So thinking about a more holistic approach, if you could design the ideal program for adolescent weight reduction, what would it include?

When we're talking about strategies, I'm going to say, look, if I could take you, when I'm talking to my child between each other, with me, we would go and live on an isolated island.

And the only food we would eat would be what we could find scattered to catch, and that includes fish, and that we would be climbing, moving, and active all day.

And there's a limited amount of food available.

It's really providing a multifaceted approach.

No single strategy is going to be effective.

And drug strategies, and we'll talk about them soon, they can be incredibly effective, but they need to be part of a package because they're not sustained.

I wonder if you could talk us through what did you find both initially and in the longer term in these adolescents?

... and, and what got you started in medicine.

It, it's interesting.

There are certain formative events for all of us that steer us in a certain direction.

So I was a young lad growing up on Waiheke before Waiheke became famous, um, and then it was a community of about four thousand people.

The only access to Auckland was by a slow ferry, two, two and a half hours each way, so we sort of stayed on Waiheke.

And I went to high school on Waiheke, um, and it was one of the last area schools in the country which goes from prima one or year one through to year 11 or form five, and then you have to leave to go on terms of high school education.

But while we were there, my mother, bless her cotton socks, um, became secret- se- the local secretary of the National Party.

But what started you on that particular road?

So tell us about the evidence here

Well, to start with, Louise, a baby is born essentially without a gut microbiome, and then over the first three years of life, that child develops a more adult-like microbiome.

So it starts with nothing, gets to an adult-like microbiome.

So that's quite a critical phase, those first three years of the microbiome developing.

In part, that's supported in the first about six months during breastfeeding, and we'll come back to why that is.

During that critical development phase, every time a child receives a course of antibiotics, it smashes the microbiome, the gut microbiome around.

The gut microbiome will recover over many weeks after that course of antibiotics, but it may not be back to where it was before in terms of the balance of the gut microbiome.

Is that something that we need to consider in this space? Do you recall the outcomes of that?