14:43 Yeah.

Dr. Rangan Chatterjee 1:14:43 Good to see you. Catch us more on the podcast.

James Maskell 1:14:45 Great to be in London. Thank you.

Dr. Rangan Chatterjee 1:14:46 If that conversation resonated with you, here is another incredibly powerful one that I really think you're going to enjoy.

Guest 1:14:52 I think one of the greatest things about food is that, and food and health, is that it actually puts the agency of choice into our own individual hands. And so we, we take our... We make our own choices