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The Situation Room

Pakistan Preps for U.S.-Iran Talks; Sources: Vance Expected to Head to Pakistan; The Hill: Trump Says Energy Secretary is "Totally Wrong"; Tariff Refunds are Finally Kicking Off; Some GLP-1 Users Report Experiencing So-Called "Ozempic Personality". Aired 10:30-11a ET

Aired April 20, 2026 - 10:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[10:30:00]

WOLF BLITZER, CNN ANCHOR: Breaking news. Pakistan's capital Islamabad is preparing for a possible second round of peace talks between the U.S. and Iran in that city. But it's not clear yet whether they will even take place. The two main hotels in Islamabad's so-called red zone have been vacated of guests in anticipation of the delegation's arrival. Sources now telling CNN the vice president, J.D. Vance, is expected to depart for Pakistan tomorrow. But Iran's foreign ministry insisted earlier there are still no plans for negotiations at this point.

Joining us now to discuss CNN political and national security analyst David Sanger. He's also a New York Times White House and national security correspondent. When we last spoke, David, there were some glimmers of hope about the possibility of a broader peace talk -- peace talks developing. Where does all of this stand right now in your view? And what would a possible deal look like?

DAVID SANGER, CNN POLITICAL AND NATIONAL SECURITY ANALYST, NEW YORK TIMES WHITE HOUSE AND NATIONAL SECURITY CORRESPONDENT AND AUTHOR, "NEW COLD WARS: CHINA'S RISE, RUSSIA'S INVASION, AND AMERICA'S STRUGGLE TO DEFEND THE WEST": Wolf, I think we're seeing the outlines, the hazy outlines of a possible deal come together. But the weekend in the Gulf where the Iranians fired on two ships and then the U.S. took out the engines and engine room of an Iranian tanker, that didn't help. And so, to some degree, I think what you're seeing right now is the prepositioning of each country saying we're willing to go back to open conflict if we can't get a deal.

[10:35:00]

Now, I think behind the scenes, they are beginning to narrow down on them. But there are some unresolved issues. One of the unresolved issues is how long would Iran agree to suspend all nuclear work? And how would the president explain to the public that at some point that time period would wear off? Since that was one of his big criticisms of the Obama era deal.

Another big question, Wolf, is what do you do with the existing stockpiles of uranium in -- that are right now in Iran? Not only the stuff that's near bomb grade, but more than 10 tons of lower grade uranium. During the Obama era, that was 97 percent of it was shipped out. They built up after President Trump pulled out of that deal. So, those are two of the big issues.

And of course, the president may have to end up releasing frozen Iranian funds in some form, either cash or goods. And of course, that was another critique of what Obama did.

BLITZER: The two-week ceasefire, as you know, David, declared by President Trump with Iran expires this week in the coming days. Based on what you know right now about the administration and the Iranian regime, where do you see this going over the next, let's say, 24 hours or so?

SANGER: I wouldn't be surprised if that gets extended. All the president needs to do is say that the talks are going well and he wants to extend it. I think the president is under a lot of political pressure not to resume the combat operations that would send the markets down, would probably send oil up. And of course, the Iranians know that, Wolf, and they're playing that for everything they can.

BLITZER: Some news that actually went under the radar amid all of this was the Trump administration's recent decision to at least temporarily lift sanctions against Russian oil already at sea. Why is that move so notable and what is Ukraine saying about that?

SANGER: So, it's notable in part because just two days before they made the announcement, Treasury Secretary Scott Bessent said they weren't going to do it, that the sanctions were going to go back into effect. When they did do it on Friday night, the explanation was, well, most of that's going to China anyway. And it may well have been that they were trying to keep the Chinese happy ahead of the president's trip.

And of course, it comes at the expense, as you point out, of the Ukrainians. The oil at sea right now may be worth up to $10 billion. So, that's money that would go right back to Putin to both recover his economy and pay for the war. So, there's no question at this point that the Ukrainians are paying the price for trying to sort out what's happened in the Gulf.

BLITZER: David Sanger, always good to get your analysis. Thank you very, very much.

SANGER: Great to be with you.

BLITZER: Pamela.

PAMELA BROWN, CNN ANCHOR: All right. Coming up here in the Situation Room, Wolf, tariff refunds are finally kicking off. Who is and is not getting them? That's ahead. We'll be right back.

(COMMERCIAL BREAK)

[10:40:00]

BLITZER: Happening now, AAA reporting that the average cost of gas in the United States today is at $4.04. That's down from roughly $4.13 a week ago. But analysts say they don't necessarily expect that trend to last. This comes as Iran and the U.S. remain at an impasse over control over the critical Strait of Hormuz, causing oil prices to rise. Administration officials say it may be a while before people start to see some real relief at the pump.

(BEGIN VIDEO CLIP)

JAKE TAPPER, CNN ANCHOR: When do you think it's realistic for Americans to expect that gas will go back to under $3 a gallon?

CHRIS WRIGHT, ENERGY SECRETARY: I don't know. That could happen later this year. That might not happen until next year.

UNIDENTIFIED FEMALE: Do you believe the price of oil and gas will be lower before the midterm elections?

DONALD TRUMP, U.S. PRESIDENT: I hope so. I mean, I think so. It could be. It could be or the same or maybe a little bit higher.

UNIDENTIFIED FEMALE: How much longer will Americans continue to see these high gas prices?

TRUMP: Well, they're not very high. If you look at what they were supposed to be in order to get rid of a nuclear weapon with the danger that entails.

(END VIDEO CLIP)

BLITZER: President Trump pushed back on Energy Secretary Chris Wright's comments this morning, telling The Hill that Wright is, quote, "totally wrong," his words, totally wrong about it potentially taking until next year for gas prices to drop below $3 a gallon.

Let's go live right now to our senior business reporter, David Goldman. David, how should consumers interpret these very different messages from the White House? And when might we actually start seeing gas prices returning to what they were before the war with Iran?

DAVID GOLDMAN, CNN BUSINESS SENIOR REPORTER: And you need to add in Treasury Secretary Scott Bessent, who said last week that we could have gas with a three in front of it in the summer. So, what does that mean? Is it $3.99 or is it three with a couple of zeros in front of it? There are active questions about what when we would actually see $3.

The thing to know is that oil needs to come down to historically around $60 a barrel before we start to see sub $3 prices. And we are nowhere close to that right now. We are in the 90s right now, closing in on 94 U.S. oil. And what we don't know is when we're going to see that Strait reopened. There's a lot that needs to happen before then. And so, that's where we are right now, with a big question mark about the future path of gas prices.

[10:45:00] BLITZER: I filled up my car with regular gas yesterday, four dollars and fifty cents a gallon here in the DC area, a lot of money. All right. David, quick question, tariff refunds are supposed to start today. Who's getting them and who's not?

GOLDMAN: Yes, it's -- there's a big process for this and it's hard to extract them because you don't know if you're paying the illegal tariffs, right, if you get that money back or if you paid legal tariffs, right. The Supreme Court only overturned some of President Trump's tariffs, not all of them.

And so they say -- the Customs and Border Patrol say that they need about 60 to 90 days to kind of figure out whether you paid an illegal tariff or not and who is they? Who is due a refund? There's about a$166 billion out there in refunds that are going to go to American businesses, but not just any business, not, you know, Costco and Walmart and retailers, it's actually the importers that are going to get that first.

And so, the question is if they get a refund, are they going to refund the retailers that paid them for the higher prices and then are you ever going to get a refund? It seems unlikely, don't count on it and certainly don't count on it anytime soon because there is a lot that needs to happen before we get there, Wolf.

BLITZER: All right. David Goldman, he knows his stuff, Pamela, he certainly does.

BROWN: He -- and makes it make sense. All right. Well, thanks so much. Happening now, some individuals who use popular weight loss drugs known as GLP-1s like Ozempic and Wegovi are sharing a new possible side effect and they call it Ozempic personality. This term refers to a sense of diminished enjoyment, emotional flattening or as one user, Cori Stevenson, told the Washington Post, feeling just meh. She described it, quote, "Like you're trying to be excited about a moment but can't fully connect to it."

Joining us now to discuss is Dr. Alexandra Sowa, a dual board- certified physician in internal and obesity medicine. She's also the founder of the SoWell Method and the author of the book, "The Ozempic Revolution." Doctor, thanks for coming on. Share with our viewers what your understanding of so-called Ozempic personality is and what you've heard from your patients about it.

DR. ALEXANDRA SOWA, DUAL BOARD-CERTIFIED PHYSICIAN IN INTERNAL AND OBESITY MEDICINE, FOUNDER, SOWELL METHOD" AND AUTHOR, "THE OZEMPIC REVOLUTION": So, I have been practicing in this field for about 15 years and so I knew this phenomenon to be true and I actually wrote about it in my book. We call it anhedonia and it's a flattening of feeling. And there's been so much attention on these drugs potentially causing increased risk in suicidal ideation, which we know not to be true, that I think this softer side effect has gotten overlooked.

And in my patient population, I find it affects people the most when they've relied on things like food and alcohol as their solo pleasure source and the world they've built around them, friends, family, spouses, everyone participates in that and there aren't other outlets for pleasure. So, even before I have patients start these drugs, I screen for this and I make sure people are working on building other habits that really help them find joy in this new process.

BROWN: And we should note there is no evidence suggesting GLP-1s cause permanent changes to a user's personality and an FDA study found no link between the drugs and suicide. As you noted, the maker of Ozempic and Wegovi says that it collaborates with the FDA to monitor the safety of its medications. But, you know, we've heard people talk about how GLP-1 medications can blunt cravings and addictions.

So, from what I hear from you, if you're trying to assess a patient before putting them on there, if a patient has an addiction or certain cravings, would that be a red flag for you that potentially they could be vulnerable to this?

DR. SOWA: Vulnerable, yes, but in those cases, I actually think they're quite good candidates for GLP-1. So, we know that there is this positive correlation between going on a GLP-1 and helping stop cravings for things that are harmful, excess alcohol, potentially drugs, and in the cases that have been studied, food addiction.

So, I monitor for it and then I really work with a patient before they even start. OK, maybe we need to get you into therapy as we're doing this to -- you know, two truths, two things at the same time, where we make sure that we're working on your mental health and we're supporting you.

GLP-1s are not just appetite suppressants, they work on the brain. So, we know that they're working on the dopamine or the reward system and as we see in people who are coming off of alcohol and drugs, there can be a brief period of time where your brain kind of has to learn its way through this new world without these fuels, these, you know, alcohol, sugar, drugs, and it needs to kind of recalibrate how it's finding joy. So, I think it's not a reason to not go on these medications, but it is a reason not to play with them.

[10:50:00]

You know, we're kind of seeing more and more talk about just purely cosmetic use or going way off label and saying, well, I heard it helped for XYZ. The fact of the matter is, these are drugs and they work on receptors all over the body, including our brain, and so we need to monitor for these subtle signs of change and help our patients through them.

BROWN: Right. And as you pointed out, some people are using them when they may not meet the medical criteria for them because they just want to look skinnier or whatever the case may be, and I think it's really important to weigh the pros and cons of getting something like this, and you talk about how the brain has to sort of navigate once it's maybe not getting that dopamine hit it was once getting from, for example, alcohol. So, could this sort of flat personality that we're describing just be a temporary hurdle to overcome, or what do you see in patients about how long it lasts? DR. SOWA: I've seen it be temporary. Now, I think that there are a few things you can do to help people with this bridge is, one, use the lowest dose possible, and sometimes I've had to pull people back on the dose when, you know, we kind of have to balance weight loss versus side effects, and if they've achieved significant loss, they're still losing, but it's slower, I'll keep them on a lower dose, especially if some of these side effects kind of pop up, and they'll tell you, you have to listen to patients.

And one of the worries I have in the modern world of how people are getting these meds, they're often not even talking to a doctor, they're using a bot, it's all asynchronous, and sometimes you really have to dig for these things, so it's good for people to look out for themselves, and then to bring it to the attention, but I really also want providers to kind of be looking for this, because it can often be subtle.

So, I'll keep patients kind of low, slow on the dosage of the medicine, and sometimes I have to switch classes. And then finally, maybe if you do have a history of depression and anxiety, we might augment your serotonin and dopamine by potentially putting you on an SSRI, and helping you, you know, boost that hormone as you go through this transition, and of course, kind of really working on all of these other healthy lifestyle behaviors.

It is true, exercise does boost your dopamine, so in this journey, people are often open to going to the gym, walking outside, they feel better in that way. So, I really encourage them from the very beginning, get your body moving, get outside in the sunshine, let's help ourselves through this process.

BROWN: Always good to get moving. I've never regretted going outside for a walk in the sunshine. All right. Dr. Alexandra Sowa, thank you so much for coming on. Wolf.

BLITZER: Good discussion. Thank you very much. And coming up, stunning comeback, truly stunning comeback, my Buffalo Sabres rallied from a 2-0 deficit to beat the Boston Bruins, their first playoff win in some 15 years. So, many of you probably know I grew up in Buffalo, and seen as Coy Wire, actually played for my Buffalo Bills years ago.

Coy, you lived in Buffalo for a while, you know how many -- the fans are so crazy, they love the Bills, they love the Sabres, but that was truly last night an incredible game.

COY WIRE, CNN SPORTS ANCHOR: The playoff energy was turned all the way up in Buffalo, and it wasn't only the first playoff win in 15 years, something else happened in that game for the Sabres that hadn't happened in more than 30 years. That magic and more with Wolf and Pamela coming up.

(COMMERCIAL BREAK)

[10:55:00]

BROWN: Happening now, it's Boston marathon time. More than 30,000 runners are now on their grueling 26.2-mile journey.

BLITZER: Want to go live to our sports anchor Coy wire right now. Could we see some records fall today, Coy?

WIRE: Wolf, records could fall, but let's be honest, just finishing the Boston Marathon is a victory. This isn't just any race, it is the race. The 130th Boston Marathon. As Pamela mentioned, 30 plus 1000 runners on a course that interrogates your soul from Hopkinton to Boylston Street. It's heartbreaking grit all rolled into one run. And we have what are considered ideal marathon conditions between 35 and 55 degrees. Maybe we will see history written today. Runners from Kenya won the men's and women's races last year. They've been dominant.

We've had one winner already. Switzerland's Marcel Hug winning the men's wheelchair title for the ninth time in Boston. Congrats to him. And how about this? Our very own CNN colleague, Hannah Brewitt, is out there right now, not chasing the finish line running with purpose. Hannah has already raised more than $17,000 for Boston Children's Hospital in honor of her brother Ryan, who received life changing care there as a child today. Every step, along with so many other runners, is a thank you, a tribute and a powerful reminder of the Boston Marathon is so much more than a race.

Let's go to some NHL playoff pandemonium. Buffalo fans going buck wild. Where's Wolf? The Sabres snapping a 15-year playoff droplet looked frozen late. Down 2-0 in the third until Tage Thompson, the Olympian, gets a goal. And then he says, let's do it again. Two goals in his playoff debut to tie it. Sabres hadn't had a multi goal comeback in the third in 33 years. But Mattias Samuelsson rips a wrister for his first career playoff goal. Sabres hold on to win 4-3. It was snowing before puck drop and Buffalo says, keep those coats on because this Sabres storm is just getting started.

Finally, the --

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