Sep 21, 2026 · 2 hr 28 min · 21 segments
Dr. Chris Thompson, MD, Professor of Medicine at Harvard Medical School, Chief of Interventional Gastroenterology at Mass General Brigham in Boston, and Co-Director of the Center for Weight Management…
Chris ThompsonGuestYou know, earlier we were talking about CGMs, and there's sort of a, kind of a common theme here, which is the general public now, because of online health information, good and bad, is starting to, um, create their own nomenclature, and I could see why that would scare physicians.
But I think that m- a more symbiotic relationship between, like, the public's under- like, knowledge of their own data, questions about, like, maybe it's leaky gut, you know, um, and being able to approach their physician with, with these things in mind and still acknowledging that the physician is the physician, right, could be really helpful.
if these are- aren't meaningful or, uh, um, well, I get a lot of questions about artificial sweeteners and negative effects on the gut microbiome.
Seems like they're m- marginal to zero effect on insulin and bl- resting, uh, blood glucose from artificial/ uh, low-calorie sweeteners in a way that, like, would lead people to say these are bad.
There's no reason to run out and use them if you don't want to, but the weight loss data say people who drink diet sodas instead of wa- water actually lose more weight.
It sounds like, you know, saccharin and Splenda are probably worse for you than stevia and aspartame.
... with these things in terms of their potential negative effects, and if you know of any positive effects, I'd be curious.

I think they're better than high-fructose corn syrup for sure, right? I mean, that I think we should be treating like alcohol, right? Yeah.

... fructose in fruit, fructose in general, uh, 'cause it comes with a matrix around it.

It's not, you know, it's not like a rush of ca- of, of, of fructose into your liver.

But fructose can only be processed by the liver, right? And so it's busy as it is.

Now it's gotta take the burden on of, of, uh, you know, uh, a beverage which is absorbed very rapidly, goes directly to the liver, and it has to be, has to be dealt with.
You know, earlier we were talking about CGMs, and there's sort of a, kind of a common theme here, which is the general public now, because of online health information, good and bad, is starting to, um, create their own nomenclature, and I could see why that would scare physicians.
But I think that m- a more symbiotic relationship between, like, the public's under- like, knowledge of their own data, questions about, like, maybe it's leaky gut, you know, um, and being able to approach their physician with, with these things in mind and still acknowledging that the physician is the physician, right, could be really helpful.
if these are- aren't meaningful or, uh, um, well, I get a lot of questions about artificial sweeteners and negative effects on the gut microbiome.
Seems like they're m- marginal to zero effect on insulin and bl- resting, uh, blood glucose from artificial/ uh, low-calorie sweeteners in a way that, like, would lead people to say these are bad.
There's no reason to run out and use them if you don't want to, but the weight loss data say people who drink diet sodas instead of wa- water actually lose more weight.
It sounds like, you know, saccharin and Splenda are probably worse for you than stevia and aspartame.
... with these things in terms of their potential negative effects, and if you know of any positive effects, I'd be curious.

I think they're better than high-fructose corn syrup for sure, right? I mean, that I think we should be treating like alcohol, right? Yeah.

... fructose in fruit, fructose in general, uh, 'cause it comes with a matrix around it.

It's not, you know, it's not like a rush of ca- of, of, of fructose into your liver.

But fructose can only be processed by the liver, right? And so it's busy as it is.

Now it's gotta take the burden on of, of, uh, you know, uh, a beverage which is absorbed very rapidly, goes directly to the liver, and it has to be, has to be dealt with.
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