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What a Year on Ozempic Taught Johann Hari

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Friday, June 7, 2024

In the fall of 2005, Johann Hari, then a young columnist for The Independent who was struggling with his weight, described a trip he said he’d taken to a wellness spa in the foothills of the Carinthian Alps. After spending just four days there on a cleansing diet that consisted almost entirely of drinking tea—Hari could not bear to stay a moment longer—he’d lost seven pounds. “The cravings for lard had leeched out of my system,” he marveled in his write-up, noting that he hadn’t yet regained the weight.Hari tells this Alpine-detox story once again in Magic Pill, his fourth and latest book, released last month—but the anecdote now appears to hold a different lesson. Instead of maintaining his new diet, he seems to relapse: “When I got home, I felt like a failure,” he now says of the very same experience. “Where, I wondered, was my willpower?”The new book’s title is a slanted reference to Ozempic (which doesn’t come in pill form), and to the new class of anti-obesity medications that is already reshaping health care for tens of millions of Americans. Many of Magic Pill’s 250 pages describe these drugs’ amazing benefits and potential harms; most of the rest are devoted to a workmanlike review of certain social causes of obesity, and how they might one day be reversed. Some portions of this story have been told in other places—Hari makes ample references to other well-known books. But his account brings an element of human drama that few could match, even when it’s just rehashing others’ work. That drama is the author’s own: Above all else, Magic Pill describes Hari’s everlasting struggle to control himself. Whether purposefully or not, he has produced a revealing record of his shame.Why does Hari feel ashamed? For one thing, he’s on Ozempic. Hari doesn’t really need to take Ozempic, but he’s on it nonetheless: That’s the premise of the book, as laid out from the start. He decided, “quite abruptly” as he puts it in the introduction, to begin injections. It was 2022, and his pandemic BMI had risen to a hair over 30, just high enough to qualify for a prescription. Going on it “was a snap decision,” he explains, “and later I realized I was driven by impulses I didn’t fully understand at the time.” A methodical examination of those impulses unspools from there: Across the book’s 12 chapters, Hari will ask himself why he can’t just stop eating. Why should he need the help of a powerful drug to lose weight? Where, he’ll wonder again and again, is his willpower?There are scientific answers to those questions, and also there are moral ones. “Taking Ozempic was a betrayal of my values. Every time I injected myself, I felt fraudulent,” he writes. A few pages later, he elaborates: “If I am totally honest, at some level, I believed that by taking these drugs, I was cheating.” This inner sense of crookedness is meant to stand in for a more expansive one. If he’s a victim of his impulses, then we all are as well. Why can’t any of us stop eating? Whatever happened to our willpower? And if Hari feels uneasy injecting himself with artificial self-restraint, then society should feel the same. We’ve made a religion, more or less, out of limitless consumption; we’ve allowed our diets to be overrun with processed, packaged foods. Now we’re rolling back the ill effects of too much eating with yet another branded product. Doesn’t this approach to public health feel a little bit like cheating? Isn’t it a form of fraud?This line of thinking holds a special resonance for Hari, who has in other contexts shown a catastrophic lack of self-control. In fact, his history as a journalist would seem to offer special insight into the battle between the id and the superego. As a columnist for magazines and newspapers—and as the guy who wrote about the Alpine weight-loss trip almost 20 years ago—he was once a lauded journalist. Hari’s work “combines courageous reporting and forceful writing with honest analysis,” announced a judge who awarded him the Orwell Prize in 2008. But Hari’s career appeared to reach an early end a few years later, when some of his work was found to be conspicuously dishonest. In 2011, he was outed as a plagiarist, and then for making vicious accusations about his rivals through a sock-puppet account on Wikipedia. “I did two wrong and stupid things,” Hari wrote in his final column for the Independent, under the headline “A personal apology.” He promised to step away from writing for a while so that he could study journalism, and that when he finished he’d be more scrupulous than he’d ever been before, footnoting all his work and posting audio of all his interviews. “I hope after a period of retraining, you will give me the chance,” he said.That chance arrived a few years later, when Hari reappeared with a best seller, Chasing the Scream, on the social causes of addiction, and a viral TED Talk—which has now been viewed 21 million times—on the same topic. He’s since written three more pop-science books, all of which are variations on this theme. In 2018, he published Lost Connections, another best seller, about depression, anxiety, and, to some extent, the nature of addiction. Hillary Clinton blurbed that one, and Ezra Klein had Hari on his podcast. After that was Stolen Focus, in 2022, about technology, distraction, and the limits of the will. Hari got another blurb from Clinton (among other celebrities), and spent another hour as a guest on Klein’s show. And now this year we have Magic Pill, Hari’s book about obesity, overeating, and, once again, the limits of the will.Which is to say, all of Hari’s writing since his comeback has been concerned—one might even say obsessed—with self-control and self-destruction; and with the interplay of forces, from without and from within, that may lead us into ruin. They present as social commentary, and also as self-help, and further as a meditation on the links between the social and the self. As Klein put it on his podcast, the books compose “a little subgenre taking conditions and afflictions that we individualize and arguing for their social roots.”Hari tends to use himself to illustrate those conditions and afflictions, however they arise. According to his books, he’s been hooked on stimulants; he’s also been strung out on antidepressants, dependent on his phone, and addicted to fried foods. He says he has a family history of drug dependence, and of mental illness, and also of obesity. In other words, Hari lives in just the way we all do: caught between desire and self-blame. His books describe dysregulation. They’re also a product of it.Back in 2015, when Hari gave his first post-scandal interview, he described himself, in a joke, as a “recovering former columnist.” His work since then does read like one extended chronicle of a struggle for sobriety—particularly when it comes to sticking to the facts. Hari’s books remind you in a hundred different ways that he’s on the wagon as a journalist. He posts the audio from many of his interviews, just as he promised he would, and he piles on the endnotes. “I went on a journey of over forty thousand miles. I conducted more than two hundred interviews across the world,” he boasts in the introduction to Lost Connections. “I went on a 30,000-mile journey … In the end, I interviewed over 250 experts,” he says in Stolen Focus. And now, apparently having rushed a bit for Magic Pill: “I went on a journey around the world, where I interviewed over a hundred experts.”But showing off is not the same as showing discipline. In spite of Magic Pill’s 394 endnotes (including those published on the website for the book) and 318 posted clips from interviews, and notwithstanding the pair of fact-checkers whom Hari thanks in his acknowledgments, the book is strewn with sloppy errors. Some of these have already been made public. When a British restaurant critic named Jay Rayner, described by Hari as having lost his love for food after going on Ozempic, pointed out on X last month that this was “complete and utter bollocks,” Hari admitted his mistake: “I apologise to Jay for getting this wrong, & am gutted I & my fact-checkers missed it,” he wrote. Then his proffered explanation—that he’d meant to cite the experience of the film critic Leila Latif when she was on Ozempic—ran aground as well. “I’m not, nor have I ever been, on semaglutide,” Latif chimed in just hours later.A few weeks ago he posted fixes for another seven errors from the book on his website, in response to an email from a journalist. (A detailed roundup of those mistakes has since been published in The Telegraph.) I came across a bunch of other glitches in my reading of the book. In one instance, Hari writes about an evening long ago when he heard about a restaurant in Las Vegas where the servers doled out spankings to anyone who didn’t clean their plate. According to the book, that conversation happened in the late 1990s or early aughts, but the restaurant in question—called the Heart Attack Grill—didn’t open in Las Vegas until 2011. This tiny error makes no difference to the story Hari tells, but lots of tiny errors, set against the backdrop of the author’s ostentatious rigor, tell a story of their own. In a chapter on the scourge of ultra-processed foods, Hari talks about the slurry of defatted beef that is sometimes called “pink slime,” suggesting that it got this name from a food executive. This is precisely not the case. (Food executives sued the guy who coined that phrase, along with the news outlet that reported it, for defamation.) When Hari writes about the big reveal of findings from a major trial of Ozempic’s use for losing weight, he sets the scene on “one day in 2022.” The reveal occurred in 2021. And when he describes a study of mothers who have been taught “responsive parenting” techniques, he says their children ended up half as likely to become obese or overweight as those of other parents. (Hari puts the word half in italics, to emphasize the size of the effect.) But this finding was not statistically significant, according to the published work to which he is referring. “Differences between study groups were modest,” it says.When reached by email, Hari acknowledged two of these mistakes and insisted that the other two were spurious. Some food executives did end up uttering the words pink slime, he said. (This was only in the course of responding to the PR crisis that the coinage had produced.) He also said that he’d drawn the stat about responsive parenting from a different paper that came out of the same research project, which was published two years earlier than the one cited in the endnotes of his book. (The text in Magic Pill clearly refers to the findings of the more recent paper.)I’m worried by this indolence with details, from a (once again) successful writer whose commitment to the truth was formerly in question. But I was disconcerted, too, by Hari’s careless use of language. He’s a lovely writer when he wants to be: As a columnist, his early work—filled with fizzy, funny formulations—was a pleasure to consume. Now he sometimes writes as though he’s dishing day-old cream of wheat. “Then a breakthrough came from totally out of left field,” reads one characteristic section opener. The scientists in Magic Pill are said to have “aha moments,” “light-bulb moments,” and moments as “in a game show, where you realize you’ve won the jackpot”; and many of their reported quotes—which Hari tends to give at snippet-length—are comically banal. “That was unbelievably exciting,” an endocrinologist tells him, in reference to the FDA’s approval of a diabetes drug. “When you have obesity as a child, it’s very difficult to become un-obese,” another source explains.[Read: Ozempic or bust]He’s also shameless about recycling his work. “I’d like to briefly restate a little of what I wrote,” he offers at one point, as the setup for a two-page run-through of a scene from Lost Connections. In other places, second-hand material gets passed off as something new. “If I was a sandwich, you wouldn’t want to eat me,” he says he told his trainer in Magic Pill, after learning that his body-fat percentage was up to 32. He made the same incomprehensible joke about his body-fat percentage, using almost the same words, in the story about his visit to the Austrian health spa from 2005: “If I were a sandwich, nobody would eat me. Except me.” He also used it in a column from 2010: “If I were a sandwich, nobody would eat me except me.”Some stretches of Magic Pill are so caked over with cliché that you can’t help but wonder if Hari might be doing it on purpose. He writes about a time when “something unexpected happened,” and then another time when someone “stumbled on an unexpected fact,” and a third when a lot of people started to “notice something unexpected.” This formulation—someone noticed something—keeps coming back: We hear from people who have variously “noticed something weird,” “noticed something odd,” “notice[d] something disconcerting,” “noticed something striking,” “noticed something peculiar,” or simply “noticed something” (which occurs multiple times on its own).Some people are so rich they’re said to have fuck-you money. As I read through Magic Pill, I couldn’t help but wonder: Is this Hari’s fuck-you prose? But then something else occurred to me: Ironically, and despite its tendency toward sloppiness, this is Hari’s writing on a diet. Sure, he used to tell his stories with panache, but that was the old Johann Hari—the fried-chicken-eating Johann Hari, the pill-popping Johann Hari, the plagiarizing Johann Hari. Now he’s on a strict regimen of bullet points. He’s skimmed the oil from his writing and doubled down on adding fiber.Why else would he insist on keeping track of all the miles that he’s traveled for each book? Why else would he be calculating (and reporting!) the numbers of his interviews? And why else would Hari feel the need to enumerate his every thought and argument as if it were a meal to be recorded in a food-tracking app? Magic Pill, like all his other books, is preoccupied with numbered lists. He can’t seem to stop himself from tallying: the five reasons we eat; the seven ways that processed foods will undermine your health; the 12 potential risks of taking drugs like Ozempic; and the five long-term scenarios that these drugs may yet produce. Was this just another form of laziness? He’s counting calories, of course; he’s showing you his work is made from whole ingredients. This is journalism on a detox cleanse. This is how you write for sustenance instead of pleasure. And this may be what you do when you’re a recovering former columnist.“I work hard to make my books both factually accurate and transparent,” Hari told me in his emailed response. “Because of some things I did that were unambiguously wrong 14 years ago, I am held to a high standard, and I embrace that high standard.” But few efforts at self-discipline can last for long, as Magic Pill itself explains.The book describes a long history of research showing that losing weight by eating less is often ineffective. “When I injected myself with Ozempic for the fifth month in a row, I thought of all the diets I had tried over the years, all the times I had tried to cut out carbs or sugar,” Hari writes. “I wondered if all those diets had been a sad joke all along, and this was my only option now.” As a journalist, he also ends up straying from his regimen: From time to time, and in place of conversations with his expert sources, Hari slips into a looser and more entertaining style. He talks about his friends, for instance, and describes the conversations they’ve had about Ozempic. Hari’s pals, unlike his sources, tend to speak in long and lively monologues that just happen to encapsulate the themes of Magic Pill. “How much is this really about improving your health?” asks a friend whom he decides to call Lara. “I don’t think, for you, it is. Not really. Not primarily. I want you to stop, and really think about it.” She goes on: I’ve known you for twenty-five years, and you’ve never been happy about how you look. You look good. I’ve always thought you looked good. But you don’t think you do. So you’re taking this drug—and all these huge risks—to conform to a particular look, an approved look, the most socially approved look. That’s why you’re doing it. You want to be thin. Those people at that Hollywood party you went to, where you learned about this drug for the first time, and you texted me all excited—they weren’t doing this to boost their health. They were already healthy. They had private chefs to cook them the healthiest possible food. They see a personal trainer every day. They were doing it to be unnaturally thin. You aren’t taking these risks to have a healthy heart. You’re taking them to have cheekbones. Lara continues in this vein, with very minor interjections from the author, across five pages of the book. This reads like Hari’s writing on a binge, unchecked by endnotes or the need for posting audio from interviews. (The bits about his friends come with no citations.) And he’s in binge mode, too, when he’s telling stories from his past, like the one about the wellness trip to Austria. Certain rigors now appear to be suspended, and the facts get kind of doughy.[Read: Ozempic patients need an off ramp]For instance, when Hari first wrote about his visit to the Alpine clinic, for The Independent in 2005, he said that he was met at the entrance by a man. In Magic Pill, it’s “a woman dressed in an elaborate nineteenth-century Austrian peasant costume.” (When reached by email, Hari blamed this gender inconsistency on a typo in the first version, which turned she into he.) The same woman comes back later in the retold version of the story, still in her elaborate peasant costume, where the original version refers only to a “nurse.” Hari says in Magic Pill that multiple staffers at the clinic were in these silly peasant outfits. The version from The Independent—from which entire paragraphs have otherwise been borrowed word for word—mentions none of them. (“It’s normal, when writing an article, to leave out some minor descriptive details, and to include them when you have more space later,” Hari told me in the email.)Similar adjustments can be found in Hari’s other reheated anecdotes. He starts the book with one about a trip he took to KFC on Christmas Eve in 2009, where all the members of the restaurant’s staff surprised him with a giant Christmas card addressed “to our best customer,” which included personal messages from each of them. He told the same story a few years ago in Lost Connections, and before that in an Independent column in 2010. But the original version takes place on December 23, not Christmas Eve; “You are our best customer” is a thing that’s said out loud, not written on a card, and there’s no mention of any personal messages from anyone at the restaurant. (Hari acknowledged that he’d made an error on the date, and told me that he’d be “happy to correct this.”) If these stories have been lightly edited, all the changes were of course unnecessary. Perhaps the clinic sounds a little sillier with the staff in dirndls, and the story of the card from KFC lands a little better when it plays out on Christmas Eve. But why would Hari bother to adjust these minor details when he’s taking such pains in other ways to demonstrate his scruples?Hari’s subject matter and his execution seem to come together in these moments. He’s explained the social and environmental causes of compulsive overeating, and he’s appealed to all the ways in which behavior can be shaped by past experience. In recent years he’s done the same for drug abuse, depression, and distraction. After nearly losing his career for taking liberties with facts, Hari has gotten famous as a chronicler and social theorist of our lack of self-control. But however it’s presented, his struggle to constrain himself still appears to be ongoing. Johann Hari keeps wondering what happened to his willpower. Four books into his comeback, we all might wonder just the same.

A chronicler of addictions struggles to control himself.

In the fall of 2005, Johann Hari, then a young columnist for The Independent who was struggling with his weight, described a trip he said he’d taken to a wellness spa in the foothills of the Carinthian Alps. After spending just four days there on a cleansing diet that consisted almost entirely of drinking tea—Hari could not bear to stay a moment longer—he’d lost seven pounds. “The cravings for lard had leeched out of my system,” he marveled in his write-up, noting that he hadn’t yet regained the weight.

Hari tells this Alpine-detox story once again in Magic Pill, his fourth and latest book, released last month—but the anecdote now appears to hold a different lesson. Instead of maintaining his new diet, he seems to relapse: “When I got home, I felt like a failure,” he now says of the very same experience. “Where, I wondered, was my willpower?”

The new book’s title is a slanted reference to Ozempic (which doesn’t come in pill form), and to the new class of anti-obesity medications that is already reshaping health care for tens of millions of Americans. Many of Magic Pill’s 250 pages describe these drugs’ amazing benefits and potential harms; most of the rest are devoted to a workmanlike review of certain social causes of obesity, and how they might one day be reversed. Some portions of this story have been told in other places—Hari makes ample references to other well-known books. But his account brings an element of human drama that few could match, even when it’s just rehashing others’ work. That drama is the author’s own: Above all else, Magic Pill describes Hari’s everlasting struggle to control himself. Whether purposefully or not, he has produced a revealing record of his shame.

Why does Hari feel ashamed? For one thing, he’s on Ozempic. Hari doesn’t really need to take Ozempic, but he’s on it nonetheless: That’s the premise of the book, as laid out from the start. He decided, “quite abruptly” as he puts it in the introduction, to begin injections. It was 2022, and his pandemic BMI had risen to a hair over 30, just high enough to qualify for a prescription. Going on it “was a snap decision,” he explains, “and later I realized I was driven by impulses I didn’t fully understand at the time.” A methodical examination of those impulses unspools from there: Across the book’s 12 chapters, Hari will ask himself why he can’t just stop eating. Why should he need the help of a powerful drug to lose weight? Where, he’ll wonder again and again, is his willpower?

There are scientific answers to those questions, and also there are moral ones. “Taking Ozempic was a betrayal of my values. Every time I injected myself, I felt fraudulent,” he writes. A few pages later, he elaborates: “If I am totally honest, at some level, I believed that by taking these drugs, I was cheating.” This inner sense of crookedness is meant to stand in for a more expansive one. If he’s a victim of his impulses, then we all are as well. Why can’t any of us stop eating? Whatever happened to our willpower? And if Hari feels uneasy injecting himself with artificial self-restraint, then society should feel the same. We’ve made a religion, more or less, out of limitless consumption; we’ve allowed our diets to be overrun with processed, packaged foods. Now we’re rolling back the ill effects of too much eating with yet another branded product. Doesn’t this approach to public health feel a little bit like cheating? Isn’t it a form of fraud?

This line of thinking holds a special resonance for Hari, who has in other contexts shown a catastrophic lack of self-control. In fact, his history as a journalist would seem to offer special insight into the battle between the id and the superego. As a columnist for magazines and newspapers—and as the guy who wrote about the Alpine weight-loss trip almost 20 years ago—he was once a lauded journalist. Hari’s work “combines courageous reporting and forceful writing with honest analysis,” announced a judge who awarded him the Orwell Prize in 2008. But Hari’s career appeared to reach an early end a few years later, when some of his work was found to be conspicuously dishonest. In 2011, he was outed as a plagiarist, and then for making vicious accusations about his rivals through a sock-puppet account on Wikipedia. “I did two wrong and stupid things,” Hari wrote in his final column for the Independent, under the headline “A personal apology.” He promised to step away from writing for a while so that he could study journalism, and that when he finished he’d be more scrupulous than he’d ever been before, footnoting all his work and posting audio of all his interviews. “I hope after a period of retraining, you will give me the chance,” he said.

That chance arrived a few years later, when Hari reappeared with a best seller, Chasing the Scream, on the social causes of addiction, and a viral TED Talk—which has now been viewed 21 million times—on the same topic. He’s since written three more pop-science books, all of which are variations on this theme. In 2018, he published Lost Connections, another best seller, about depression, anxiety, and, to some extent, the nature of addiction. Hillary Clinton blurbed that one, and Ezra Klein had Hari on his podcast. After that was Stolen Focus, in 2022, about technology, distraction, and the limits of the will. Hari got another blurb from Clinton (among other celebrities), and spent another hour as a guest on Klein’s show. And now this year we have Magic Pill, Hari’s book about obesity, overeating, and, once again, the limits of the will.

Which is to say, all of Hari’s writing since his comeback has been concerned—one might even say obsessed—with self-control and self-destruction; and with the interplay of forces, from without and from within, that may lead us into ruin. They present as social commentary, and also as self-help, and further as a meditation on the links between the social and the self. As Klein put it on his podcast, the books compose “a little subgenre taking conditions and afflictions that we individualize and arguing for their social roots.”

Hari tends to use himself to illustrate those conditions and afflictions, however they arise. According to his books, he’s been hooked on stimulants; he’s also been strung out on antidepressants, dependent on his phone, and addicted to fried foods. He says he has a family history of drug dependence, and of mental illness, and also of obesity. In other words, Hari lives in just the way we all do: caught between desire and self-blame. His books describe dysregulation. They’re also a product of it.

Back in 2015, when Hari gave his first post-scandal interview, he described himself, in a joke, as a “recovering former columnist.” His work since then does read like one extended chronicle of a struggle for sobriety—particularly when it comes to sticking to the facts. Hari’s books remind you in a hundred different ways that he’s on the wagon as a journalist. He posts the audio from many of his interviews, just as he promised he would, and he piles on the endnotes. “I went on a journey of over forty thousand miles. I conducted more than two hundred interviews across the world,” he boasts in the introduction to Lost Connections. “I went on a 30,000-mile journey … In the end, I interviewed over 250 experts,” he says in Stolen Focus. And now, apparently having rushed a bit for Magic Pill: “I went on a journey around the world, where I interviewed over a hundred experts.”

But showing off is not the same as showing discipline. In spite of Magic Pill’s 394 endnotes (including those published on the website for the book) and 318 posted clips from interviews, and notwithstanding the pair of fact-checkers whom Hari thanks in his acknowledgments, the book is strewn with sloppy errors. Some of these have already been made public. When a British restaurant critic named Jay Rayner, described by Hari as having lost his love for food after going on Ozempic, pointed out on X last month that this was “complete and utter bollocks,” Hari admitted his mistake: “I apologise to Jay for getting this wrong, & am gutted I & my fact-checkers missed it,” he wrote. Then his proffered explanation—that he’d meant to cite the experience of the film critic Leila Latif when she was on Ozempic—ran aground as well. “I’m not, nor have I ever been, on semaglutide,” Latif chimed in just hours later.

A few weeks ago he posted fixes for another seven errors from the book on his website, in response to an email from a journalist. (A detailed roundup of those mistakes has since been published in The Telegraph.) I came across a bunch of other glitches in my reading of the book. In one instance, Hari writes about an evening long ago when he heard about a restaurant in Las Vegas where the servers doled out spankings to anyone who didn’t clean their plate. According to the book, that conversation happened in the late 1990s or early aughts, but the restaurant in question—called the Heart Attack Grill—didn’t open in Las Vegas until 2011. This tiny error makes no difference to the story Hari tells, but lots of tiny errors, set against the backdrop of the author’s ostentatious rigor, tell a story of their own. In a chapter on the scourge of ultra-processed foods, Hari talks about the slurry of defatted beef that is sometimes called “pink slime,” suggesting that it got this name from a food executive. This is precisely not the case. (Food executives sued the guy who coined that phrase, along with the news outlet that reported it, for defamation.) When Hari writes about the big reveal of findings from a major trial of Ozempic’s use for losing weight, he sets the scene on “one day in 2022.” The reveal occurred in 2021. And when he describes a study of mothers who have been taught “responsive parenting” techniques, he says their children ended up half as likely to become obese or overweight as those of other parents. (Hari puts the word half in italics, to emphasize the size of the effect.) But this finding was not statistically significant, according to the published work to which he is referring. “Differences between study groups were modest,” it says.

When reached by email, Hari acknowledged two of these mistakes and insisted that the other two were spurious. Some food executives did end up uttering the words pink slime, he said. (This was only in the course of responding to the PR crisis that the coinage had produced.) He also said that he’d drawn the stat about responsive parenting from a different paper that came out of the same research project, which was published two years earlier than the one cited in the endnotes of his book. (The text in Magic Pill clearly refers to the findings of the more recent paper.)

I’m worried by this indolence with details, from a (once again) successful writer whose commitment to the truth was formerly in question. But I was disconcerted, too, by Hari’s careless use of language. He’s a lovely writer when he wants to be: As a columnist, his early work—filled with fizzy, funny formulations—was a pleasure to consume. Now he sometimes writes as though he’s dishing day-old cream of wheat. “Then a breakthrough came from totally out of left field,” reads one characteristic section opener. The scientists in Magic Pill are said to have “aha moments,” “light-bulb moments,” and moments as “in a game show, where you realize you’ve won the jackpot”; and many of their reported quotes—which Hari tends to give at snippet-length—are comically banal. “That was unbelievably exciting,” an endocrinologist tells him, in reference to the FDA’s approval of a diabetes drug. “When you have obesity as a child, it’s very difficult to become un-obese,” another source explains.

[Read: Ozempic or bust]

He’s also shameless about recycling his work. “I’d like to briefly restate a little of what I wrote,” he offers at one point, as the setup for a two-page run-through of a scene from Lost Connections. In other places, second-hand material gets passed off as something new. “If I was a sandwich, you wouldn’t want to eat me,” he says he told his trainer in Magic Pill, after learning that his body-fat percentage was up to 32. He made the same incomprehensible joke about his body-fat percentage, using almost the same words, in the story about his visit to the Austrian health spa from 2005: “If I were a sandwich, nobody would eat me. Except me.” He also used it in a column from 2010: “If I were a sandwich, nobody would eat me except me.”

Some stretches of Magic Pill are so caked over with cliché that you can’t help but wonder if Hari might be doing it on purpose. He writes about a time when “something unexpected happened,” and then another time when someone “stumbled on an unexpected fact,” and a third when a lot of people started to “notice something unexpected.” This formulation—someone noticed something—keeps coming back: We hear from people who have variously “noticed something weird,” “noticed something odd,” “notice[d] something disconcerting,” “noticed something striking,” “noticed something peculiar,” or simply “noticed something” (which occurs multiple times on its own).

Some people are so rich they’re said to have fuck-you money. As I read through Magic Pill, I couldn’t help but wonder: Is this Hari’s fuck-you prose? But then something else occurred to me: Ironically, and despite its tendency toward sloppiness, this is Hari’s writing on a diet. Sure, he used to tell his stories with panache, but that was the old Johann Hari—the fried-chicken-eating Johann Hari, the pill-popping Johann Hari, the plagiarizing Johann Hari. Now he’s on a strict regimen of bullet points. He’s skimmed the oil from his writing and doubled down on adding fiber.

Why else would he insist on keeping track of all the miles that he’s traveled for each book? Why else would he be calculating (and reporting!) the numbers of his interviews? And why else would Hari feel the need to enumerate his every thought and argument as if it were a meal to be recorded in a food-tracking app? Magic Pill, like all his other books, is preoccupied with numbered lists. He can’t seem to stop himself from tallying: the five reasons we eat; the seven ways that processed foods will undermine your health; the 12 potential risks of taking drugs like Ozempic; and the five long-term scenarios that these drugs may yet produce. Was this just another form of laziness? He’s counting calories, of course; he’s showing you his work is made from whole ingredients. This is journalism on a detox cleanse. This is how you write for sustenance instead of pleasure. And this may be what you do when you’re a recovering former columnist.

“I work hard to make my books both factually accurate and transparent,” Hari told me in his emailed response. “Because of some things I did that were unambiguously wrong 14 years ago, I am held to a high standard, and I embrace that high standard.” But few efforts at self-discipline can last for long, as Magic Pill itself explains.

The book describes a long history of research showing that losing weight by eating less is often ineffective. “When I injected myself with Ozempic for the fifth month in a row, I thought of all the diets I had tried over the years, all the times I had tried to cut out carbs or sugar,” Hari writes. “I wondered if all those diets had been a sad joke all along, and this was my only option now.” As a journalist, he also ends up straying from his regimen: From time to time, and in place of conversations with his expert sources, Hari slips into a looser and more entertaining style. He talks about his friends, for instance, and describes the conversations they’ve had about Ozempic. Hari’s pals, unlike his sources, tend to speak in long and lively monologues that just happen to encapsulate the themes of Magic Pill. “How much is this really about improving your health?” asks a friend whom he decides to call Lara. “I don’t think, for you, it is. Not really. Not primarily. I want you to stop, and really think about it.” She goes on:

I’ve known you for twenty-five years, and you’ve never been happy about how you look. You look good. I’ve always thought you looked good. But you don’t think you do. So you’re taking this drug—and all these huge risks—to conform to a particular look, an approved look, the most socially approved look. That’s why you’re doing it. You want to be thin. Those people at that Hollywood party you went to, where you learned about this drug for the first time, and you texted me all excited—they weren’t doing this to boost their health. They were already healthy. They had private chefs to cook them the healthiest possible food. They see a personal trainer every day. They were doing it to be unnaturally thin. You aren’t taking these risks to have a healthy heart. You’re taking them to have cheekbones.

Lara continues in this vein, with very minor interjections from the author, across five pages of the book. This reads like Hari’s writing on a binge, unchecked by endnotes or the need for posting audio from interviews. (The bits about his friends come with no citations.) And he’s in binge mode, too, when he’s telling stories from his past, like the one about the wellness trip to Austria. Certain rigors now appear to be suspended, and the facts get kind of doughy.

[Read: Ozempic patients need an off ramp]

For instance, when Hari first wrote about his visit to the Alpine clinic, for The Independent in 2005, he said that he was met at the entrance by a man. In Magic Pill, it’s “a woman dressed in an elaborate nineteenth-century Austrian peasant costume.” (When reached by email, Hari blamed this gender inconsistency on a typo in the first version, which turned she into he.) The same woman comes back later in the retold version of the story, still in her elaborate peasant costume, where the original version refers only to a “nurse.” Hari says in Magic Pill that multiple staffers at the clinic were in these silly peasant outfits. The version from The Independent—from which entire paragraphs have otherwise been borrowed word for word—mentions none of them. (“It’s normal, when writing an article, to leave out some minor descriptive details, and to include them when you have more space later,” Hari told me in the email.)

Similar adjustments can be found in Hari’s other reheated anecdotes. He starts the book with one about a trip he took to KFC on Christmas Eve in 2009, where all the members of the restaurant’s staff surprised him with a giant Christmas card addressed “to our best customer,” which included personal messages from each of them. He told the same story a few years ago in Lost Connections, and before that in an Independent column in 2010. But the original version takes place on December 23, not Christmas Eve; “You are our best customer” is a thing that’s said out loud, not written on a card, and there’s no mention of any personal messages from anyone at the restaurant. (Hari acknowledged that he’d made an error on the date, and told me that he’d be “happy to correct this.”) If these stories have been lightly edited, all the changes were of course unnecessary. Perhaps the clinic sounds a little sillier with the staff in dirndls, and the story of the card from KFC lands a little better when it plays out on Christmas Eve. But why would Hari bother to adjust these minor details when he’s taking such pains in other ways to demonstrate his scruples?

Hari’s subject matter and his execution seem to come together in these moments. He’s explained the social and environmental causes of compulsive overeating, and he’s appealed to all the ways in which behavior can be shaped by past experience. In recent years he’s done the same for drug abuse, depression, and distraction. After nearly losing his career for taking liberties with facts, Hari has gotten famous as a chronicler and social theorist of our lack of self-control. But however it’s presented, his struggle to constrain himself still appears to be ongoing. Johann Hari keeps wondering what happened to his willpower. Four books into his comeback, we all might wonder just the same.

Read the full story here.
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Building Apartment Projects Near Public Transit Helps Address Housing Crisis, Combat Climate Change

Quantavia Smith, who was often homeless for a decade, now has a studio apartment in Los Angeles with easy access to public transit

BOSTON (AP) — After years of living on the street and crashing on friends' couches, Quantavia Smith was given the keys to a studio apartment in Los Angeles that came with an important perk — easy access to public transit. The 38-year-old feels like she went from a life where “no one cares” to one where she has a safe place to begin rebuilding her life. And the metro station the apartment complex was literally built upon is a lifeline as she searches for work without a car.“It is more a sense of relief, a sense of independence," said Smith, who moved in July. She receives some government assistance and pays 30% of her income for rent — just $19 a month for an efficiency with a full-market value of $2,000. “Having your own space, you feel like you can do anything."Metro areas from Los Angeles to Boston have taken the lead in tying new housing developments to their proximity to public transit, often teaming up with developers to streamline the permitting process and passing policies that promote developments that include a greater number of units.City officials argue building housing near public transit helps energize neglected neighborhoods and provide affordable housing, while ensuring a steady stream of riders for transit systems and cutting greenhouse gas emissions by reducing the number of cars on the road.“Transit-oriented development should be one of, if not the biggest solution that we’re looking at for housing development,” said Yonah Freemark, research director at the Urban Institute’s Land Use Lab, who has written extensively on the topic. “It takes advantage of all of this money we’ve spent on transportation infrastructure. If you build the projects and don’t build anything around the areas near them, then it’s kind of like money thrown down the drain,” Freemark said. Transit housing projects from DC to LA The Santa Monica and Vermont Apartments where Smith lives is part of an ambitious plan by the Los Angeles County Metropolitan Transportation Authority to build 10,000 housing units near transit sites by 2031 — offering developers land discounts in exchange for affordable housing development and other community benefits.In Washington D.C., the transit authority has completed eight projects since 2022 that provided nearly 1,500 apartments and a million square feet of office space. About half were in partnership with Amazon, which committed $3.6 billion in low-cost loans and grants for affordable housing projects in Washington, as well as Nashville, Tennessee, and the Puget Sound area in Washington state. Almost all are within a half-mile of public transit. “Big cities face the greatest challenges when it comes to traffic congestion and high housing costs,” Freemark said. “Building new homes near transit helps address both problems by encouraging people to take transit while increasing housing supply.”Among projects Boston has built, the Pok Oi Residents in Chinatown is a 10-minute walk to the subway and a half-dozen bus stops. That's a draw for Bernie Hernandez, who moved his family there from a Connecticut suburb after his daughter got into a Boston university.“The big difference is commuting. You don’t need a car,” said Hernandez, who said he can walk to the grocery story and pharmacy. His 17-year-old daughter takes the subway to school. Now, his car mostly sits idle, saving him money on gas and time spent in traffic.“You get to go to different places very quickly. Everything is convenient," Hernandez said. States take aim at zoning regulations States from Massachusetts to California are passing laws targeting restrictive zoning regulations that for decades prohibited building multifamily developments and contributed to housing shortages. Last month, California Gov. Gavin Newsom signed a state law allowing taller apartment buildings on land owned by transit agencies and near bus, train and subway lines. “Building more homes in our most sustainable locations is the key to tackling the affordability crisis and locking in California’s success for many years to come,” said State Sen. Scott Wiener, a Democrat who authored the bill.California joins Colorado, which requires cities to allow an average of 40 housing units per acre within a quarter-mile of transit, and Utah, which mandates about 50 units per acre. In Washington, the governor signed a bill this year allowing taller housing developments in mixed-use commercial zones near transit. “We want to ensure that there are mixed-income, walkable, vibrant homes all around those transit investments and that people have the option of using cars less to improve the environmental health of our communities,” said Democratic Rep. Julia Reed, who authored the Washington bill.“It’s about giving people the opportunity to drive less and live more." Housing takes center stage in Massachusetts Among her most potent tools is a 2021 law that requires 177 towns or communities nearby to create zoning districts allowing multi-family housing. The state provided nearly $8 million to more than 150 communities to help create these zones, while threatening to cut funding for those that don't. More than 6,000 housing units are in development as a result.“You put housing nearby public transit" Healey said. "It’s great for people. They can literally get up, leave their home, walk to a commuter rail and get to work.” Among the first to comply was Lexington, which has approved 10 projects, including a $115 million complex with 187 housing units and retail space.Walking past earth-moving equipment and dump trucks at the construction site earlier this year, project manager Quinlan Locke said: “This is a landscape yard. It’s commercial. It’s meant for trucking.” But, he added, in “two years from now, it’s going to be meant for people who live here, work here and play here. This is going to become someone’s home.” Opposition to zoning changes Some advocates argue the lofty goals of transit housing are falling short due to fierce local resistance and lack of funding and support at the federal and state levels. Higher mortgage interest rates, more government red tape, rising construction costs and lack of investment at transit stations also have contributed to a troubling trend — nine times more housing units built far from public transit versus near it in the past two decades, according to a 2023 Urban Institute study.In Massachusetts, 19 communities still haven't created new zones. Some unsuccessfully sued the state to halt the law, while residents rejected new zones in others. Lexington eventually shrank its zone from 227 acres to 90 acres after residents complained.“If we allow the state to come in and dictate how we zone, what else are they going to come in and dictate?” said Anthony Renzoni, a selectman from the town of Holden, which sued the state and is drawing up a new zoning map after residents rejected the first one.In Los Angeles, the six-story complex where Smith lives in East Hollywood is home to 300 new residents since opening in February. It's revitalizing the area around the metro site, with a Filipino grocery, medical clinic and farmers market opening early next year. Half the 187 units are reserved for formerly homeless residents like Smith, who had been living in a rundown motel paid for with a voucher and before that on the street. She's been assigned a case worker and is getting help with basic life skills, budgeting and finding work. Equally important: Smith, who can't afford a car, doesn't need one.“I’m very very fortunate to be somewhere where the transit takes me where I want to go,” she said. “Where I want to go is not that far.”Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Photos You Should See – Oct. 2025

Tehran Taps Run Dry as Water Crisis Deepens Across Iran

By Parisa HafeziDUBAI (Reuters) -Iran is grappling with its worst water crisis in decades, with officials warning that Tehran — a city of more than...

DUBAI (Reuters) -Iran is grappling with its worst water crisis in decades, with officials warning that Tehran — a city of more than 10 million — may soon be uninhabitable if the drought gripping the country continues.President Masoud Pezeshkian has cautioned that if rainfall does not arrive by December, the government must start rationing water in Tehran."Even if we do ration and it still does not rain, then we will have no water at all. They (citizens) have to evacuate Tehran," Pezeshkian said on November 6.The stakes are high for Iran's clerical rulers. In 2021, water shortages sparked violent protests in the southern Khuzestan province. Sporadic protests also broke out in 2018, with farmers in particular accusing the government of water mismanagement.WATER PRESSURE REDUCTIONS BEING APPLIEDThe water crisis in Iran after a scorching hot summer is not solely the result of low rainfall.Decades of mismanagement, including overbuilding of dams, illegal well drilling, and inefficient agricultural practices, have depleted reserves, dozens of critics and water experts have told state media in the past days as the crisis dominates the airwaves with panel discussions and debates.Pezeshkian's government has blamed the crisis on various factors such as the "policies of past governments, climate change and over-consumption".While there has been no sign of protests yet this time over the water crisis, Iranians are already struggling under the weight of a crippled economy, chiefly because of sanctions linked to the country’s disputed nuclear programme.Coping with persistent water shortages strains families and communities even further, intensifying the potential for unrest, when the clerical establishment is already facing international pressure over its nuclear ambitions. Iran denies seeking nuclear weapons.Across Iran, from the capital’s high-rise apartments to cities and small towns, the water crisis is taking hold.When the taps went dry in her eastern Tehran apartment last week, Mahnaz had no warning and no backup."It was around 10 p.m., and the water didn’t come back until 6 a.m.,” she said. With no pump or storage, she and her two children were forced to wait, brushing teeth and washing hands with bottled water.Iran’s National Water and Wastewater Company has dismissed reports of formal rationing in Tehran, but confirmed that nightly water pressure reductions were being applied in Tehran and could drop to zero in some districts, state media reported.Pezeshkian also warned against over-consumption in July. The water authorities said at the time 70% of Tehran residents consumed more than the standard 130 litres a day.TEHRAN'S RESERVOIRS AT AROUND HALF CAPACITYIranians have endured recurrent electricity, gas and water shortages during peak demand months in the past years."It’s one hardship after another — one day there’s no water, the next there’s no electricity. We don’t even have enough money to live. This is because of poor management," said schoolteacher and mother of three Shahla, 41, by phone from central Tehran.Last week, state media quoted Mohammadreza Kavianpour, head of Iran’s Water Research Institute, as saying that last year’s rainfall was 40% below the 57-year average in Iran and forecasts predict a continuation of dry conditions towards the end of December.The capital depends entirely on five reservoirs fed from rivers outside the city. But inflow has plummeted. Behzad Parsa, head of Tehran’s Regional Water Company, said last week that water levels had fallen 43% from last year, leaving the Amir Kabir Dam at just 14 million cubic meters — 8% of capacity.He said Tehran’s reservoirs, which collectively could once store nearly 500 million cubic meters, now hold barely 250 million, a drop of nearly half, which at current consumption rates, could run dry within two weeks.The crisis extends far beyond Tehran. Nationwide, 19 major dams — roughly 10% of Iran’s total — have effectively run dry. In the holy Shi'ite city of Mashhad, Iran’s second-largest city, with a population of 4 million, water reserves have plunged below 3%."The pressure is so low that literally we do not have water during the day. I have installed water tanks but how long we can continue like this? It is completely because of the mismanagement," said Reza, 53, in Mashhad. He said it was also affecting his business of carpet cleaning.Like the others Reuters spoke to, he declined to give his family name.CLIMATE CHANGE INTENSIFIED WATER LOSSThe crisis follows record-breaking temperatures and rolling power outages. In July and August, the government declared emergency public holidays to reduce water and energy consumption, shutting down some public buildings and banks as temperatures topped 50 degrees Celsius (122 degrees Fahrenheit) in some areas.Climate change has intensified the problem, authorities say, with rising temperatures accelerating evaporation and groundwater loss.Some newspapers have criticized the government’s environmental policies, citing the appointment of unqualified managers and the politicization of resource management. The government has rejected the claims.Calls for divine intervention have also resurfaced."In the past, people would go out to the desert to pray for rain,” said Mehdi Chamran, head of Tehran’s City Council, state media reported. "Perhaps we should not neglect that tradition."Authorities are taking temporary measures to conserve what remains, including decreasing the water pressure in some areas and transferring water to Tehran from other reservoirs.But these are stopgap measures, and the public has been urged to install storage tanks, pumps, and other devices to avoid major disruption."Too little, too late. They only promise but we see no action," said a university teacher in the city of Isfahan, who asked not to be named. "Most of these ideas are not doable."(Writing by Parisa Hafezi;Editing by Alison Williams)Copyright 2025 Thomson Reuters.

Governor Wants 27k New Homes Built in Honolulu Neighborhood, Plans to Seek Infrastructure Funding

Hawaii Gov. Josh Green has an ambitious plan for Iwilei, a working-class neighborhood bordering Honolulu's Chinatown, along the rail line

Gov. Josh Green has a big vision for Iwilei, the working-class neighborhood bordering Honolulu’s Chinatown along the rail line. It would cost an estimated $667 million in state taxpayer money for a massive infrastructure upgrade, Green says. The trade-off: 27,500 new homes and upward of $5 billion in investment into an area Honolulu Mayor Rick Blangiardi has targeted for redevelopment.Green said he’ll include a request for some Iwilei infrastructure money in his housing package for the upcoming session. “This is already being formulated in the housing plan,” he said.The Iwilei effort reflects Green’s current approach to housing, which relies on development along the Honolulu rail line, coordinating with county initiatives, building on government-owned land and focusing on affordable housing — all expedited by an emergency proclamation more modest than the one he announced to great fanfare in 2023.Housing remains a major initiative, Green said in a sweeping interview.“It’s still our top priority,” the governor said. “Affordability, in other words, cost of living and housing still are the top two concerns that our people have, and they are still our top priorities.”The market has shown few signs of improving since Green took office. While the resale prices of single-family homes and condos have leveled off, rents have increased 17% since his December 2022 inauguration, according to the University of Hawaii Economic Research Organization. Polls show 53% of residents feel burdened by housing costs, Green said, and 28% feel severely cost-burdened.Housing was one of Green’s major campaign issues. And upon taking office, he quickly announced bold measures to address Hawaii’s housing crisis. An emergency proclamation on homelessness heralded a statewide initiative to build villages of tiny homes combined with social services to get people off the streets. His emergency proclamation on housing was even bolder. Designed to encourage home building of all types, not just homes designated as affordable, the proclamation suspended an array of land-use and environmental laws that developers have long complained led to interminable delays and increased costs. The proclamation established a working group to approve projects according to a set of emergency rules set up in place of the suspended laws.The order triggered applause from builders but fierce opposition and lawsuits from environmentalists. Green quickly scaled back the order, restoring many of the suspended laws and issuing a new proclamation focusing on affordable housing.Although the Hawaii Supreme Court in September agreed the original proclamation on housing had gone too far, the court upheld the current proclamation on affordable housing. Green calls the ruling a victory — and sees it as an opening for county governments to also address the problem.“I intend to keep the emergency housing proclamation active through the entire first term,” Green said. “And I’m encouraging the mayors and other government officials to consider their own emergency housing proclamations as they see fit going forward.”Much of the governor’s attention for the past two years has been focused on issues other than housing. The Maui wildfires that killed 102 people and destroyed much of Lahaina in August 2023 created massive suffering for residents and economic damage for property owners. In response, Green’s office created a victims’ settlement fund, built hundreds of modular homes near Lahaina and crafted a settlement of thousands of lawsuits, which saved Hawaiian Electric Industries and its utility subsidiaries from bankruptcy.Last session, Green pushed lawmakers to pass a historic law imposing a fee on hotel and other short-term rental users to raise money to help offset the negative impacts of tourism on the environment. There was also a tax bill intended to put more money into the hands of people struggling to get by.“Though people might not hear me utter the words ‘housing crisis’ as often, we’re still under the housing emergency proclamation,” he said. “And I wouldn’t be under an emergency housing proclamation and all that comes with it, if it wasn’t still our top priority.Hawaii now has 64,000 units in the “affordable housing development pipeline,” Green said. Only about 3,000 of those are included in the 27,500 new homes envisioned for Iwilei.In reality, nearly 31,000 of the 64,000 homes are in their infancy and still must go through the arduous process of obtaining land-use permits and other entitlements that can take years to obtain.Green also pointed to his tiny home, or kauhale, initiative. It’s led to 23 kauhale being built since 2022 at a cost of $128.3 million. The Legislature last session handed out $88.2 million over the next two years to keep the program on track toward Green’s goal of 30 villages by 2027.At the same time, lawmakers prohibited building off-grid villages, a practice Green’s former homelessness coordinator, John Mizuno, had criticized, and requested an audit of the program.Still, Green said his housing initiative is on track.“I think it’s been successful,” he said. “You know, there’s a ton of examples here of housing projects that are on the go, you know, where we’ve had groundbreaking and even (people moving in).”Green also said he stands by a pillar of his initiative that continues to get strong pushback from neighborhood and environmental groups. An existing statute gives broad development power to the state Housing Finance Development Corp., a government agency that helps private developers finance projects meeting certain affordability requirements. But affordability is relative.A studio apartment in Honolulu can rent out for as much as $3,724 per month and still be considered affordable under HHFDC guidelines, which are set by the U.S. Department of Housing and Urban Development. A home for a family of four can be priced as high as $757,300 at today’s interest rates and still count as affordable.In exchange for building such affordable housing, projects built by government or private developers with HHFDC approval are exempt from all statutes, ordinances, and any other “rules of any government agency relating to planning, zoning, construction standards for subdivisions, development and improvement of land, and the construction of dwelling units.”The law gives county councils 45 days after plans are submitted to approve, modify or nix the projects. If the councils don’t act by the deadline, the project is considered approved. Green said the law was inspired by his emergency proclamation on affordable housing.“We don’t want to add extra conditions once we get a project approved by HHFDC,” he said. “If they’re ready to go, and then you add in two, three or four extra conditions … That’s a lot of the time how things get bogged down.” Green also defended the use of the statute even if it meant destroying existing homes that working people could afford to make way for housing that was technically deemed affordable but still priced out of reach for many.The Kobayashi Group did just that with its HHFDC-approved Kuilei Place project, located on Kapiolani Boulevard in Moiliili. To make way for the 1,005-unit, 43-story project, the developer razed a neighborhood of about 120 two-story walk-up apartments: true workforce housing walking distance from Waikiki's hotel and restaurant jobs. About 600 condos were set aside as affordable, priced for families of four earning between $104,500 and $158,600.Green said on balance the project was good for society.“It will house many hundreds of additional people, and that’s the macro housing proposal,” he said. Those who had to relocate were “comparatively a very small number of people for a greater benefit to society, which is to build thousands of additional houses.”Green doesn’t foresee the same risk of displacing Iwilei residents. The area, about the size of Waikiki, is one of Honolulu’s more affordable housing markets. Approximately 12,295 residents now live in Iwilei’s 4,297 housing units, according to data from the Census and a private research firm cited in an environmental impact statement approved for the state’s envisioned $667 million infrastructure project.Median rents are around $1,400 per month in the broader Liliha-Nuuanu neighborhood encompassing Iwilei, according to the University of Hawaii Economic Research Organization’s housing data dashboard. The annual income needed to afford rent is about $56,760 — far lower than the $91,000 median household income for Oahu. Still, the EIS notes, people struggle: the median household income is just $45,400, creating more housing affordability stress for Iwilei residents than Oahu residents in general.That said, the EIS says, the state’s infrastructure project “will not in itself impact housing stock, but its intent is to enable other planned developments to proceed.”Ultimately, Green said, the goal is to allow residents to live in Hawaii and stop the outmigration that has occurred for years before now starting to level off.He sees two potential outcomes for the state. In one, the yearslong pace of outmigration levels off and a surge in housing produces “a win for local people, Pacific Islanders, Hawaiians: people can afford housing, and your population can grow normally, so you get some economic growth … and it’s good.”The other, he said, pointing to a chart in a slideshow, is for the population to continue declining.“And then here’s the very bad scenario,” he said. “We go the opposite direction, we fail to build housing. It tightens even further. And it’s really dangerous. It’s dangerous because then only affluent people can live in Hawaii.”This story was originally published by Honolulu Civil Beat and distributed through a partnership with The Associated Press.Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Photos You Should See – Oct. 2025

Can Genetic Testing Predict Type 1 Diabetes? Experts Say Earlier Treatment Is Possible

Genetic screening can mean that people at risk of type 1 diabetes get earlier treatment and better outcomes

This article is part of “Innovations In: Type 1 Diabetes,” an editorially independent special report that was produced with financial support from Vertex.In 2024 Stephen Rich and his colleagues published a study in which they assessed the genetic risk of developing type 1 diabetes for more than 3,800 children from across Virginia. Almost immediately Rich, a genetic epidemiologist at the University of Virginia, was inundated by e-mails and calls from parents who had read the article and wanted their kids tested, too. Unfortunately the study was over, so Rich couldn’t help them. But the experience exemplified the growing interest in genetic risk tests for the disease, he says.There is currently no cure for type 1 diabetes, a chronic condition in which the body’s immune system attacks and kills insulin-producing beta cells in the pancreas. Knowing someone’s genetic predisposition to type 1 diabetes, however, can help doctors identify whom to flag for follow-up tests. It can also lead to earlier adoption of therapeutics to manage the disease or delay its onset. “There’s tremendous power in terms of understanding the genetics of type 1 diabetes,” says Todd Brusko, director of the Diabetes Institute at the University of Florida. As more therapies become available, he adds, the eventual hope is to use genetic profiling to determine who will respond best to one drug versus another.On supporting science journalismIf you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.Recent advances in genetic screening tools have not only revealed an intricate interaction between a person’s genes and their immune system but also made it possible to imagine a future in which every newborn is screened for type 1 diabetes risk. Some health-care authorities are already beginning to consider universal screening. “It’s very exciting times,” says Maria Jose Redondo, a physician and professor of pediatric diabetes and endocrinology at the Baylor College of Medicine. “A lot of progress has been made, and now we’re at the point of applying it.”In the U.S., around one in 300 people develops type 1 diabetes. Although the disease is best known for manifesting in children, adults account for almost half of new diagnoses. Scientists still don’t know what triggers it. Environmental factors seem to play a crucial role in promoting the disease’s development and progression, but the exact causative agents are unknown. “We know less about the environmental factors than we know about the genetic factors,” Redondo says.In a large study called TEDDY (for “the environmental determinants of diabetes in the young”), launched in 2004 in Europe and the U.S., researchers followed 8,676 individuals with high genetic risk to try to identify triggers for type 1 diabetes. They found just one consistent environmental factor linked to higher likelihood of acquiring the disease: early infection with enteroviruses, a type of virus that can infect beta cells. Not all children who get these common infections go on to develop type 1 diabetes, though, so additional factors are probably at play. In addition, the incidence of the disease has been increasing steadily over the past 60 years, suggesting that some change in environmental exposures or the removal of protective factors—or both—may be involved.Genetics accounts for about half of a person’s risk of developing the disease, meaning what is written into someone’s DNA is “not destiny,” Rich says. “If you have a high [genetic] risk, it doesn’t mean you’ll get it, and if you have a not-high risk, that doesn’t mean you’re protected.”For people with a close relative with type 1 diabetes, the risk goes up to about 18 in 300. Those with an identical twin with the disease have the highest risk—about one in two. They are 150 times likelier to develop the illness than someone with no family history and eight times likelier than someone with a parent or sibling who has been diagnosed. Even so, around 90 percent of people who are diagnosed with type 1 diabetes have no relatives with the disease. Until recently, population-level genetic screening, which would include individuals regardless of their known risk factors for the condition, was not a practical option. But new breakthroughs have begun to change that.Scientists have identified at least 90 regions in the human genome that hold genes connected to type 1 diabetes. Researchers are most interested in a gene cluster called the human leukocyte antigen system (HLA), which encodes proteins that help the immune system distinguish self from nonself. This gene group accounts for around half of a person’s genetic risk of developing the disease. Because it helps to protect us from infections, HLA is also highly variable, says Mark Anderson, director of the Diabetes Center at the University of California, San Francisco. “There’s selective pressure for us to have different HLA genes because that way, a virus or bacterium that comes along won’t wipe everyone out.”Most people who acquire type 1 diabetes have at least one of two specific-risk-conferring gene variants, or alleles, in this region. “This region is so critically important to whether we’re susceptible to autoimmune diseases that just by measuring variation there, we can capture risk,” says Richard Oram, a professor of diabetes and nephrology at the University of Exeter in England. Some HLA variants increase risk up to 20-fold, he adds, whereas others decrease risk by the same amount. In effect, it’s as if 10 to 15 percent of people with European ancestry carried a genetic vaccine to type 1 diabetes, Oram says, referring to the HLA gene alleles that decrease risk.In 2015 Oram and his colleagues developed the first version of what is now one of the most widely used tests for type 1 diabetes genetic risk, administered primarily in research settings (the U.S. has yet to approve any test for type 1 diabetes risk for real-world use in doctor offices). Rather than just adding up the contribution of each variant, Oram and his colleagues’ test incorporates the complex interactivity of various alleles with one another, including ones with protective effects. They also incorporated dozens of other non-HLA sites—mostly from genes also related to the immune system—that contribute small amounts of individual risk but can add up to larger cumulative risk.The original version of the test examined just 10 alleles and “worked pretty well,” Oram says. The latest version, developed in 2019, uses 67 alleles and produces “highly sophisticated” results, Redondo says, adding that it now represents “the golden standard to date.”When Oram originally developed his test, he did not have risk prediction in mind; rather he was trying to decipher the type of diabetes in a group of his patients. The individuals he was working with, who were 20 to 40 years old, had overlapping features of type 1 and type 2 diabetes. People who fall into this “gray area” of symptoms are commonly misdiagnosed, he says. While brainstorming solutions over coffee with a colleague, Oram realized a genetic test could offer clues for people with a less clear presentation of the disease.After successfully developing the test, Oram learned that other research groups were interested in tests to determine genetic risk for type 1 diabetes. Fortunately his test “also turned out to be really good for that,” he says.With Oram’s test, doctors can identify the highest-risk individuals, who can then get tested for the antibodies that attack the body’s beta cells. “If you do HLA screening followed by antibody testing at specific ages, you’ll pick up far and away the vast majority of cases,” says William Hagopian, a research professor of pediatrics at the Indiana University School of Medicine. Investigators leading vaccine and pharmaceutical trials for type 1 diabetes are also using genetic tests to maximize efficiency and funding by identifying participants who are most likely at risk for the disease.Genetic risk scores can also help doctors identify people who should be prescribed teplizumab, the first therapy able to delay the onset of an autoimmune condition. Approved by the U.S. Food and Drug Administration in 2022, this monoclonal antibody is given before the body becomes dependent on insulin, and it can delay more severe illness by two to three years. “The whole field has changed because now we have something we can do to delay progression to clinical diabetes,” says Kevan Herold, an immunologist and endocrinologist at Yale University. “Any time without diabetes is a gift, particularly for children and their families.” Other drugs are in various stages of clinical testing.People aware of their risk might also be on the lookout for symptoms such as excessive urination and lethargy; when those pop up, people can seek treatment before they develop diabetic ketoacidosis (DKA), a potentially life-threatening condition caused by a lack of insulin. Among those who don’t know they are at risk, about 40 percent wind up in this critical state, but that number drops as low as 4 percent for those who are aware. “If people can identify some of the symptoms of progression toward disease, they could go to a GP instead of an ER and prevent a real crisis,” Brusko says.There is some evidence to support these benefits, based on outcomes from one of the largest testing efforts to date, launched in 2020 by investigators at Sanford Health, a nonprofit health-care system based in Sioux Falls, S.D. As of July 2025, the study had enrolled more than 13,000 children for genetic risk testing and antibody screening for type 1 diabetes and celiac disease. Children with persistent positive antibodies are offered ongoing monitoring. Of the 75-plus children in monitoring, five have progressed to hyperglycemia, warranting clinical care, and none of these children developed DKA. Kurt Griffin, principal investigator of the study and a pediatric endocrinologist at the Benaroya Research Institute in Seattle, says the findings have already demonstrated that it is feasible to integrate type 1 diabetes screening into routine pediatric care.Type 1 diabetes has been most prevalent among people of European ancestry. It does occur in those of African, Hispanic and Asian ancestry, but the vast majority of data used to inform genetic screening results is from people of white, European descent, Rich says. This lack of representation is problematic for people of different ancestries because genetic risk factors differ across populations.In an unpublished study, Rich and his colleagues tested how well the most common HLA variants used in genetic tests predicted risk in people with European, Hispanic, African American or Finnish ancestry. They found that genetic ancestry for important HLA regions—and the many other regions of the genome associated with type 1 diabetes risk—does not transfer well from one population to another. “One of the biggest needs in the field is to understand what confers genetic risk in a much more diverse genetic ancestry,” Brusko says.Scientists are working to fill this gap. For instance, Breakthrough T1D, a nonprofit organization funding research on type 1 diabetes, provides grants of up to $900,000 for research aimed at improving the prediction power of genetic risk scores across diverse populations. For the next version of the genetic risk score test, the plan is to incorporate specific HLA types present in Africans, East Asians, and several other groups, says Hagopian, who collaborates with Oram.Genetic risk tests for type 1 diabetes are inching closer to use in clinical care. Last year Randox , a company based in Northern Ireland, released one developed with Oram and his colleagues. Commercial tests are not available yet in the U.S., but they are becoming more affordable for researchers who use them in laboratory-based settings. This affordability will translate to clinical settings once tests make their way to doctor offices. “The price has dropped and is predicted to drop even more,” Redondo says. Now the biggest remaining obstacles are political and logistical rather than scientific or financial, experts say. “All the tools are there; we just haven’t quite got countries over the line to figure out how they’re going to do it,” says Colin Dayan, a professor of clinical diabetes and metabolism at Cardiff University in Wales.Europe has been at the forefront of these efforts, Brusko says. In 2023 Italy became the first nation to pass a law mandating type 1 diabetes genetic screening across its population, but it has yet to implement this screening in practice, Dayan says. Other countries, including the U.K., are debating whether they should do the same. This past June the U.K. also announced plans to sequence the genomes of all babies within the next decade. The data obtained could be used for risk screening as well, says Emily K. Sims, a pediatric endocrinologist at the Indiana University School of Medicine. In the U.S., genetic screening for type 1 diabetes is still done primarily in research environments. “We really need federal and state authorities to decide that this testing is worth it and that they want to adopt it into general practice,” Hagopian says. The easiest way to implement such a program would be to screen at birth.What to do with the information that testing would generate, though, is a more complicated question. Health-care officials would have to set up a system for contacting the families of babies at high risk to appropriately communicate the results. There would also need to be a system to remind families to get their child checked for autoantibodies at certain intervals. States handle newborn screenings differently, so each would have to come up with its own solutions. This issue is “a major complication that has to be figured out,” says Rich, who continues to field e-mails and calls from parents interested in the testing.As the science is refined, more treatment options will be made available, and the uncertainty surrounding who will and will not go on to develop type 1 diabetes is likely to be narrowed. Redondo and her colleagues are pursuing a large project using genetic risk scores and other variables to try to more accurately predict disease development. They are also working on models to determine who will respond best to new disease-modifying therapies. As Redondo says, “personalizing prevention of type 1 diabetes is the goal.”

The federal workforce purge begins

OMB confirms sweeping layoffs across major agencies as unions sue and the shutdown grinds on

The Trump administration began large-scale firings of federal workers this week as part of an aggressive strategy to pressure Democrats during the ongoing government shutdown, marking one of the most sweeping workforce purges in modern U.S. history. According to the Office of Management and Budget, “substantial” layoffs are underway across at least seven federal departments, including Treasury, Health and Human Services, Education, Housing and Urban Development, and the Environmental Protection Agency. Early estimates suggest more than 4,000 employees are being terminated under “reduction in force” (RIF) procedures, with thousands more facing potential dismissal if the budget impasse continues. The RIFs have begun. — Russ Vought (@russvought) October 10, 2025 The White House framed the move as a necessary step to “restore accountability” and eliminate “politically motivated obstruction” within the federal bureaucracy. OMB Director Russ Vought confirmed the action publicly, posting, “The RIFs have begun.” Administration officials argue that many affected positions are tied to programs misaligned with the president’s priorities. Critics, including labor unions and civil service advocates, have called the firings unlawful and politically driven. The American Federation of Government Employees and other unions plan to challenge the dismissals in court, citing violations of due process and long-standing federal employment protections. Even Congressional politicians are joining the conversation. While few details have been shared about Russell Vought’s latest layoffs, there is no question this is poorly timed and yet another example of this administration’s punitive actions toward the federal workforce. The termination of federal employees in a shutdown will further hurt… — Sen. Lisa Murkowski (@lisamurkowski) October 10, 2025 The cuts go far beyond typical furloughs associated with past shutdowns, raising questions about service disruptions, long-term staffing gaps, and the precedent it sets for future administrations. Analysts warn that permanent layoffs could cripple key agencies and deepen dysfunction in an already strained federal system. The government remains in partial shutdown as negotiations over a funding bill stall on Capitol Hill. Meanwhile, confusion continues over whether terminated employees will receive retroactive pay once the shutdown ends — an issue that could soon add another legal battle to the widening crisis. Read more about the 2025 Shutdown Federal agencies go MAGA amid shutdown Democrats are winning the health care shutdown war How the government shutdown is hitting the health care system The post The federal workforce purge begins appeared first on Salon.com.

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