33: The Conversation Your Doctor Never Had With Your About Your IBD - with Dr. Will Bulsiewicz

There are things that your GI doctor will never tell you, like the fact that there are other treatment options for your IBD. But today, we have a GI doctor who WILL tell you that there's more to the story. 

Dr. Will B is a world renowned gastroenterologist who specializes in functional medicine and gut health, and we're talking about everything your doctor won't.

TOPICS DISCUSSED:

• Which countries have the worst gut health
• How our gut microbiomes can actually help us measure health and predict disease
• The failures of western medicine 
• How inflammatory bowel diseases like Crohn’s and Colitis develop
• The risk factors of developing IBD
• Food and food preservatives/additives
• How our immune systems and gut are connected
• What it really means to have “dysbiosis” 
• How to get our guts under control, correct and optimize every aspect of our gut health, our immune systems and our overall health.

Listen to my other top 2% globally ranked podcast: ReversABLE on Apple and Spotify (also available on all other platforms)

More from Dr. Will Bulsiewicz:

Webiste + Books: theplantfedgut.com

Instagram: @theguthealthmd

Facebook: @theguthealthmd

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Join the Reversing Crohn's and Colitis Naturally Community

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Video Podcast:
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Transcript

Josh Dech: 

There's a very harsh reality that we need to face and that is that North America, being less than 5% of the global population, has upwards of 50% of the world's cases of Crohn's and Colitis.

Now, what you're used to hearing me do is take a live that I've done inside Facebook or Instagram and I post the audio here for you to listen to — that's what the intro says. But instead, I'm actually pulling a podcast episode from my other podcast called Reversible, where I work with world-renowned doctors and experts from all over in different fields of medicine and I bring them to the show.

And on this one, I'm actually bringing Dr. Will Bulsiewicz. Now if you don't know Dr. B, he's a social media sensation. He's an award-winning gastroenterologist, internationally recognized gut health expert. In fact, he's also a New York Times bestselling author of the Fiber Fueled series. As if that's not enough, he's also the medical director of ZOE, which is a global leader in the GI health space, and they're leading the gut health research platform and microbiome research around the world.

And this episode is all about the things you've never been told about your Crohn's and Colitis — stuff that your doctor will never say, but Dr. B is not afraid to say. We're going to talk about things like which countries have the worst gut health, how your microbiome can be a measurement of your health and actually predicts diseases. We’ll discuss the failures of Western medicine — and their failure, frankly, to handle your gut health and your gut disease. How you can self-advocate and take control of your bowels.

We’ll also talk about the development of bowel disease, different risk factors that set you up. We'll get into food and food additives, the role of fiber, we'll talk about your immune system's connection to the rest of your body, what dysbiosis is and all these links it has to disease, how it happens — and of course, how to fix it.

Now, Dr. B is just the guy to have this conversation with you today. He's authored over 20 articles published in peer-reviewed journals, he's presented information like this to Congress, USDA, he's taught over 10,000 students worldwide how to optimize their gut health — and he's here today to have this conversation with us courtesy of the Reversible podcast.

Now, if you do want to listen to Reversible, it's a much more broad-spectrum show. You can always find that on the same platform you're listening on now. That's Reversible: The Ultimate Gut Health Podcast. But anyways, that’s enough droning on — enjoy the episode.

Intro Voiceover: Contrary to what your doctor’s told you, Crohn’s and Colitis are reversible. Now, I’ve helped hundreds of people reverse their bowel disease, and I’m here to help you do it too — because inflammation always has a root cause. We just have to find it. This is the Reversing Crohn’s and Colitis Naturally Podcast.

Now, I do these live trainings in my Facebook group every single week and put the audios here for you to listen to. If you want to watch the video versions of these episodes, just click the link in the show notes to get access to our Facebook group and YouTube channel. And for weekly updates, information, tips and tricks, you can sign up for our email list by clicking the link in the show notes below.

Josh: Dr. Will Bulsiewicz, welcome to Reversible.

Dr. B: Josh, thank you for having me. It’s a pleasure to be here.

Josh: A pleasure to have you here. I know we were talking off-air — I’ve been following your stuff for a very long time. It’s actually been a long time getting certain professionals like yourself in here, and you with your background specifically in gut — I’m so excited to dive into the things we’re diving into. Mostly because I think we do a lot of the same stuff, but differently, in so many different ways. I’m just jazzed to hear your opinion about this.

But before we get started, Will, just to kind of frame our audience who might not be familiar with you at this stage just yet: how did you get into gut health? Like what drew you to all the work you’re doing now with these world-renowned companies?

Dr. B: Yeah, I mean I think in some ways I stumbled into these things. I mean maybe this is the path that was intended for me. But basically, I decided in medical school — roughly like 2004 — that I wanted to be a gastroenterologist. And this was like nothing to do with gut health or nutrition or gut microbiome. I mean, to be honest with you, in 2004 we basically didn’t know anything about these things anyway. It was more so that I just saw that I would have the opportunity to interact with patients one-on-one in the clinic, take a person who has a chronic and complex health issue — like it could be inflammatory bowel disease, Crohn’s disease, ulcerative colitis, but it could also be irritable bowel syndrome or acid reflux or celiac disease — and to sit down with them and to be able to guide them through a process that leads them to a better life.

And you know the beauty of gastroenterology is that these issues that affect people are really ridiculously affecting their quality of life, and it’s hard for them to be happy and have good days. And so the impact that you make on a person's life is felt quite tangibly when you can improve and lift those symptoms that are holding them back.

So to me that’s sort of the vision of what I wanted to be. It's been my dream since I was a teenager to be a medical doctor. I never had any intent of being an author or being on podcasts or any of the other things that have happened in my life.

But I think that the other thing that’s worth bringing up for those who haven’t heard of me before or don’t know about my work, is that there was a really substantial shift in my mindset when I was in my early 30s, and I became sick myself.

And it wasn't specifically inflammatory bowel disease, although I did have my own gut issues — but it was more truly like metabolically unhealthy. I was 50 pounds, 20 kilos overweight. I had high blood pressure, high cholesterol. I was depressed, I was anxious, I had extremely low self-esteem. Even if you saw me on paper, you would think that my life was completely perfect. And if you saw me at home by myself, under a blanket in a dark room, you would understand I was not in a good place.

And in that moment, Josh, where I became the person who needed the help — I was a board-certified internal medicine doctor. I could have easily treated blood pressure and cholesterol and these things with pills. And in that moment, that’s not what I actually wanted for myself.

Dr. B (continued): And so that was a bit of an eye-opening experience because I spent 16 years pursuing my education to become a board-certified gastroenterologist, yet I felt that there was something that was missing. And what I ultimately discovered was the power of nutrition. And in discovering the power of nutrition, I discovered the power of the gut microbiome. Because it’s a quite natural fit in my field of gastroenterology, which is that:

Number one, everyone who comes in, they have problems with food. So I don’t know how it’s possible to have a good interaction with a patient without being able to talk to them about food.

And number two, I am convinced, knowing what I now know, that literally every single one of these people also has problems with their microbiome. And it’s most profound and pronounced among those with inflammatory bowel.

And so to me, like this is the root of the issue. This is where the healing opportunity exists. Is there a role for medicine? Yes, there’s a role for medicine. Medicine can be something that we use in our path toward healing. But it should not be the principal thing that we use in our path to healing. It should be an adjunct — something that we have in addition to addressing the root of the issue.

Josh: So I’ve got to ask you — being a GI, having gone through this, at six years in this career — why is it the number one thing I hear from the clients I see dealing with Crohn's or Colitis is, “My doctor said diet doesn't matter. Eat whatever you want. It has no bearing on this disease.” And I'm like, man, that is third-grade biology — what is happening, Will?

Dr. B: I think that people get stuck. So first of all, I’ve been there in terms of my mindset — granted it was 15 years ago — but I’ve been there in terms of my mindset. And I also... I also am very sad that this is the case, to be honest with you.

And I’ve seen people who are highly intelligent — highly intelligent people — who can’t, for whatever reason, see this bigger picture.

So I think part of the problem, Josh — not to get too detailed into this, but—

Josh: Dude, get as detailed as you want. I’m here for the ride.

Dr. B: Well thank you. I think like, I don’t think we want to dig into like the details of why healthcare is a broken mess — but it is. It’s a broken mess. It’s a broken mess in my country. It’s a broken mess in your country. In Canada. It’s a broken mess in the UK. We all have complaints. Most of the complaints are quite similar. The systems may be different, but the problems are quite similar.

Part of the issue is that medical doctors are trained in a hospital. There’s a reason for this — which is that if you can deal with a person who’s literally in the process of dying and get them back, then it helps you to be prepared for dealing with people that are not that sick. But the problem is that the vast majority of care does not occur in the hospital.

There’s a transition that takes place — like, in the hospital, it’s acute care. I still think that it’s a travesty, the food that we feed people in the hospital. I think it’s a travesty. It should be criminal. It’s wild. It’s a disgrace. But yet at the same time, like, it is still this acute moment where hopefully this is just a matter of days that they’re in the hospital.

Then we transition them to the outpatient world. And the outpatient world — we’re working toward long-term goals. This is not like, “Can I get this person out of the hospital in the next three days?” This is “Can I make this person healthy for the next 10, 20, 30 years?”

And so the problem is, like, all of our training happened in the hospital. So there’s no actual training in the space where we’re actually taking care of people — which is outside the hospital.

So this is a big part of the issue.

Dr. B (continued): The other part is that we’re not trained in nutrition. So in 16 years of training, I had 14 days of nutrition. And that 14 days was not complete days, nor was it my ability to have a conversation with you if you were my patient. This was like, “Hey, here’s this weird trilogy of symptoms like congestive heart failure and skin changes and delirium — name the vitamin deficiency.” Okay. That’s like completely irrelevant to actual practice.

And I think that, like, at the end of the day, the other problem is that there’s pressures within the system that are requiring doctors to produce in a very, very efficient fashion. By efficient, I mean minutes. And it’s quick and easy to write a prescription. But if we want to talk nutrition, it’s going to take us some time.

Josh: Yeah. I think that’s the biggest danger of an insurance-based model. I mean, if you’re running a medical clinic and you want to be reimbursed, and you’re making, say, $20 for a patient — you get them in and out in 7 minutes. You want to pay your nurses, your overhead, your staff — you have a lot of expenses to cover. You spend more than 10, 12 minutes, you might be breaking even. And we’re getting a lot of these people coming in and out who — exactly what you’re saying — I mean, it’s a bizarre system where people are sort of stuck sick.

Now, I definitely — I like to joke my hairline’s back here ‘cause my tinfoil hat rubs it all off — but the idea is that we have a system where really the money is made not at the beginning of life or the end of life, it’s made in the middle. Where people are sick and they’re medicated for a lifetime of these medications.

Like, talk about a subscription-based model — I mean, that’s the best business revenue there is. And you have people who start to finish — I got clients coming in, I’m sure you’ve seen them in your practice — as young as 3, 4 years old dealing with bowel disease of some kind, all the way up to geriatric patients.

And so, I mean, it’s a pretty bizarre stretch we’re starting to see in the growth of bowel disease — but people aren’t getting the treatment that they need.

So I’d love to ask, Will — in your opinion, what is driving this epidemic?

I’ve talked about it in previous podcasts — that back in 1990, anywhere from 1.3 to 1.5 to 3 million global cases of IBD, as per the CDC estimates. In 2020, I think the last point of data was like 7.5 million. So we’ve gone up arguably up to five times in the last 30 years. Exponential growth. Fifty percent of those diseases are in North America, which is just 5% of the global population. What is going on in North America — in general — that’s leading people to have this epidemic of gut disease?

Dr. B: Yeah, well Josh, we also see similar and even in some cases more aggressive emergence of inflammatory bowel disease in third-world countries as they industrialize — which I think gives us some of the clues as to what’s going on.

And I think that in order to properly understand this, you have to start with the fact that — like, what is inflammatory bowel disease?

And many people describe it as autoimmune. And I actually think we need to refine that. Believe it or not, it’s not exactly that.

Josh: I believe you so much. Keep going. Please.

Dr. B: So we all have a microbiome. You do. I do. The person with inflammatory bowel disease does. We all do.

And this microbiome is an important part of our body — the way that our body functions. Yet it’s not actually our body. It’s foreign to our body. Made up of 38 trillion microbes. And we have sort of signed an agreement with them that, you know — you help us, we’ll help you. And this is how we’re going to go through our life. And as long as we all commit to that agreement, then this should yield good results for all of us.

And unfortunately, I feel like we’ve broken that agreement in the last 50 to 100 years. And a lot of that has to do with the lifestyle changes that have taken place during this period of time.

Dr. B (continued): So pinning it down to one thing is a bit unfair, because I feel like that would be ignoring the broader context of everything that's happening here. But at the end of the day, coming back to inflammatory bowel disease and this question like — is this autoimmune?

I actually think that — so autoimmune is the rejection of our own body. But in inflammatory bowel disease, our immune system is not rejecting our own body. In inflammatory bowel disease, our immune system is rejecting our microbiome.

And so it's an attack. Our body has made the decision that our microbiome is the enemy and therefore, our microbiome needs to be eliminated in the same way that our immune system would eliminate a virus or a bacteria or a pathogen of some variety. And this is what creates that inflammation that we see. The inflammation that you see — whether it be in the colon and in ulcerative colitis, or whether it be throughout the intestines, classically the terminal ileum and the colon in Crohn's disease — this is the result of our immune system being activated in response to something that it believes to be a threat. Inappropriately believes to be a threat. And specifically in response to our microbiome.

So the action's in the microbiome. The problem is in the microbiome when these conditions emerge. It has to do with the microbiome.

I'm not saying there's no genetic element — there is a genetic element. But it's not a change in our genetics that happened in the last 50 or 100 years. It's a change in our microbiome that's happened. And this is the consequence of — you know, our microbiome is the product of our environment.

And when people say “environment,” to most of us, we would think of — oh well, you mean like the world that we live in. Yes, in some ways. But actually, if you think about these microbes living in your colon, in an almost godlike way, we control that environment.

We control it with our food choices. We control it with our sleep patterns. We control it on some level — I'm not saying this is totally controllable — we control it on some level with stress and our ability to sort of create harmony within our life. We control it with exercise or how much we’re physically active. There’s all these different factors that feed into this area.

The problem is that the shift that’s taken place in the last 50 to 100 years is all in the wrong direction.

Josh: So it’s this multifactorial thing — that the life that you and I lead in 2024 is very different than the life that my grandfather led in 1924. Very different.

You know, it’s interesting — over my entire career here, I mean, we’re going to probably see 200 cases of Crohn's and colitis this year alone. And I have yet to have one GI specialist actually sit down and have a conversation about what it is we’re doing — and remarkably successfully.

I mean, we did over the last 2 years about 300. We’ll do 200 this year, so it’ll bring us to probably just north of 500 cases. And what’s really unfortunate is, I’d say, the state of the medical system — and I will openly admit, I’ve got a bit of a chip on my shoulder against conventional medicine for a lot of reasons. And sometimes a lot of GIs. Because you know, they go in after 15 years of trying to treat their patient with all the steroids, all the biologics, every drug under the sun. They’ve been on Stelara, and Humira, and Tysabri, and Remicade — they’ve given them everything. And here they are 15 years later, and in three weeks, they go from 50 bowel movements down to three. And they go, “Well, your medication must have finally started working.”

The math doesn’t add up. And so I have yet to have any GIs really sit down. And what you guys are doing — and you're obviously affiliated with ZOE — and what you guys are doing down there is really changing the game on gut health and how people are seeing it.

Are you working with the medical system directly? Are you sort of barred out from the traditional Western medical system — be it for-profit or whatever else is going on that’s maybe keeping you out? What does that look like to integrate this information and this clearly very — what’s the word I’m looking for — very tangible, very fixable stuff… to integrate it into the Western world? What is that looking like right now?

Dr. B: Yeah. So I love talking about this because I feel like this addresses many of the concerns that you have — and that I have too, right? Like, we're sharing a lot of the same concerns here.

And I feel like ZOE — we’re a bit of like… we’re disrupting. And we’re a bit maverick in a way. Not in the way of like being out of control — but more so… let’s think about it like this.

We have healthcare systems — your country, my country, the UK — that say that diet and nutrition is not worth investing into, right? They're not going to pay to help you with this.

Yet every single person — particularly people with inflammatory bowel disease — when they go to their doctor, they want to know: “What do I eat?” And they’re smart. They're smart enough to know that diet impacts their disease — whether their doctor acknowledges that or not, they know that.

So with ZOE, what we’re trying to do is expand our understanding of the ways in which food meets microbes meets health. Right? And that’s a connection that, to me, is firmly established — but we are working to make it even more clear. And we’re also working to make it more individualized — to understand it on an individual level.

Now in order to accomplish this — in order for me to basically say, like, “Josh, for you personally, based upon your microbiome…” and by the way — so I guess I should zoom out for a quick moment.

People who do ZOE — and this is available in the U.S. and the UK, it’s not yet available in Canada, although we would love to be there one day — people who do ZOE, they receive a kit in the mail. And using that kit, they provide a microbiome specimen, they wear a continuous glucose monitor for two weeks, they enter into an app what they’re eating, they eat cookies, and then they measure their blood fat through a finger prick onto a card.

So in taking that information, you can put it into a database where we now have well north of 100,000 people — closing in on 200,000 people. Again, we have their microbiome. That’s a tremendous amount of data by itself. We know their blood sugar response to what they were eating for every single meal during those two weeks. We know how they respond to the same meal, so that I can compare my results to your results or to any one of these other 100,000 people’s results.

Put it into a computer system and basically run the equivalent to artificial intelligence — like you run machine learning algorithms. And now instead of saying, “In general, this is what we recommend,” now we can say, “No, no, hold up — for a person who’s exactly like you — your age, your gender, similar microbiome characteristics, similar response to blood sugar — here’s what we would recommend.”

Josh: That’s so cool.

Dr. B (continued): Now, the thing I want to really get into that I think is really cool and exciting about this is that this is community-driven, right? So this is not authorized by the government — frankly, the government would never do this. If we wait for the government to do this, it’ll never happen.

This is when people band together and they say, “I know that there’s not one-size-fits-all when it comes to diet, and I want the science to explain that to me in a way that’s not just me kind of trying to figure it out.” Nothing wrong with that — but in a way where the science actually can back up my understanding of my body and how my body works.

And in order to accomplish that, you need tons and tons of data. Tons and tons of people. And that’s what this basically is — where every single person who participates in ZOE, they get that information themselves. They also are contributing that information of themselves so that we can apply it to other people. And as we grow, it allows us to get more granular and detailed.

The future is having more than a million people. The future is having people with inflammatory bowel disease, Crohn’s disease, ulcerative colitis, and other health conditions — irritable bowel syndrome — and getting granular with those conditions. Not just on a general basis.

So to me, like this is… we are, I think, doing really cool things. We just published our first randomized controlled trial in Nature Medicine, which is one of the top medical journals on the planet. We’re doing really cool things already.

Like, I think we’re just getting started. I think it’s going to be amazing what we do in the future. I think the entire science of the microbiome is just scratching the surface. You know, there’s so much more that’s out there. And for everything we know, it’s like the more we learn, the less we know. And we know nothing — which I think is really amazing.

Josh: You know, we got trillions of microbes — I mean, tens of millions of different strains and species — and how they interact, it’s really a grain of sand on a beach for how much we actually really fully understand of the microbiome. What each individual strain and species does and how they interact, how they signal… it’s a really bizarre system.

But you had mentioned that IBD is really a microbiome issue, which I find obviously interesting as someone who works in Crohn’s and colitis. But I’d be curious — your take on what you believe is in the microbiome that’s driving the changes?

And here’s why I ask: you know, we’ve distilled it down — really to what we tend to see — as three different things as being the primary.

Now, the gut microbiome being as complex as it is — we might be 10, 20, or 50 years away from really hammering this down to the individualization of the gut microbiome and really being able to fine-tune and tailor through FMT or whatever kind of intervention and treatment.

But we look at this and say, okay — we’ve got hundreds of cases that we’ve seen. Ninety-five percent of them, it comes down to three things: parasites, clostridia, and fungal issues. And then whatever else is underlined that may have changed or altered that terrain.

So maybe there is — like you said — the industrialization. I mean, we know, as a fun sidebar, Will — the EPA, when they actually approve pesticides — it’s on their website, the quote, it says:

“EPA only registers a pesticide when it determines it will not cause unreasonable adverse effects on humans or the environment while considering the economic, social, and environmental costs and benefits of the use of the pesticide.”

So the people being paid to approve the thing get to determine if there’s a reasonable amount of damage to human life or the environment — whatever it is — before they say, “Yep, go ahead, the finances make sense, then we’re good with this.”

And that’s sort of what we’re dealing with. So there’s going to be many other layers looking at some of those — maybe it’s heavy metals that sets the stage for fungal overgrowth and immunosuppression, or whatever it is.

So in our practice, we’ve got this distillation. What is it you guys are seeing specifically in the microbiome? Is it the good? Is it the bad? Are there specific external microbes — like more easily detected things, like you can do an organic acids test and see the fungal issues — what is it you guys are figuring are the root causes of these diseases?

Dr. B: Well, I think it’s hard to pin it down to, like, some specific thing — at least in the landscape that I’m looking at. So I appreciate that there are different ways to approach similar issues.

And again, what I get back to is that if you’re guiding a person to a place where their inflammatory bowel disease is under better control, then that is a win. And that’s what we’re looking for. So I’m an outcome-driven person. And I celebrate those outcomes — regardless of how we got to that place.

So to me, this is a dysbiosis-driven thing. I mean, we do have examples of specific bacteria, you know — such as an inflammatory invasive E. coli — that’s been associated with the development of Crohn’s disease. So… or there are other microbes that have been associated with these things.

Now, like whether or not you can draw a microbiome specimen from an individual person who does not yet have inflammatory bowel disease and then predict that they will develop inflammatory bowel disease in the future — we’re not yet at that place.

But at the same time, as you have seen throughout your experience in dealing with these people, the development of inflammatory bowel disease does not happen like that — it takes time. And it is a process that ramps up until it becomes fulminant.

So I do think that there’s an evolving process that takes place. And certainly we could learn more by collecting microbiome specimens along the way — it would require us to have basically a massive cohort study of people that we’re monitoring their microbiome prior to developing inflammatory bowel.

Josh: So you gotta get real lucky or specialize in, like, wizardry or something to figure out who’s going to have it — where it’s coming from — or are you looking at genetic models and predictive factors?

Dr. B: Yeah, I think so. I mean, there are aspects that are predictive of developing inflammatory bowel disease. That being said — like, predictive in a way where you can say with confidence that a person is likely or unlikely to develop the condition? No, that’s not the case.

But I think what we come back to though, Josh, is that — like, you know, you and I, we may be talking about inflammatory bowel disease right now, but obviously there’s a world that exists… like, you take care of people with other digestive health issues outside of inflammatory bowel disease. And I have throughout my career as well.

There’s a world that exists where there’s all these other health conditions that are digestive in nature — related to our microbiome. And then, like, I want to expand that view much, much wider than that.

Where in — you know, in my view, I’m seeing that there are these metabolic issues — and that’s a lot of the work that we do at ZOE. There are these cognitive issues or mood-related disorders. There are hormonal-related problems.

That again — like, the connection — it’s not to say that the microbiome is the only factor in our health. That would be ignoring many other aspects of our body and how we work. But I think that it’s worth acknowledging that the microbiome is a factor in the health and the manifestation of these issues.

Josh: Yeah.

Dr. B: And if — when we expand the scope — like, if it’s just digestive issues, it’s already a lot of people. But if you expand that scope to include these other health-related issues, which include metabolic — frankly, it’s the majority of Americans.

And to me, this is where this conversation becomes really important. Because this is an opportunity. Which is that — don’t wait until you have inflammatory bowel disease. And don’t ask — like, I’m not saying it’s wrong — but don’t ask for a test to tell you whether or not you could or could not develop inflammatory bowel disease, knowing that it’s not going to be… it’s not likely to be accurate.

Let’s focus on what we can do to elevate our health — all of us. Whether we are healthy or unhealthy. Let’s focus on that. That’s what the opportunity is.

Josh: It’s a really unfortunate position I think a lot of people are put in. I was literally on the phone with a friend of mine today — his wife’s having some bowel issues. You know, she’ll go two weeks without a bowel movement and then she’s on for a week on the toilet ten times a day, and it’s back and forth, and she can’t figure it out.

And she went to her doctor and they said, “Well, we can’t refer you until you’re bleeding or until we have A, B, C.” It’s like, it’s not broke-don’t-fix-it to the nth degree — where it’s like, imagine the insanity of going to your doctor with a hairline fracture, and they’re like, “Yep, keep walking on your leg. When it turns into a compound — the bone breaks through the skin — then we’ll treat you. And by treat you, we’ll just put numbing cream on it for the pain. And your leg will kind of manage itself because we’re not treating the root cause of the problem.”

And we see this time and time again. And so, we’re not getting to these roots. And these people — I mean, I know we can go around the same mountain a hundred times in a row, but they’re stuck here.

And so I’d love to figure out your lens. You mentioned metabolic. You mentioned E. coli. There’s lots of different factors. Are you finding — this is obviously, you’ve got 16 years professionally trained, working in this, beyond what I’ve got — a handful of years through one specific lens.

And I like to say if you give me a hammer for long enough, eventually everything looks like a nail. Where I’ll go, “Oh yeah, well I see clostridia, I see parasites, I see fungus, I see A, B, C, D, therefore…”

And so as clinicians, we’re responsible to do our due diligence — to not repeat the same thing and put people in a box. Because, “Oh, you look like these last hundred clients, therefore you must be the same thing.”

So I’d love to get an idea of your scope and what you guys are doing right now. Are you finding there are common threads across the board? Where it’s environmental? Is it toxins people are getting?

You mentioned industrialization of third-world countries where bowel disease is more prominent. There’s a lot of different factors here — but at least in North America, and we’ll even say the UK, where the majority of these cases might be housed right now — are you seeing common threads where you can go, “80% of people have this as a layer to their bowel disease”?

Dr. B: Well, what I can tell you is this — that we have a substantial amount of information about the microbiome of Americans versus British people.

So I mean, we have — you know, a large microbiome study would be a thousand people. That would be a large one. We have, you know, again, well over a hundred thousand — over ten thousand in the United States, right?

So with that many people, you can start to look and see things. And one of the things that we’ve discovered is that people in the United States generally have a less healthy microbiome than people in the UK.

So we assign a score for a person’s gut health. And if you were to give a score to most Americans using the British standard — most Americans would have an unhealthy gut.

Josh: So it’s kind of interesting to think — we’re not the same, we’re not the same country — but things are worse here in the US.

Dr. B: They’re worse.

Josh: Well, here’s what I’d like to ask. So I mean, obviously the health outcomes are different. But if we look — there was a study in Cell Reports or something back in like 2018, 2019 — I’ve talked about this a few times on a couple episodes sporadically — they compared rural and urban Nigerian microbiomes to that of urbanized American centers. And they found the difference between, you know, childhood, infant, children, and adults was actually less of a gap in these rural Nigerian communities versus, say, North America.

And my interpretation of the data was like, okay — well maybe we are, over time, really destroying a lot of our microbes that we get innately from birth, from coming through the birth canal, through breastfeeding, all these different bits. And we’re destroying them.

And maybe this is why — I mean, looking at the microbiome samples from some of these countries — it looks like they have a lot more ability, through their microbes, to actually break down, digest, and utilize fibrous tissue. Whereas over here, you have millions of people going to carnivore and doing better.

Is that because we’ve lost the microbes and our ability to digest fibrous foods? Is that because the junk we’re spraying on it is actually causing a lot of upset — looking at the pesticides and the billion-plus pounds that they utilize on these foods? Is this what’s really causing some of these diseases and these differences between the microbiomes? Or is it that geographically and genetically you’re born here, you adapt with these microbes?

Like, what do you think is going on? I know that’s kind of a… not well-articulated, but if you could interpret that one I’d love to hear your thoughts.

Dr. B: Yeah, no, totally. So we’ve seen this repeatedly — that if you look at the microbiome of people that are native to Africa, that they have greater diversity within their microbiome.

That diversity within the microbiome — it’s not the only measure of health within the microbiome. I feel like in some ways it’s a little bit too simple. But at the same time, it is a measurable way in which you can look at general gut microbiome health and understand capability and function, right?

Because when we have a more diverse microbiome, it’s more like — basically, we have a more variety of microbes that have these different functions and enzymes that we need in order to help us to process and break down our food.

So now, in the United States, we have a long-standing history — going back multiple generations at this point — of fiber deficiency. So people simply haven’t been eating this food.

The reason why is because we have replaced it mostly with ultra-processed foods. Ultra-processed foods now make up 60% of the American diet. Seventy percent of a child’s diet. And these ultra-processed foods — many of the things that are in there, we don’t really know what they do.

The majority of things that are approved by our FDA — under a loophole called “generally recognized as safe,” or GRAS — this is what I call…

Josh: GRAS. Garbage Recognized As Safe. I’m sure there’s other ways to name it.

Dr. B: [laughs] Yeah. The majority of things that have been approved using this loophole have never actually had feeding studies.

Now when I say that, I don’t just mean human feeding studies — which, by the way, to me should be the standard. Like, you should be required to do a human feeding study in order to introduce something into the complete American diet.

Josh: The irony is — don’t they consider human studies like that, in a lot of these cases, “unethical”?

Dr. B: That’s an interesting question, you know. Well, I think that you have to go back to the history of this law — which is that it was passed immediately after World War II. And the intent was that they were going to start — the Food and Drug Administration was going to start to regulate food. Right?

And they were just starting to develop these sort of new foods that didn’t previously exist. And the government said, “Look, we don’t want to stand in the way of stuff that we know is safe.”

Right? So we’re not going to require you to do, like, feeding studies for salt. Because humans have been consuming salt for hundreds of years. So let’s just approve this and move on.

The problem is — by creating this loophole, they started to then apply this to everything. And now here we are — we have 10,000 food additives in our food system. We don’t know what they do. They haven’t had feeding studies in animal models or humans. Very few have had human studies of any variety. We certainly don’t have long-term studies at all.

And when you try to disentangle or decipher what’s doing what — when a person’s 60% of their calories is ultra-processed, and they’re consuming all these different additives — good luck.

It’s impossible to peel apart, “Oh, this one thing is doing this thing.” It’s impossible. There’s way too many things in there to make any sort of understanding of that.

So now, the problem is that your gut microbiome is adapted to whatever it is that you’ve been eating. And that adaptation is manifested in function.

So if you eliminate fiber-rich foods, and you replace it with ultra-processed foods, you are making the choice to basically sacrifice the capacity and ability of your microbiome to process and digest fiber.

And fiber is a complex thing. Because we as humans have the ability to process and digest many different things. But the one thing — or like, one of just a couple things — that we clearly cannot process or digest ourselves is dietary fiber.

That’s where our microbiome comes in. Our microbiome is the workforce that allows us to basically break down the fiber into its essential components — and ultimately to release the short-chain fatty acids that we can potentially get.

If you take a person who has eliminated fiber and then you apply inflammatory bowel disease to this — we are in a very, very deep hole in terms of our capacity and ability to process and digest fiber at that point. So it’s a legitimate challenge.

Dr. B (continued): The other aspect that I would add to this — it starts… like, I hate talking about this in some ways, Josh, because it feels very dark. But I’m going to bring it back to an optimistic view.

Josh: I appreciate that. I know as practitioners, we can often raise the red flags and not bring it back to like, “Look, there’s a solution.”

Dr. B: Yeah. I want to talk about this because I think it’s quite important — but it’s also nuanced. It’s also nuanced, and we have to keep it real.

So the other aspect to this is that there is a professor at Stanford who is a friend of mine — Justin Sonnenburg — and he’s been studying this sort of question. Like, he’s gone and immersed himself in Africa and done many of these microbiome studies.

And one of the things that he’s done is shown generational passing of the microbiome through fiber deficiency.

So in other words, basically what he does is he says, “I’m going to start with mouse number one. All right? And I’m going to give mouse number one a low-fiber diet.” Okay, Grandma — let’s pretend that Grandma started with 1,000 microbes. But now, by the time Grandma has her daughter, Grandma is down to 600 microbes.

Okay. Now the daughter inherits 600 microbes. And the daughter’s on a low-fiber diet, so the daughter goes from 600 microbes down to 300 microbes. She has the granddaughter, and the granddaughter inherits 300 microbes.

This daughter has already inherited dysbiosis — in this research.

Now of course, you can’t recreate this in humans, because that would take us a hundred years. But in this research, when he reintroduces fiber, you’re able to bring many, many of these things back — but not all of it.

So is it possible that we have, through generations that started with our grandparents — of transitioning in the post–World War II period to a more ultra-processed diet, a more fiber-deficient diet — is it possible that we have created an issue that has been transferred from our grandparents, to our parents, to us?

Yes.

Now the key though, from my perspective, is that — and this is most applicable more than any other type of patient that I’ve ever worked with — to inflammatory bowel disease.

Because these are the people where, to me, the dysbiosis is the deepest. Because you don’t just have dysbiosis under the hood — you have an inflammatory, a chronic inflammatory condition, where your immune system is actually digging you deeper.

The dysbiosis in the state of a flare is worse. These people would benefit from the short-chain fatty acids that come from fiber. The challenge is that their gut microbiome is not designed to process and digest fiber — particularly during the flare. And the amount that they can tolerate is very limited.

So how do we address this?

Number one, we should work to get them out of a flare. When we get them out of a flare, that in itself is going to enhance their capacity and ability to process and digest food substantially.

Number two, we need to introduce fiber — but we need to do it in a very gentle, slow way.

So — and this to me is a low-FODMAP approach initially. So FODMAPs are fermentable carbohydrates that can cause a lot of gas and bloating and be hard for people who have gut issues to process and digest.

So to me, you would start with a low-FODMAP approach. And I’m not sitting here and saying that you need to just inflict pain on yourself and go 100% plant-based. This is not the argument.

The argument is that fiber is to your benefit. Fiber can help you to heal your gut and make it stronger. It is in your best interest to reintroduce fiber. But it is a process. And it’s not necessarily easy.

Josh: So on that note — you know, fiber is something that I’m always very cautious with. Obviously in the IBD space, people dealing with these types of things don’t have the capacity — like you said — to break down and utilize it. Their microbes can’t turn them into short-chain fatty acids. They don’t get all these benefits from it, etc. etc.

And so a lot of people — of course, the doctors will classically go, “Well, follow the white diet.” You know, white breads and white rice and white potatoes — and things that require really little to no mechanical breakdown in the GI. Like, your mouth could do it all if it really tried hard enough — you can just chew on it till it turns to sugar. And so there’s really little work to be done.

On the other hand, a lot of these people have responded extraordinarily well to, say, a carnivore diet. And on that same note, we’ve seen people go carnivore with microbiome testing at, say, three months and a nine-month period — who have actually shown an increase in their gut microbes.

Now is this simply through hormesis? Is this through something else? Are there microbes being introduced to these heavy proteins when they’re carnivore-based?

What are we seeing here in the splits? Because obviously you’re an advocate for fiber when appropriate. I’m not against fiber — in my practice I’ve definitely seen, obviously in the limited scope that I’ve got here — I’ve seen a reduction in fiber, at least temporarily, be beneficial, then reintroducing it later.

What is your take on that and what it’s doing to the biome — and why some of these diets might be beneficial on the animal-based before transitioning to fiber, if at all?

Dr. B: Sure. So I guess what I would say in response to this — and this is trying to focus on… because at the end of the day, what I care about again is outcomes. And people being better. Like, that’s what I care about.

I’m not here to promote a dietary pattern above all else.

Josh: I respect that.

Dr. B: Yeah, right?

So now, when it comes to carnivore — like as you know, we don’t really have much data. That doesn’t dismiss the fact that there are clearly people who have come forward to say that this has helped them substantially. So let’s acknowledge that first.

What may be going on there? How would I explain that, knowing everything that I now know?

Okay, number one — they are eliminating ultra-processed foods. There are additives that exist within ultra-processed foods that I’m very concerned are disruptive to the gut microbiome, disruptive to the gut barrier, and as a result of that, are basically promoting the ongoing inflammation that results in inflammatory bowel disease. So that’s number one.

Number two — I do think that there’s something to the idea that the simplicity of it — it’s a little bit easier than, for example, what I’m proposing. Which is to reduce your fiber intake, go low-FODMAP, reintroduce over time. Right? Like, there’s a lot more complexity to my proposition than there is to, “Say, eliminate all plant-based foods entirely.” Right? It’s like, pretty straightforward.

Number three — I do think that by doing this, you are going to enhance the production of beta-hydroxybutyrate and other ketone bodies.

And so, what is beta-hydroxybutyrate? One of the ketones. It is a cousin of butyrate. It’s actually conceptually similar. It’s not the same. They have looked at, like, activity of beta-hydroxybutyrate versus butyrate — and it’s less active than butyrate is. So if you had a choice, you would choose butyrate.

Yet at the same time, for a person who’s not getting either — right, because they’re on a fiber-deprived Western diet and they’re clearly not in ketosis — to shift towards getting beta-hydroxybutyrate is clearly a step in the right direction.

So that to me can be part of this process.

Number four — the fourth thing that I would mention is that it’s a journey. It’s a journey of healing. And what’s right for you in one moment may not be exactly what’s right for you in six weeks.

And in some ways, I think that there’s a healing process — that let’s pretend for a moment, Josh, that this person who’s struggling with inflammatory bowel disease, they do this. They get better. Right?

And it’s six weeks later, and their microbiome’s in a better place — I would make the argument that in the… this would be my argument — that in the long term, not the short term, I’m not worried about six weeks, but in the long term, in terms of suppressing their inflammatory bowel disease, in terms of reducing their health risks, I would want to reintroduce fiber.

I would want to transition them back to including this in the diet.

So that’s the way that I feel about it. And I think that that would be more possible if there was a healing that took place during those six weeks — as opposed to like, I don’t know that people are trying to permanently restrict fiber for the rest of their life. But that to me is a quite scary idea. Because we don’t know. We don’t know what that means.

Josh: It’s interesting — have you had much of a chance to study some of these, like, populations? These tribes who are literally like raw meat carnivores? Like, they kill a reindeer living up north in somewhere in Nunavut, and they eat the organs raw and drink the blood raw?

Have you guys studied much of that through ZOE and in the work that you guys are doing?

Dr. B: No, we haven’t studied that at all. Now, part of that is — I think that what you’re describing are Indigenous people to Canada, right? So like, we’re not available in Canada.

But I do think that, like, independent of ZOE, there is something about the adaptability of the body that is undeniable. And so, to me, I think that part of what the message is here — in trying to find the common ground, even though, like, as you can tell, this is not the diet that I advocate for — but trying to find that common ground, I think that there is a message to be said for the adaptability of the body and the microbiome.

And we see this through Indigenous tribal people throughout human history. And the fact that — like, the reason why we developed this relationship with our microbes… if we want to get back to, like, why do they exist? Why are they here? Why are they a part of us? How did we get here?

The answer to that question is that humans started in Africa and radiated out. And we found ourselves in different ecosystems and different environments across the planet. And because humans are not readily or easy to evolve, we needed something that was easy to evolve — that could adapt to a changing environment.

And that’s where the microbes come in. Because they can change real fast.

Josh: Very interesting.

Dr. B: So yeah.

Josh: Huh.

Dr. B: It’s really interesting that we do live in a world — you talk about this adaptation. I just talked to Eric Edmeades the other day — he wrote The Evolution Gap, if you’re familiar with the book. And the whole idea is that humans have created this world that is no longer biocompatible with our world today.

And it’s the adaptability — or I should say, the lack of adaptation — right? Because technology evolves so much faster than the human capacity — than human genetics or our biomes. Even though our biome can adapt quite quickly, our technology, our way of life and our living is adapting — or changing — so much faster than we can adapt.

And this has sort of left us in this gap — really, an evolutionary gap — where we find ourselves full of disease.

And so the question is — can we adapt? Is the human body available or able in the next hundred years or hundred thousand years to adapt to eating all the seed oils, all the sugars, and all the junk? Or do we die out long before that happens?

Dr. B: So we adapt. We are adapting. We adapt in the sense that — you can introduce 10,000 food additives into a food system and people are still alive.

Josh: Right.

Dr. B: That’s amazing.

Josh: Yep.

Dr. B: That by itself — like, think about that, right? These are things that — like, the majority of them didn’t exist a hundred years ago. There was never a human in history that had ever consumed this. And now we’re doing that — times 10,000.

All right, so yeah, we clearly adapt.

I think that the issue is more so that — through our healthcare system and advances in nutrition that have taken place that basically can make nutrition more readily available — right? Like, nutrition is very easily accessible in our countries — because of that, people are living longer.

And by living longer, I mean, like, in general relative to the fact that the life expectancy not that long ago — you know, 150 years ago, life expectancy was like 50, right?

And that’s because, like, if you had a heart attack, you clearly were going to die. If there was a pandemic, most people were going to die, right?

And we have this ability to — like, using our healthcare system — do things to keep people alive and propped up artificially.

So now what we have is — you may be living longer, but actually the quality of that living, the level of health that you have during that time is becoming progressively diminished.

And actually, we’ve started to recently turn the corner. Just in the last few years, our life expectancy is now actually going down.

Dr. B (continued): The thing about evolution, Josh, is that — this is something I think about — if we think about it in a purely Darwinian way, so the concept is “survival of the fittest,” right?

And the idea throughout human history — or the evolution of all life on this planet — was that basically, if you could survive long enough to procreate and put children out into the world, then you would pass on your genetics. And therefore your genetics would ultimately, like, become more and more dominant. Right?

And the traits that weren’t able to survive to the point of procreation — they would stop existing.

We clearly live long enough to procreate now, right? So that sort of concept — like, to me, evolution has gone out the window.

But in recent years, I’m getting increasingly, like, disturbed by what I see in terms of birth rate and fertility. It’s dropping off substantially. And many countries are below the birth rate in order to sustain their country.

And believe it or not — even India has dropped substantially in recent years.

Now I’m not claiming that this is all health-related. There are also sociocultural aspects to what’s happening. But I do think, though, that it’s just part of this broader picture of trying to understand where we fit as humans within this planet — and how to make it work, where we are going to coexist with modern technology, yet we have a body that was not designed for it.

Josh: Well, you’re a very interesting guy, and I realize this has been almost an hour and it’s flown by. And regrettably, we haven’t even quite gotten to the breakdown of what it looks like to reverse IBD and all that.

So I’d hate to put the pressure on you to do this — can you sort of give us an idea here, bullet points in the next few minutes, sort of a 1-2-3-4-5 — or whatever that looks like for you — to say:

“Look, we talked about all these different factors and all the things that are not biocompatible, where it’s coming from, what’s happening, dietary principles, things we can apply, when and how…”

We could do a weekend symposium and hardly scratch the surface, so an hour is just enough to kind of give a taste — but I’d love to give the listeners dealing with IBD some kind of something to look forward to, or to look through and say:

“Hey, if I explore these options, this might give me a new lens to sort of help reverse the IBD.”

What do those steps look like if someone comes to see you?

Dr. B: All right, so — the way that I like to approach inflammatory bowel disease is, I think about it like it’s a forest fire. And it’s burning out of control.

Right? So now that forest is their microbiome. We want to restore the forest. But it doesn’t make sense to start planting trees while the fire is burning.

So from my perspective, step one is: we have to get these people into remission.

Now once they’re in remission, and the fire has actually been put out — now we have the ability to regrow the forest. But we must acknowledge that will take time. So this is not a quick-fix type of thing from my perspective.

And there are different tools that we can apply and use within this setting to try to rebuild this forest and plant these seeds.

One of them is nutrition. You and I may have different views on how to approach that — and that’s okay. Like, again, I’ve done my best to try to find that common ground, because I think it’s important for people to have opposing views and be able to find common ground these days.

Josh: Especially nowadays.

Dr. B: Yeah, exactly. And we can respect one another and have that conversation.

So one of them is nutrition. And from my perspective, that includes the implementation of fiber and plant-based foods. And that’s not — to me, I don’t… like, I do get a little bit frustrated at times, because I think that that comes across as being a vegan thing, and it’s not.

It’s more so, to me, a frustration in the inadequacy of our intake of these foods. And my feeling that we would be much more healthy if we would increase these foods in our diet — ideally prior to having inflammatory bowel.

So to me, part of this process is wanting to introduce those foods — but doing it gently, through a low-FODMAP approach.

Dr. B (continued): The second thing would be the addition of fermented foods. We have data that show — and by the way, there’s many options for fermented foods, not just plant-based — but in addition to that, we have data from Stanford where they did an 8-week fermented food intervention and were actually able to increase the diversity within the microbiome and reduce measures of inflammation.

So this is an exciting thing.

I have to acknowledge with that — there may be people who have histamine intolerance with inflammatory bowel disease. And so the fermented foods may not be… like, that may not be early process for you. That may be later process for you.

But histamine intolerance — my second book, The Fiber Fueled Cookbook, is all about this topic. And if I were to summarize real quick: to me, if we repair the gut barrier, that’s how we repair histamine intolerance.

So there’s a nutritional approach.

Secondarily, I think it’s quite important to acknowledge there are aspects to healing that have nothing to do with lifting a fork.

And that is building a daytime routine where we are no longer flogging our microbiome.

It is about building a daytime routine that’s in line with our circadian biology. And basically, we’re getting out of the way — we’re going to stop doing things that disturb the microbes, and instead we’re going to start doing things that allow them to grow and thrive.

And we do that through orienting toward the rise of the sun and the fall of the sun in the evening.

The rise of the sun includes things like getting early daytime exposure to sunlight — so that basically teaches our body, anchors our body to that time. Right? It actually makes it a lot easier to go to sleep at night.

I believe in spending time outdoors on a daily basis. That includes exercise. So to me — a morning walk, I like to actually ruck. So I have a ruck vest that I’ll use when I do this. This is one of the ways in which we can help to accomplish this.

I also think on the flip side we need a nighttime routine.

Way too much bright light, devices, staying up late, alcohol, late-night snacks — and all these things are disrupting us.

So to me, like, trying not to consume any alcohol or food after 8:00 p.m., winding down in the evening, trying to maintain consistency of our bedtime — consistency is important. These are all strategies that I use in terms of wanting to align my body.

And then beyond this, I guess the last thing that I would add is — many people with the most severe dysbiosis, they can do everything right. They can eat the right food, they can sleep, exercise, all these different things.

And there may be something in their past, from a trauma perspective, that is — whether they are conscious or not conscious of the harm that it’s causing — it can be the engine that drives dysbiosis. It’s basically chronic activation of the inflammatory pathways.

And so I think it’s important to acknowledge that for many people, the greatest healing that can take place is actually when they heal the wounds of trauma that are holding them back.

And I do think that’s an important part of understanding digestive health — including inflammatory bowel.

Josh: What’s really interesting, Will — coming in here, because having seen your stuff, having followed you for a long time — and I know we’re just getting to the end here, so I’ll make her quick.

I was very much under the impression — it’s plants, plants, plants, plants, almost vegan. So even I, as a longtime follower, misunderstood some of that messaging.

And there’s a lot that I disagree with out there, as I’m sure you do — a lot I agree with, some parts and pieces of people I follow where I go, “You know what, I like this, what they’re saying. I don’t like this so much.”

I have yet to have a single thing in this conversation where I actually did disagree and go, “That doesn’t make any sense to me.”

All of it is very founded. All of it is very middle-ground. It’s solution-based and results-oriented ultimately — with always like a, “Hey, you know what? I don’t know, but I’d love to learn.”

And this has just been super eye-opening. And I really had a very interesting time just hearing from you.

I know again, we just scratched the surface — I appreciate you saying that. And I think that, like, if I were to unpack this — because this is a point of frustration for me in my private life, away from what you see on a screen?

If I were to unpack this for a quick moment — there’s a very big difference between the way that I would treat a person who had Crohn’s disease or ulcerative colitis, compared to the advice that I would basically put on the table for the average American who does not have inflammatory bowel disease.

And I think that that’s part of what it is. Many of these things that I’m trying to do — I sincerely believe, Josh, and people are entitled to their opinion on this — but I sincerely believe that as we sit here in the United States, we’re getting more sick.

And the solution to this issue is — like, to me, this is me — if we could correct our fiber deficiency in the United States (this is for the general person), we would address a lot of these health issues. And I’m completely convinced of this.

Now, to me, this is not a vegan thing. If we simply got rid of our ultra-processed foods — which you and I would clearly agree on — this would be a massive step in the right direction.

But again, I think that the important point though is that when I sort of give that general advice, I’m looking at the big scope of people out there and the way in which I think that, like, what is the general approach?

But there should be an individualized approach. And this is why I say my messaging changes when I’m talking to someone who has Crohn’s or ulcerative colitis.

But this is also why things like ZOE need to exist. Because ZOE is not trying to give one-size-fits-all advice.

ZOE — what we’re trying to do is crack the code on personalized nutrition, so that we can show you how to eat for your — like, what works best for you personally.

So that’s, like… I think it comes back to these same general concepts.

Josh: Yeah, I think it’d be very interesting one day to see almost like a standardized version of personalized healthcare — where we have this data and all this information based on blood and microbiomes. We can do all these tests, and here’s what we can do for you, and here’s what we know is going to work based on a thousand years of data.

I think we can get there. I think it’s a really interesting conversation to broach.

Dr. B: Yeah. And wouldn’t it be a great day, too, if the left hand was talking to the right hand in healthcare? And we didn’t have these silos of — there’s the Western medicine and doctors, and then there’s the, you know, “alternative medicine” or however we want to describe this.

Josh: Well, 4.4 trillion dollars speaks pretty loudly. And that’s sort of what the system is worth right now financially.

And you know, we have to go back and recognize that the EPA and the FDA have considered the economic and social and environmental costs and benefits of the use of these protocols — and have decided that it’s financially worth it.

And so here we are.

At least, my tinfoil hat theory on it.

Dr. B: [laughs] I don’t think there’s one big evil plot to keep everybody suppressed and everybody ill. But I think there are special interest groups that have unfortunately lobbied and pushed certain things in a certain way where it’s ended up where people are sort of milked like cattle for profit.

Josh: It’s the—

Dr. B: Well, what it is, is that there are certain industries that are empowered with money, and they can flex that money on an individual person to get the vote that they’re looking for.

And it’s an unfortunate thing, because I don’t think that should exist in any way — but it does exist.

And so it’s not so much that the system — that there’s some broader conspiracy to try to inflict harm on people. I think it’s more so that the system has a weakness — which is that lobbying can be used to empower specific industries that have an agenda.

And that agenda may have nothing to do with human health. It may be 100% making more money.

And unfortunately, that’s what we see.

Josh: Yeah. I totally agree.

Will, I know we could go for hours and hours. I’ve really enjoyed this, and maybe we get to have you back one day.

But for right now — if you could just let our listeners know, what are you up to? Where can they find you? What do you want them to dig into as a next piece of information here?

Dr. B: Well, you can find me — so I guess a few things.

For those who are interested in learning more about ZOE, go to joinzoe.com/willb. If you decide that you want to do it — and by the way, like, a great place to start is we have the ZOE Science & Nutrition podcast. So you can definitely start with that and check it out.

But if you decide you want to do it, the value is that — using that website, joinzoe.com/willb — there’s a code that you can use to save some money. So that’s a beautiful thing.

My social media is @theguthealthmd. You can find me on Instagram and Facebook there. I would encourage people to come check it out.

You can just join my email list, which I’m quite proud of — this is where I like to have good conversations.

And then I have my books. My books are Fiber Fueled and The Fiber Fueled Cookbook. Quite proud of them.

Josh: Thank you, Will. It’s been brilliant.

I’ll make sure all that’s in the show notes. If you guys are listening right now, just hit pause — there’s 30 seconds left — just go down, click those links, grab those things, and we’ll make sure you have access to all this fantastic info from Dr. Will B, @theguthealthmd.

Will, thanks so much for being here.

Dr. B: Thanks, Josh. Thank you, everyone.

Josh (closing): One of my favorite things to hear as an IBD specialist is something along the lines of, “I learned more from you in 15 minutes than from my doctor in 15 years.”

And if this, for the first time, is really starting to click, and it’s starting to make sense, and you’re going, “Wait a minute — this might be reversible… I think there’s more that I can do…”

This condition came out of nowhere — it happened to me out of the blue — I was healthy for 10, 20, 30, 40 years and suddenly I wasn’t. And you’re telling me there’s no cause?

If you’re understanding finally that there is a cause — that something is driving this — I want to invite you to check the link in the show notes below. Send me an email. Ask a question. See if a program is the right fit for you.

Because I promise you — this doesn’t have to be a lifelong sentence. You’re not doomed to this. And IBD can be reversed.