Science Extra: Weight of the world
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ABC Listen. Podcasts, radio, news, music and more. The irresistible appeal of ultra-processed foods, plus weight loss drugs that just won't quit. Ah, and the AI doctor will see you now. The future is here when it comes to our bodies. Welcome to Science Extra on Radio National. I'm Belinda Smith and today we'll snap on some gloves, grab a scalpel and dissect the year in health.

Coming up, much of the hand-wringing in health has been around rising obesity rates over the past few decades. We might think we know the causes, but what does the research say? And can new generation weight loss drugs like Ozempic reverse that trend?

But first, I'm joined by Tegan Taylor, presenter of The Health Report and What's That Rash? Welcome, Tegs. Hey, Belle. Now, artificial intelligence has been a story that's just been inescapable these past few years. It feels like it's moved super quickly from being something futuristic and slightly frightening to being much more part of our daily lives.

And that's fine if you're using it to, I don't know, draft an email for work or something. But it feels slightly different when we're talking about human health. Yeah, the stakes are somewhat higher when we're talking about our own bodies. And we're used to human doctors treating us differently.

as humans. There are similar problems with AI and health as there are to its use in other technologies. So computers are really good at some things and quite bad at others, but also humans are really bad at some things and good at others. And so I think with AI and health, it's about finding out where our strengths are and where the computer's strengths are. So what are computers particularly good at then that we perhaps are not? They're good at big data sets. They're

They're good at crunching large amounts of data quickly and kind of making inferences from that. And they're also really good at not getting tired and...

and not having sort of mood swings or other things happening in their lives that might cloud their judgment. And this is absolutely not to cast aspersions on doctors, but there have been studies that show that, say, judges. It has been shown that the time of day that a judge is handing down a judgment might affect how they do that judgment. And so doctors are humans too, which is something that we see as a strength because we have empathy and compassion, but also means that we are fallible. And so it's about going, okay, what can the computers do to perhaps improve

support the doctors in giving the best healthcare to people without undermining what makes a human doctor so good. Sure. Yeah, that judge study is really interesting, right? So just before lunch, they tend to hand down more severe sentences than after they've eaten and their blood sugar levels have gone up a bit. They're a bit more lenient, right?

It's worrying when you think that you might be standing in front of a judge, but I kind of feel like that's really relatable as well. Oh, 100%. 100%. Weaving AI into healthcare, that's not a future problem. It's being used in clinics now, isn't it? So what's it being used for? Yeah, no, it is. And I think that's the thing. I think we've been framing it up very much as a future thing, but it is in the now. Two of the big – this isn't comprehensive, but two of the big areas that it's being used are in radiology –

So for example, chest x-rays are one of those things that there are just so many chest x-rays done all the time. And sometimes it's because they're looking for something really urgent and severe like pneumonia. And other times it might be a follow-up

Each one of those at the moment has to be looked at by a radiologist, which is a specialist doctor. There's sort of predictions that there won't be enough radiologists to kind of keep up with the population very soon. And so in being able to use an AI to basically triage these chest X-rays, what they can do is that the AI can kind of look at it and go, yes, probably pneumonia, probably not pneumonia.

It's not going to be 100% perfect, but what it is going to do is surface those potentially more urgent cases to the radiologist first so that they're more likely to be seen quickly. They all get looked at in the end. It's not like anyone's missing out necessarily, but it's that... I mean, we know about triage in healthcare. That's how emergency systems work. That idea of urgent cases being seen more quickly and then other cases being seen but not straight away. So that's one. And then another one is triage.

transcription. So if you go and see your doctor, you're sitting in your GP's office with them, you're talking about all the weird things that your body's doing and they're tap, tap, tapping away on their computer as you talk.

And there's a lot of different GP practices that are now using medical specific transcription software so that the transcription software can be taking those clinical notes, which are a really important part of healthcare. And your doctor can be listening to you and engaging with you and probably building up that more of a bond there. You can see the benefits there of having a doctor that's really kind of looking in your eyes and engaging with you. But then also what you're doing is relying on the transcription software to hear the

correctly and record correctly, which is tricky when different parts of the body maybe have similar sounding names or different medications, importantly, can have very different effects but have similar sounding names. And so there are risks there and the risk still sits with the doctor using the software to make sure it's correct.

They can't kind of fob that off onto the software, but it is being used now. And I think it's just the tip of the iceberg of what we're going to see in the next few years. That's so interesting. I mean, look, as journalists, we use transcription software a lot.

And oftentimes it will spit something out that's just nonsensical. And it might just be an interview about, I don't know, planets or diabetes or something which is not particularly tricky. And yet the transcription software often gets it quite wrong. For me, that would be the biggest issue, I guess. But also things like accents.

Someone talking in a thicker accent, for me at least, with my transcription services don't come out as accurately as people who speak with what you would consider a sort of more typical accent. So how much more work is there to do in these kinds of services? So much. And it's so interesting that you say the thing about accents because I think it speaks to one of the big potential pitfalls of AI, at least as it is at the moment, in that it relies on a data set. So it can only learn from the data set that it's given and

And we know that not just in AI, but also just in healthcare and medical research generally, there is a big skew towards people from European ancestry being used to generate those data sets, which means that they can be quite good, quite reliable and predictable if you're working with someone who is of that same ancestry and a bit fuzzier.

in its applicability for groups who aren't in that. So part of ensuring that AI is actually doing as good of a job for everyone as it could be means making sure that the data sets that it's based on are inclusive. And what are we likely to see then in 2025 and beyond? Well, like I say, though, that $30 million is research into developing tools. So that kind of gives us a bit of a glimpse at what could be coming down the track

maybe in 2025, maybe further down the track. And then I think the other thing that we're going to have to see in the next year or two is more clarity around how to use these tools in ways that are for good and not for evil. And so that's not necessarily people using these tools for nefarious purposes only.

on purpose, but making sure that that data is secure, making sure that those data sets are representative, like I say, and being aware of the fact that whenever humans are designing a machine that's in learning for itself,

It's based on biases and ethical frameworks that we have programmed in and really being in the same way that we would check whether a medical device or a medicine is causing harm once it goes out into the community. We need to make sure that these tools that are effectively medical devices are also being monitored once they're in the community. Well, I for one can't wait for my next appointment with Dr Rowena Bott.

Anyway, another mainstay in health news this past year, well, I guess longer really, has been weight loss drugs like Ozempic. Yeah, we talked a lot about them in 2023. That was kind of the year of hype and shortages and discussions about who deserves the most because at that time Ozempic really was the only kind of big one on the market in Australia and that's actually a diabetes drug.

In the past year, in 2024, the supply has become steadier. And we've also had drugs from that class, GLP-1 agonists, approved for use in weight loss specifically, which we didn't have before. And there's been more evidence coming through. And it's been interesting to me because I think whenever there's big hype around something like weight loss, it's really showy. I'm kind of waiting for the other shoe to drop. Obviously, it has. But I think I personally, as a health reporter, have been surprised at how much

the evidence has borne out the fact that these could be a really important class of drug for people with great need. Yeah, it's interesting that a lot of the commentary around this last year was, oh, how dare people be using these drugs to lose weight when there are people with diabetes who need them? The real challenge is the people who are most in need of drugs like this

often the people who are least likely to access them. They're not subsidised at the moment. And of course, each of these drugs can only treat an individual. And for a lot of the problems that they're trying to solve, what we really need is a public health intervention. More on that particular class of drugs in just a sec, but we'll say goodbye to you, Tegan Taylor. Thank you so very much. It's been an absolute joy to talk to you. It always is. Thanks, Belle. And you're listening to Science Extra on Radio National. ♪

Over the past century or so, our rates of nearly every type of disease, that's infections, deficiencies, lung cancer, they've all dropped, at least in developed countries. But with a notable exception, diabetes and obesity, although there's debate on whether obesity itself should be classed as a disease. So what's to blame?

Certainly not a global decrease in willpower, according to Boyd Swinburne. He's a professor of population nutrition and global health at the University of Auckland, who's spent his career in endocrinology and public health. He talks here to Dr Norman Swan about how to unpick the drivers of the so-called obesity epidemic and

and whether new wonder drugs are enough to reverse them. Well, let's go to the causes. If you go back in time, my understanding is your work I'm quoting here, so you can tell me I've got it wrong.

We've got fatter in 10-year lots. In other words, you go back 30 or 40 years for every group born in that 10-year period. So the next 10-year period, we're fatter or heavier, and then heavier the next 10 years and heavier the next 10 years. We haven't changed. It's the same kids, same parents. Something else has changed. And we've not had these masturbinate mutations, yet we have a lot of obesity, a lot of overweight around us.

What has your work found is the cause of the obesity pandemic, given that I presume you're not going to say it's weak will? I'm not going to say that at all, Norman, as you know. But when I first started doing research in this, and this was with

Pima Indians in the US who have extremely high rates of diabetes, about two-thirds of the adults have diabetes, and they have a whole research group there trying to understand the causes of diabetes and obesity.

But of course all of that research was looking inside the body for abnormalities or problems that are causing the obesity. In other words, what are the ancient genes? Well, the genes, but it was also looking at all the molecules and the receptors and the hormones, trying to identify the problem, the pathology, if you like, what's going wrong there.

And when I started looking outside the laboratory, if you like, and into the real world, you could see that the environment was highly conducive to creating obesity.

And that's when we started framing the problem not as pathology within the body but pathology outside the body. So as a normal physiological response to this pathological or as we called it obesogenic environment outside. And that's the thing that's been changing.

Our bodies have been responding normally as a normal physiology, but it's the outside environment, the obesogenic environment, that's changed over this time. You talk about the food industry as being the prime cause. Yes, so we have been chasing what is the...

overarching narrative? What's the story that is driving this pandemic, especially when you zoom up to the whole global level and you find that every country, except those in war-torn countries, every country is increasing its obesity rates. So this is not a global collapse of willpower. It's not a global metabolic abnormality. This is changes in the environment. But what's causing our behaviours? Why are we over-consuming food?

food and calories when we don't want to. We don't want to get fat. We're not trying to overconsume, but it just happens. But in the last 10 years or so, there has been this concept of ultra-processed foods, which was first articulated by Professor Carlos Monteiro from Brazil in

saying actually when you look at what the processing is of these foods that we would call non-core foods or discretionary foods or unhealthy foods,

there's something in the processing which is really important. And I think this has come to be a much better, more parsimonious, satisfactory solution to explain the wider pandemic of obesity. So they produce these foods which fill up the middle of our supermarket, all of these things that are in packages that have long shelf lives, specifically designed to be very tasty and

These products really, I think, have taken over or are taking over the traditional diets, the traditional foods. So in countries like Australia and New Zealand, probably about half of our diet is these ultra-processed foods. Half of the diet? In America, it's about 60%.

For low- and middle-income countries, it's 20%, 30%, but increasing much more rapidly. And what's happened here is that the food industry, the ultra-processed food industry, has struck a formula for making large amounts of money. They get these industrial products. They build them exactly to our taste buds. They hit what's called the bliss point, making them perfectly ultra-palatable.

They add in a lot of other value to us like long shelf life, like cheap price. They market them heavily. It's a value to the shopkeepers as well because they don't have to keep changing and throwing out fresh produce and so on. Not only does it affect how we think about value and why we purchase them because they're tasty, because they're marketed, because they look cool and so on, but it also affects

affects us in our taste buds in kids when they learn from very early age.

to like the high fat and the high salt and so on and the higher sugar. But they also give us a little kick, a little hedonic kick, a little dopamine kick, and we quite like that. And so we're kind of trapped within this ultra-processed food system, which to me explains why, when we've known the negative effects of all these foods, why they still occupy places.

50% of our diets. You and others have described this as behaviour that's very similar to the tobacco industry. Well, the tobacco industry, of course, have a much more addictive product, but it's the same sort of thing that traps people within it. There is discussion and quite a lot of debate within the food world about

how much these products are actually addictive under the usual criteria. And they do actually fulfill quite a lot of the criteria for an addiction. Obviously, it's not as powerful as tobacco and so on.

But, you know, they do light up the areas of the brain that give us pleasure. They do give us a little bit of a hit. People do describe cravings of them and withdrawal symptoms and some people do. And so there is a little bit of an addictive element to it as well. But it's more than just that. It's all the convenience and the taste and a whole lot of other things as well. Now, you've studied this for WHO reports or health organization reports on obesity. And when you quantify...

what you believe are the effects of the food industry in the terms you've been describing, and quantify, for example, the effects of the motor car, lack of exercise, suburbs that aren't designed for walking. What's the relative contribution of the fact that we're getting less incidental exercise? We're living in an environment where we're more dependent on the car. Well, we've been dependent on the car for quite a long time. It's probably increasing.

Recreational physical activity, that's the small amount that we do on a recreational basis, probably hasn't changed or it might even be going up, but it's only a small part of our total physical activity. The biggest part of our physical activity is just in our daily lives, at work and getting to and from work.

And so, yes, over the century, if you like, or the last 50 or 80 years, that has declined, those physical activity has declined. But it's been harder to get a handle on it than on the food side. You've actually set a date almost on the beginning of the obesity epidemic, which is not necessarily linked to motor cars. Yeah, the big up kick, and it's a little bit hard to know exactly when it started, but the country with the best data is the U.S.,

And there does seem to be a kickoff from the early 70s, which has been kind of relentless since then. It might have tapered off in the last 10 years or so in countries like Australia, but it kicked off earliest that we can tell in about the 70s.

Even going back further, you know, colleagues have done studies looking at the level of physical activity that we had to do, you know, 130 years ago at the turn of the 20th century to just get around and get daily activities, chopping all the wood and carting it and walking and cycling and things with hardly any cars. There was quite a heavy physical activity load and then over the first decade

50 years or so of the 20th century, as more and more mechanisation, including car transport, came on board, people obviously picked it up and became less physically active because there's less demand. And actually we have seen from food sources

supply data that actually the average calorie count kind of went down with it. So in other words, we're exercising less and eating less to compensate. Yeah, yeah. There wasn't the demand. You know, if you go and spend your day chopping wood and walking around, you've got quite an appetite at the end of the day. And then you don't have to do that. The appetite signals drop and you don't need to do quite so much. So the first half of the 20th century seemed to be operating like that with a reduction in

physical activity but not an increase in obesity because appetite mechanisms were creating the energy balance. Then the second half and I guess starting particularly from the 70s was the big uptick. We have

increase in energy intake driving our energy balance. So we are now faced with a whole wider variety of more tasty food at a more affordable price and tend to end up eating more of it, putting on weight. In the 19th century and the early 20th century, it used to be said, people would say to each other, you're looking prosperous. Yes. Because being fat was a sign of being rich. Yes.

That's no longer true. That's the case in some earlier studies, particularly in African countries and the Pacific countries, found that there was a much greater tolerance of a large body size and in some ways it carried some of those positive characteristics that you mentioned and that a skinny body size

on the flip side, had negative connotations. Nobody loves you. Nobody's looking after you. You must be sick. You must have HIV AIDS or tuberculosis or be poor or something like that. Classically, Uriah Heep and Dickens. Yes.

So that was the case, but actually much more contemporary studies have found even in those countries like Pacific and African countries, now they've taken on much more the body size perception of the Western countries. So I think that actually has been changing quite a lot in the last several decades. Now your erstwhile colleagues in endocrinology said

are very firm that obesity is a disease. Do you agree? Yeah, it's a tricky one, and I kind of resisted that for a long time with my public health hat on, with the thinking that, OK, you call it a disease and then it becomes medicalised and it's seen as an internal, individual problem, not a societal problem.

The whole push for it was also quite strong from the pharmaceutical companies because they wanted it to be defined as a disease. Therefore, it could be treated. Therefore, their drugs could be paid for through the taxation system and so on. They could be on the schedule. So I was a bit opposed to it, but I was actually persuaded the other way, talking with people who...

have lived their lives with obesity and struggled with it and so on. And for them, it may seem a bit paradoxical, but for them, for it to be labeled as a disease, as something more real, more tangible, this is not just my lack of willpower. This is actually something a little bit like

high blood pressure or my high cholesterol or the fact that I'm getting arthritis. It's something that's not exactly beyond my control, but it's something that's happening to me, not something where I've been a bad person and done it to myself. So they really appreciated it being labelled a disease. And of course, when

effective drugs do come along as they have now then they are in a position to perhaps have more access to them than they otherwise would have so I now support it being called a disease while at the same time still try to paint it as a

public health problem and a societal problem. You're listening to Science Extra on Radio National, where Dr Norman Swan is in conversation with Professor Boyd Swinburne, who studies population, nutrition and global health at the University of Auckland. So we're sitting in government where governments all over the world have really failed to regulate the food industry.

Some countries have put taxes on sugar, talking about putting taxes on fat and so on, but it's been resisted, particularly in Australia. The introduction of drugs which treat obesity must be, in one sense, a great relief because you're off the hook. On the other side, you're on the hook for the expense, I suppose. Well, that's true. And, you know, things have not been happening in Australia and New Zealand. I have to say our countries are laggards.

The countries that are making the most progress in action are Latin American countries. Most of them have got warning labels on their food for ones that are high in fat and salt and sugar. They have restrictions on marketing to kids. They have taxes on the sugary drinks. They have restrictions on none of these ultra-processed foods.

in schools and so on. So Latin America is really leading the charge and even the UK under a Tory government managed to get through sugary drinks taxes and bans on junk food marketing and improvements in school lunches and things. So, you know, we really are the laggards and we should be way better than we are.

So don't give up yet on the public health side, Norman, because a lot of countries are doing really well. We just need to catch up with the rest of the world. But yeah, these drugs, these GLP-1 agonist drugs that have hit the market have really changed the face, I think, of treatment. We see this actually at obesity conferences. In the days before there were any drugs, it was a pretty niche kind of conference. And then we had

some drugs and that came along and then suddenly a whole lot of clinicians started coming to these conferences to find out about it and then they turned out to be not so good and the interest waned and then some magic compounds like leptin and these other hormones which seemed like they'd have the answer were found and that was all exciting and all the endocrinologists arrived and then they'd

Turned out to be a bit of a fizz and was back to the sort of niche public health people again. But now we've got this new class of drugs, the GLP-1 agonists, and all the clinicians are back and the endocrinologists are back because this is a pretty exciting time. But as you said, it has...

put governments now in a bit of a challenging position because these drugs are now shown to be very effective, but they are still very expensive. And you're on them for life. And you're on them for life, although they, of course, won't do that. And where they have been introduced into countries, they are usually introduced for a limited time.

And this is a mindset thing. This is sort of saying, we'll give you this drug that'll drop 15% of your body weight over a couple of years. And by then you should have learned how to control yourself. And then we're going to stop paying for the drug and you're on your own. That's not how it works.

you know, the body will fight back. The body does not want to lose weight and it will fight back and increase appetite and people really struggle to hold that weight off. And even in similar circumstances like people who have high blood pressure or high cholesterol, again, those are risk factors for heart disease. They are a mix of people's behaviours, the environment, their genetic predisposition and things. And yet

We put them on antihypertensive drugs. We put them on cholesterol-lowering drugs for life because that's just what we do. They've shown to be effective. We pay for it. Now, when the

statins first came out and they were really expensive and still under patent. Governments were pretty reluctant and in New Zealand they dragged their heels for a long time until these drugs come off patent and become cheaper. But we're going to see the same sort of thing with these new drugs. They're going to swamp the market. There's going to be lots of Me Too. This is

such a goldmine for the pharmaceutical companies. They've struck the rich seam of an anti-obesity drug that works and they will make gazillions from it as they already are. So we'll see them coming through in lots of different varieties. We'll see oral forms at the moment slightly injectable. We'll see them in combination with other drugs and over time they'll become quite cheap and it will be

quite plausible to just treat them the same way that we do with antihypertensives and cholesterol-lowering drugs. I mean, has it got the potential? I mean, the extent of which is a game changer. The GLP-1, this system in the body, this hormonal messenger system in the body affects different organs. So it doesn't just affect your appetite and food. It affects the heart directly. It affects the brain directly and the kidneys directly, almost independent of your weight.

I mean, some people are saying, well, why wouldn't you just give it to everybody at risk?

And it might relieve the pressure on our emergency departments in general practice because people aren't going to get their heart attacks anymore, same way as they did with statins and high blood pressure pills. You know, there's some rationale to all of that. And these drugs, which are sort of mimicking hormones, they have multiple effects, as you said. The biggest effect people notice is the effect on the brain and the appetite and this decreasing of the food cravings. People talk about it as the...

The food noise has left my head, you know. I'm not thinking about it all the time. The feelings of fullness after smaller meals and so on. But it does. It affects the pancreas. It affects the gut. It has other metabolic effects. It affects the heart.

And we don't know the full extent of that, but there are a number of trials which have shown substantial reductions in heart disease deaths and kidney disease and so on. So these may well have multiple uses in the end. I mean, they started off as diabetes drugs because, of course, you lose some weight and improve insulin sensitivity and diabetes control really improves. So these drugs were first of all paraded out for use

diabetes and now obesity but you're right it may well turn out that there's a whole lot of other risks around stroke and heart attacks and so on. So move forward five years are you out of a job? I wish I might be out of a job because of my age and stage Norman but I'm not going to be out of a job because we have cured obesity. Gee you just look at how many decades has it taken to get to this point for smoking?

you know, a single highly toxic product. We're 70 years on and still struggling to stamp it out.

So this obesity is a far more challenging beast to deal with. It's quite instructive that if you look around the world, high-income countries like New Zealand and Australia, a lot of diseases are actually decreasing with better prevention and better treatment and so on, except for obesity and diabetes. We just have not nailed it.

And so this is a really hard nut to crack. Yeah, I won't be out of a job anytime soon because of that. Boyd Swinburne, thanks for joining us. You're welcome. And that was Dr Norman Swan in conversation with Professor Boyd Swinburne, who studies population nutrition and global health at the University of Auckland. If you want to hear more from Norman, check out the health report. You can find it on the ABC Listen app.

This is Science Extra on Radio National. I'm Belinda Smith. Now to the new podcast about weather that changed us called The Weather That Changed Us. Today we go back to 1999 when a hailstorm like no other came out of the blue and pummeled Sydney. The hail shattered roofs, windows and cars, but it also smashed the record for the most expensive natural disaster. Imagine a golf ball, its size, its weight.

Now imagine it falling from the sky at 200km an hour. It would hurt, right? OK. Now imagine thousands of them falling from the sky all at once with no warning. Just eight minutes and I have no house left. One evening in Sydney in 1999, that's what happened. Giant hailstones started pelting the city

But they weren't just golf ball-sized. Some of them were also the size of cricket balls, and others even bigger. Sound like machine gun fire, just crackling, like if you were in a war zone, basically. They got hit on the head with a block of ice and realised what was going on. And they tore the city apart. I'm Tyne Logan, and this is The Weather That Changed Us.

In mid-April 1999, a hailstorm like no other came out of nowhere and rained down on Sydney, slamming into houses and cars, shattering roofs and windows. It overwhelmed emergency services, becoming an insurance catastrophe and a transformative moment for the SES.

It's the middle of the week at the Sydney Cricket Ground and Troy Luff is working up a sweat. He's a long-time player for the Sydney Swans, an AFL team. He's also a landscaper. Footy wasn't as lucrative back in 99. So at the time we'd go to training early in the morning and then I'd go off to work and then come back to training again in the afternoon. It's the evening and they're under the stadium lights. But Troy notices something's not right.

It's like the temperature changed all of a sudden. It got really cool and there was no wind. You could still see the sky and you could see that it was just turning too dark. It was almost like a dark green, as dark as green as you can get. I'm an outdoor worker. You know what coloured clouds mean what? And so green means hail. Then...

He hears it. It was like an avalanche getting closer and closer until we could hear on the roofs of the SCG. They were cricket ball-sized hailstones, and as they started to hit the ground, we just ran.

And thankfully, I think there was only one player, Stephen Carey. He did cut one in the head and it did cut his head. He had the nickname Pumpkin Head because he had a massive head, so it was a pretty good target for a hailstone to hit. He was probably being a bit of a smart-ass, to be honest. He's like, oh, he just ran out there, you know, and see what happened and bang, straight on his head. And, of course, we just laughed. Safely undercover, Stephen Carey patching up his head, Troy and his teammates stood in awe.

as the noise of the hail got louder and louder. We stood underneath the players' race and just watched the size and the enormity of what was happening and how big these hailstones were and the damage that it was doing. You couldn't talk to the guy next to you. It was so loud.

There wasn't really any conversation at all. No-one knew what to say, because what do you say when you're looking at something like that? It was just so amazing. Then his thoughts turned to the cars. We used to actually park on the concrete on the footpath out in front of the SCG, and I quickly ran out to see how my car was looking. You could hear the metal just breaking as the hailstones hit them.

It was like if you ever go to a demolition derby and you can hear the metal crunching up against each other. The sound of just the hammering of the cars.

It was so big that it actually put holes in the metal. Like, obviously, every windscreen was totally smashed, but the actual metal of the cars, particularly on the arches over the wheels where it's a little bit softer, when the hailstones were hitting it, it was actually putting cuts into the side of the car. I picked a couple up and I think you saw the photo. I had three hailstones in my hand holding it like that. Just three. This photo is actually how we found Troy.

He's standing at the SCG Oval in a white training jersey, his hair drenched against his face, and he's just holding these huge rocks of ice in his huge footballer hands. That's how big it was. You know, some bigger than cricket balls. They were just giant. The storm, the hail...

it was a bit of a thrill at first to see such a natural phenomenon like that and witness it firsthand it was exciting it was amazing and then you start thinking about everything else of where the other damage is are people actually hurt if people are driving and that came through your windscreen like what would have happened and then the houses and then everyone started getting on their phone and calling their wives and girlfriends or or flatmates to see

what had happened. I did the same, you know, called my wife at the time to find out what had happened and if they were okay. And basically it was just everyone just get home and, you know, make sure everything's all right at home. Troy was far from alone. At that point, hundreds of thousands of people were calling loved ones, checking on their family, their homes, their cars and their other belongings. Tens of thousands discovering damage so bad, they needed help.

Before I knew it, the pager system that we used to use was going off frequently. Across town in Sydney's inner west, 18-year-old Paul McQueen was home alone, watching TV when he got the call up for assistance. He was a volunteer for the state emergency services. Had been since he was 13 years old, actually. A bit of a family tradition.

I could tell that the storm was something quite different to the normal storms that we get on a regular basis. And at times, while the storm was very much hail-centric, I suppose, there was some howling winds of up to around 80 kilometres per hour. He was about to leave when his own skylight broke in. Being 18 years old, I jumped on the roof, the hail was still coming down.

I sort of covered up that hole in the skylight with some garbage bin bags to make it watertight and came down and that was fixed. It was time to go and help some other people. The city had been completely caught off guard, not only because it was April, outside of the usual storm season...

but because there was no warning from the Bureau of Meteorology either. The duty forecaster at the bomb, Evan Bathe, told the ABC the next day he'd seen it on the radar, but he thought it was going out to sea.

The storm was there, but I thought it was going to stay offshore, but it just came inland. And before I could do anything, the phone started to ring and I was caught up. It was, you know, there was reduced staff overnight, so we were too busy. Was it a guess and you guessed wrong? No, it wasn't a guess. Well, it was a forecast. The forecast was to follow, you know, follow the scientific...

Sydney was in tatters. Picture Troy's car, with its shattered windows and pierced metal. 70,000 vehicles were smashed up like that, as if someone had just dropped a cannonball over them, over and over. 50 people were injured.

and one person was killed by lightning. There was also major damage to more than 25,000 homes and buildings. And when I say major damage, I'm talking shattered roof tiles, skylights and solar panels broken in, windows smashed, and a lot of water damage from rain just pouring through the open roof. Every single house I can see has huge holes in the tiles. These are not...

And the bill was huge. For the Australian insurance industry, it was the most expensive natural disaster ever. A title it would still hold if it were to happen today. $1.7 billion at the time, $8.85 billion today.

Partly because it's the eastern suburbs of Sydney, an area that's both expensive and widely insured. With all that damage, Paul McQueen and the rest of the SES had a lot of work ahead. Across the event, the New South Wales SES received around 40,000 calls for assistance regarding...

that single storm. Sometimes we hear on the news that the ACS has responded to an event and there's 500 jobs, and we think that's really bad, and that is really bad. But just times that several times out to get to 40,000 jobs, that's what we were dealing with. And the recovery would end up changing the whole organisation.

Day after day, they patched up roofs and cut and removed trees. The big thing that stood out was just driving the streets and there was tarpaulins pretty much on every house. The point that there was a tarpaulin shortage and we ended up actually receiving tarpaulins from UNICEF to tarp people's houses. And Paul's unit was running this mammoth operation...

out of just a tiny three-bedroom house with little time for rest. That house had actually previously been a brothel before the New South Wales SES moved in, so it wasn't really in tip-top shape. I was working pretty solidly for about three months. Probably took off about ten days in three months initially in that response. While the first three months were the worst, it actually took six months before Sydney's roofs started looking normal again.

And by that time, it was very clear to the New South Wales SES they had never had to deal with something like this before. And their systems were just not built to handle it. We were trying to combat that situation in very different times when we didn't have the tools or the techniques that we have these days. To understand what changed and why...

I think it's helpful to look back at how the SES and the community was dealing with it in the aftermath of this storm. For starters, if you needed help from the SES at the time, and a lot of people did...

There was no centralised number to call. People would look up and then the white pages or the yellow pages, their local SES unit, and they'd call that number. We had people sitting at that building taking calls pretty much constantly. And that's if you were lucky enough to get through, because a lot of people were probably hearing this. The technology didn't improve for the jobs that did get through either.

They were all coordinated with just pen and paper, like it was someone taking your order at a cafe. We would literally be handing them a pile of papers with job details and the requests from the assistants from the community and saying, you know, here's these 10 jobs, get through as many as you can and come back to us at the end of the day. Yeah, in my head, I'm imagining phones ringing off the hook and just paper flying everywhere. That's very much what it was.

The SES was doing the best it could with what it had, but everyone knew it was far from enough. With the scale of damage and just not enough people, some things slipped through the cracks or simply didn't get done.

The volunteers found themselves facing criticism for being too slow. Today is, what, seven or eight days after that. I haven't heard from them since. I've rang them back quite frequently. They tell me, yes, we're coming to you. We've had no more. So you still haven't heard from the state emergency service? Not a word. They haven't rang us or anything. For Paul, that criticism stung.

But he also knew it wasn't universal. Look, it was certainly hard to hear, but at the same time, we knew the reality of how thankful people were when we came to assist them in their homes. Families were coming past our building and had baked cookies and cakes and were dropping off slabs of soft drink for the team. So...

We knew that the feeling in the general community might somewhat be different to some of that negative media that was circulating. Did you even have a media department at the time in 1999?

Not that I know of. No media department back then. There wasn't many paid staff at all. If I was to put myself back into the 1999 situation, if you had all of that media communication, why would that have been important? What could that have done? I think it means that what could have happened is we could have given, you know, extremely regular updates around the wait times for teams to be on site. We could have given advice on how to self-help teams

There's a range of advice that we could have pushed out there, but at the time there was no real means of doing that. These days, they do have a much better way of communicating all of the risks and advice. Think of all the press conferences you watched during COVID, with politicians and emergency services all fronting up to give you the latest. It's the same for disasters.

That all started to change after the hailstorm. Really what we do these days is we welcome the media into the event. Something we didn't have back then was studios within our incident management centres. We proactively used our social media, again didn't exist at that time. We used as many pathways as possible to get our messaging out there to ensure the safety of the community. And of course they've graduated from the

the cafe order paper and pen system as well. I think the public messaging, there's the Australian warning systems that we now use across the nation, the hazard watch apps, there's much greater ability to see what risk is headed my way. It's a different world in comparison to where we were. A lot of this does come down to the era changing, technology shifting, modernising, and they would have come in eventually anyway.

But I think this hailstorm shows us how sometimes it takes a disaster to be the catalyst for change. I think it was a transformative moment for the SES and I think a big part of that was actually the community understanding our place and the value of the SES.

I think the interactions with the media, the public messaging that we do these days, which, yeah, there's some world-leading things that we really do. If it wasn't for that hailstorm, you know, potentially we still might not have that capability today. And it wasn't just the SES that learnt lessons. The storm was also a big wake-up call to the scale of damage a hailstorm could do.

Hailstorms are expensive. And Sydney's location makes it particularly vulnerable. Henrith was pummeled by hail. Hailstones for Halloween. The hailstorm left Sydney's north-western suburbs looking more like the snowfields. The shorts and thongs the only giveaway. You know who's paying attention to those stories? The insurance industry. They want to know what hailstorms will cost them going forward. And ultimately, you.

They're already more expensive than ever because our population is increasing and we're buying and insuring more stuff. They're also paying close attention to climate change too. There's a lot that is uncertain about hail. But generally, what we know is that a warmer atmosphere makes bigger hailstones more likely, even if it happens less often.

And, as we know from 1999, big hail equals big bills. The inconvenience was massive. If it happened today, the bill to repair everything would just... It'd be phenomenal. But then again, you can get a few bargains too. It's funny, there were so many hail sales after this because a lot of car yards just went, "You know what? We'll cut our losses. "We'll just sell them for, you know, half price or less." And a lot of players,

Because at the time we were sponsored by City Ford and there were so many players that turned up in brand new, very dinted Fords after that. Check out the full season of The Weather That Changed Us on the ABC Listen app. And that's all from Science Extra today. I'm Belinda Smith and I'll be back next week talking environment and animals in 2024. Have a great one. Bye.

Hollywood. It's all glitz and glamour and crazy headlines. But when it comes to the natural world, how accurate are the movies? Are father-son connections universal, like in The Lion King? Should groundhogs really be predicting anything? I mean, they sleep for eight months of the year. I'm Anne Jones and I'm going to break down Hollywood myths and tell you what they got right and what they lied about in my new series, Hollywood Lied To Us. Get it by searching What The Duck Is.

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