Oprah Through the Years, Part 11 — Concepts of Will

The previous post drilled down into the concept of will/willpower, and as predicted, this and the next two mention some thoughts from three prominent individuals: Robert Pretlow, M.D., Bob Greene, and Oprah Winfrey.

Dr. Pretlow

Years ago, after studying messages from many children via his interactive Weigh2Rock website, the Childhood Obesity News founder pointed out the futile and intractable nature of a mental/emotional mechanism that ties in with the overeating that is the chief cause of childhood obesity. Sadly, the child involved may resist any intervention, and show “classic, addict-like behaviors of obfuscation, rationalization, deflection, lying, cheating, and denial of their struggles.”

This also connects with the “willpower vicious cycle” in which a child finds resisting the excessive eating behavior so stressful that the resistance itself generates a (perceived, not actual) need to cope with that stress by eating even more; followed by an awareness of failure and sense of guilt that creates yet more stress and… well, we can all see where this is going.

That discussion was connected with the idea that “although the addiction basis for obesity remains a debate, addiction treatment methods may still be evaluated.” In particular, we are talking about the smartphone app and obesity intervention tool known as BrainWeighve, which additionally serves as a research tool for refining addiction treatment and finding ways to overcome treatment resistance.

… Which leads back to willpower

How so? It takes plenty of determined resistance to fight off the efforts of caring parents, attentive school officials, a concerned government, and a very well-equipped and competent medical profession. It is quite possible that kids who resist help in the struggle against obesity do not lack willpower at all. They have plenty of it, and are simply employing it counter-productively by resisting the wrong thing.

Quite some time ago, Dr. Pretlow began speaking and writing about the displacement mechanism:

Moving the opposing drives out of equilibrium, by resolving a person’s problems (displacement sources), theoretically should halt the displacement mechanism and might comprise an intervention for overeating/obesity, as well as other addictions. If the individual can either face or escape from the problematic situations, the displacement behavior of overeating should stop on its own without struggling and without willpower.

Stating this another way:

The displacement mechanism may be a useful basis for treatment of eating addiction and obesity and may provide individuals with hope that they can curb their addiction without relying on willpower to not overeat. If the displacement mechanism accounts for overeating, then targeting this mechanism in treatment should facilitate significant reductions in overeating without necessitating willpower to eat less.

Could it be that displacement intervention (problem-solving, rechanneling excess brain energy), is just another way of saying “willpower”? Is it possible that the brain energy is not even excessive, but only misdirected? Maybe we need all of it, and maybe it is just like the will — a neutral force that can be used to achieve good or bad ends. Perhaps the problem is not how much of it is present or absent in the person. The whole problem may be how that capacity to want something is set to work in the real world.

There is also the tendency of willed results to be self-replicating. Will can lead to success, and success can lead to more willpower, because success feeds the will. Some people have found that even a tiny bit of will, pointed in the right direction, can fan the flame and strengthen their will’s overall potency. For some people it works that way; for others, it does not. If there is to be hope of achieving anything, a recurring concept presents itself: the impossibility of creating a one-size-fits-all program.

Your responses and feedback are welcome!

Source: “A Smartphone App Platform for Treatment of Obesity Using the Addiction Model,” Weigh2Rock.com, 2015
Source: “The displacement mechanism: a new explanation and treatment for obesity,” Weigh2Rock.com, 2010
Source: “Reconceptualization of Eating Addiction and Obesity as Displacement Behavior and
a Possible Treatment,” Springer.com, 06/22/22
Image by Brad Hagan/Attribution 2.0 Generic

Oprah Through the Years, Part 10

This definition appears on many, many web pages:

Will is that faculty of the mind which selects, at the moment of decision, the strongest desire from among the various desires present.

A lengthy online search reveals two things:

1. The only reference anyone seems willing to use as a footnote for that quotation is Wikipedia.
2. Philosophers will argue all day about the tiniest nuance of the concept, including whether there is a difference between “will” and “willpower.”

Will is often known as “free will” with good reason, as any desire, however strong, is futile unless one has the freedom to impose one’s will upon the environment (including oneself and other people) in order to fulfill that desire. Someone chained in a stone-walled pit could possess the most awesome will in the world, and still not be able to use it.

The series “Breaking Bad” and other popular entertainments in the action genre are fascinating because they illustrate prodigious feats of willpower exerted in extreme situations. Anyone who gets excited about such a TV show or movie can probably be depended on to recount at tedious length an impressive escape sequence.

One definition of will begins with, “Arguments for free will have been based on…” — and what does that even mean? The notion that free will exists at all? Or “for” in the sense of being in favor of it, as in, “Free will is a good thing”? And even those few words are misleading, because they assume that will and free will are the same thing.

The initial quotation, about selecting the strongest desire, runs into a problem, because a paralyzed person can will all day long, “I will move one finger” and no matter how strong that intention is — even if it is the strongest of many various desires — it’s not going to happen, which would imply a definite lack of power. So how could will and willpower be synonymous? It would seem that will alone is not enough, and that power is a separate and distinct factor here.

Getting a grip on will

Philosophers might explore the theoretical notion that everyone has the same amount of willpower. Could it be that (leaving aside the possibility of organic brain damage) every human is born with willpower, even an enormous reservoir of it, or at least as much as anyone else? Then why are the end results so different? Can a person grow, cultivate, or otherwise obtain more willpower? Can a person steal someone else’s? Or take a pill and get some? Can a human renounce willpower, as religious doctrines recommend? Apparently, it is quite possible for someone to put aside their own desires and live instead by the will of a deity, or karma, or fate.

Why does will so frequently go wrong? Does the problem lie in whatever particular end the person is willing or wanting? Can someone who sincerely wishes to die find a way? Should they be allowed to? When someone’s strongest desire is apparently to weigh 800 pounds, should they be allowed to? If not, who should stop them? And how? To what extent should an individual be permitted to follow the dictates of her or his own will? To what extent should a population be expected or forced to accede to the willful desires of a political leader?

Fortunately, this venue is not where such matters are decided. Here we are concerned with the individual. If a person gives the appearance and displays the behavior of someone wanting a harmful condition or outcome, what can be done? It would seem like the trick is to figure out why that person wants what they want; and then to help them internalize the concept that it would be better if they wanted something else instead; and then to somehow teach, lead, or persuade them into wanting something else instead, and then help them figure out how to attain the desired dénouement.

Rather than be sidetracked into researching Plato, Spinoza, Descartes, Schopenhauer, et al, subsequent posts look into what three contemporary authorities (Robert Pretlow, M.D., Bob Greene, and Oprah Winfrey) have said about will and willpower.

Your responses and feedback are welcome!

Image by aphrodite-in-nyc/Attribution 2.0 Generic

Trauma Doubles the Risk for Obesity, But It Can Be Helped

Unsurprisingly, children who face trauma early in life are at a higher risk of becoming obese, but new research suggests that positive experiences can help reduce this risk. A new article in The Conversation discusses the research and throws some light on what could be done to reverse or improve the situation.

Childhood trauma is unfortunately widespread. A study of nearly 5,000 children in New Zealand found that 87% had experienced at least one major traumatic event by age eight, and about a third (32%) had endured three or more. Traumatic experiences can range from physical and emotional abuse to exposure to bullying, domestic violence, substance abuse, mental illness, parental incarceration, divorce, or discrimination.

Children from lower-income families, as well as Māori and Pasifika children, were particularly affected by multiple types of adversity and had higher rates of trauma overall.

The consequences of these early experiences are significant. Children who had at least one traumatic event were twice as likely to be obese by age eight, with the likelihood increasing with the number of adverse experiences. Children who had four or more traumatic events were nearly three times more likely to be obese. Certain types of trauma, such as physical abuse and exposure to domestic violence, were more strongly linked to obesity, emphasizing the connection between early adversity and physical health.

One possible explanation is that stress from these traumatic experiences contributes to emotional distress, which may lead children to adopt unhealthy behaviors such as overeating, poor diet choices, lack of sleep, too much screen time, and physical inactivity. The study found that children who had faced adversity were more likely to engage in these behaviors, which in turn raised their risk of obesity.

However, the research also highlighted a hopeful finding: Positive experiences can help counteract some of the negative effects of trauma.

Positive experiences included things like:

  • Parents in stable relationships
  • Mothers having positive interactions with their children
  • Children involved in community activities, like visiting museums or participating in sports
  • Families with structured routines for bedtimes, screen time, and mealtimes
  • Access to quality early childhood education

The study found that children who had more positive experiences were significantly less likely to be obese. For instance, children with five or six positive experiences were 60% less likely to be overweight or obese compared to those with no or just one positive experience. Even having two positive experiences reduced the likelihood of obesity by 25%.

To offset the impact of trauma, a minimum of four positive experiences was necessary. Although nearly half of the children in the study had at least four positive experiences, a concerning number (more than 10%) had very few positive experiences at all.

The key takeaway is that traditional weight-loss programs focusing solely on behavior change are insufficient. A more holistic approach is needed, one that addresses the social, emotional, and environmental factors contributing to childhood obesity. Fostering positive experiences is critical, as they not only protect children from the harmful effects of trauma but also promote overall physical and mental well-being.

For vulnerable children, creating supportive environments is essential. Policymakers, schools, and families all have a role to play. Community programs such as after-school activities, healthy relationship initiatives, and mental health services can provide crucial support. A trauma-informed approach, particularly for children from disadvantaged backgrounds, is essential to address the impacts of domestic violence and other traumatic events.

Families can help by creating stable routines, engaging in social networks, and involving children in enriching activities. Schools and early childhood education providers also play a vital role in helping children build resilience and recover from trauma. Policymakers must invest in programs that provide positive experiences, helping to level the playing field for children who are at greater risk due to their circumstances.

When positive experiences outweigh the negative, children have a far greater chance to thrive physically, emotionally, and socially.

Your responses and feedback are welcome!

Source: “Children with traumatic experiences have a higher risk of obesity — but this can be turned around,” The Conversation, 1/13/25
Source: “Identification of positive childhood experiences with the potential to mitigate childhood unhealthy weight status…,” BMC Public Health, 1/13/25
Image by cottonbro studio/Pexels

Oprah Through the Years, Part 9

The previous post explored the idea that perhaps willpower is a neutral quality that can be either helpfully used, or dreadfully exploited. It has a dual nature, like so many things in life, as portrayed by the ancient yin-yang symbol.

The piece also proposed that no matter what ailed our subject in the years when her weight bounced up and down, or soared as high as 237 pounds, her accomplishments in several fields are undeniable. Whatever else might be thought, or said, about her, one thing is for certain: Oprah Gail Winfrey has never experienced a shortage of the energy we know as willpower.

Some might point out that many people have struggled with weight issues, so why choose her as a case study? But… is there anyone more suitable? Data is the basis of research, and who else on the planet do we have more information about, and more pictures of? And just as an extra bonus, Oprah happens to be a very sharing (some might say over-sharing) individual when it comes to revealing facts about herself. How else would we know how much she weighed in 1992?

Speaking of oversharing, that 1988 fat-wagon show-and-tell session that she later regretted was actually brilliant. (Third photo down on this website: TV is a visual medium; movement is an essential part of it, and what else could seize the attention like a ginormous 67-pound blob of fat in a little red wagon?

A mortifying fiasco

But in the history of show business, many a brilliant publicity stunt has turned out to be an embarrassing mistake, which is what happened here. Before long, Oprah had to admit that the benefits of four months on a liquid diet had gone into reverse the moment she started eating normally again. A recent article by Clare Stephens, Executive Editor at Mamamia, articulates the two distinct reasons why the incident was so regrettable. Years later (2011), as a guest on Entertainment Tonight, the star described it as “One of the biggest ego trips of my life” because:

The ego was my belief that being in those Calvin Klein jeans made me worthy as a human being, or more valuable, or made me better.

But disproportionate self-regard, however pathological it might be, is an individual problem, and a matter for discussion with one’s spiritual advisor or psychologist. The second reason why Oprah called it a mistake is much more far-reaching, especially for one whose sphere of influence is the entire planet, as Stephens explains. It was tantamount to an accusation, a stunt that stigmatized fat to an audience of millions of humans, mainly women, with the implication that they too could shed their extra poundage if only they cared enough and were smart enough to make the required effort.

Messing with their self-esteem

As Oprah later acknowledged, the wagon demonstration basically “set a standard for people watching that I nor anybody else could uphold.” But rather than reining in an unhealthy tendency and cutting short a harmful trend of thought, the wagon episode was only the start of further years of maintaining and upholding a diet culture that “has far more to do with aesthetics than health.”

Oprah’s famous quotation about how “all the success doesn’t mean anything if you can’t fit into your clothes” was a scathing indictment of women (and men) everywhere. It belittled wonderful parents who happen to be fat, regardless of how beloved and beautifully raised their children might be. It denigrated overweight workers who have no time or money to join a gym. It dismissed overweight artists, no matter how outstanding their creations might be. It criticized people who struggle with the genetic misfortune of being born with large frames and bodily systems that do not process food optimally.

“It means the fat won,” Oprah declared, which amounted to labeling a vast number of her devoted fans as losers. But, as Stephens points out, Oprah was not an “aberration,” not just some weirdo who hated fat people and didn’t mind letting them know — but a particularly noticeable individual articulating the mindset of a fat-hating culture.

Your responses and feedback are welcome!

Source: “In 1985 Joan Rivers asked Oprah a Question,” Mamamia.com, 05/13/24
Image by Vic/Attribution 2.0 Generic

E-Health and Social Media Studies in the News This Week

We’ve discussed before how e-health and telehealth can be effectively used to combat childhood obesity in conjunction with other interventions. This week, in the news, there were two studies that seemed of interest. One was an Australian study involving kids ages 7-13 and dealt with e-health (electronic health) intervention, and another looked at the connection between social media use and binge eating behaviors in adolescents.

The purpose of the e-health study

E-health interventions have the potential to enhance the effectiveness of traditional, in-person treatments for childhood obesity. This study assessed the impact of a 10-week, web-based healthy lifestyle program designed for school-aged children with overweight or obesity. The results were published in BMC Public Health this week.

Methods of the study

This randomized controlled trial (RCT) involved families with children aged 7–13 years, living in Victoria, Australia, who had a body mass index (BMI) at or above the 85th percentile (indicating overweight or obesity). Families were randomly assigned to either the intervention group or a waitlist control group and participated in the 10-week web-based program. The primary outcome was the change in the children’s BMI scores over the 10 weeks. Secondary outcomes included changes in waist circumference, dietary habits, physical activity, and quality of life over the same period.

In the intervention group, families accessed weekly modules on a secure website, covering topics such as healthy eating, physical activity, and family-centered behavior changes. Each week, families had phone sessions with a health professional coach (e.g., dietitians, nutritionists, or exercise physiologists), during which they discussed the week’s content and confirmed the completion of activities. The program also included interactive elements like online quizzes and goal-setting exercises to help families implement lifestyle changes.

The study results

Out of 148 children (125 families) recruited, 102 children (85 families) completed the trial. The intervention group showed a significant reduction in BMI scores compared to the control group after 10 weeks. The web-based program also led to improvements in children’s quality of life and lifestyle behaviors. In the intervention group, there were significant improvements in quality of life scores, overall diet quality, and daily physical activity levels compared to the control group.

Why it matters

A web-based healthy lifestyle program was effective in improving short-term health outcomes for children with overweight or obesity. Future research should focus on identifying factors that contribute to the program’s effectiveness, assessing its long-term impact, and ensuring the program is adapted to meet the needs of diverse populations.

Social media’s impact on binge eating, a study

Dr. Susan Carnell, an associate professor in the Division of Child and Adolescent Psychiatry at Johns Hopkins University School of Medicine, recently spoke about her research on the connection between social media use and binge eating behaviors in adolescents. Carnell is a co-author of the study, “Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence,” published in Obesity and highlighted this week in Contemporary Pediatrics. The article included an interview with Dr. Carnell conducted by the article’s author, Joshua Fitch, Senior Editor of Contemporary Pediatrics.

Dr. Carnell and her team wanted to investigate how social media might influence eating disorders, particularly by examining the role of social comparison and certain content that could lead to body dissatisfaction. The study used data from the Adolescent Brain Cognitive Development (ABCD) study, a large, ongoing project that tracks children across 21 sites in the U.S.

Dr. Carnell said:

The study began by recruiting children around 9 to 10 years old, and we’ve been following them ever since… This allowed us to analyze the relationship between social media use, how much time kids spent on it, and whether they exhibited addictive behaviors related to social media.

Carnell observed that social media use increased with age:

At ages 11 to 12, kids spent an average of about an hour per day on social media, and by adolescence, that rose to over two hours… For those who developed persistent binge eating, however, social media use went up to more than three hours a day.

Interestingly, the study found a key difference. To quote Dr. Carnell one more time,

We didn’t find that simply spending more time on social media was linked to binge eating. However, adolescents who showed high levels of addictive behaviors around social media at the start of the study were about 3.5 times more likely to develop binge eating by ages 14 to 15.

Carnell’s research underscores the importance of addressing addictive social media behaviors to help reduce the risk of eating disorders in adolescents. While the amount of time spent on social media isn’t inherently harmful, compulsive and addictive patterns of use can increase the likelihood of disordered eating behaviors.

Your responses and feedback are welcome!

Source: “The effectiveness of a 10-week family-focused e-Health healthy lifestyle program for school-aged children with overweight or obesity: a randomised control trial,” BMC Public Health, 1/7/25
Source: “Social media use and binge eating in early adolescence,” Contemporary Pediatrics, 1/6/25
Image by Polina Tankilevitch/Pexels

Oprah Through the Years, Part 8

Remember Oprah’s 1986 quotation? “All the fame and the success doesn’t mean anything if you can’t fit into the clothes. If you can’t fit into your clothes, it means the fat won. It means you didn’t win.”

Of course, a billionaire can hire the best dress designers to make beautiful and flattering clothes of any size, and the best hair designer to create a wide hairstyle that fools the eye into making the figure appear slimmer. But you still didn’t win. The fat still won.

This is one of the tragic realities of financial success. You will still be you, even if you can afford some workarounds. “Being you” can mean a lot of different things, but perhaps one of the things it does not mean is a lack of willpower. The idea is worth exploring.

At that point, Oprah Winfrey had not yet begun to work with trainer Bob Greene. Skip ahead 10 years to 1996, when he published a book called Make the Connection: Ten Steps to a Better Body and a Better Life, in which he wrote,

The tough part is finding the discipline, inner strength and willpower to carry out the ten steps.

But wait! If this Greene fellow was correct about the necessity for willpower, and if Oprah truly had none, then how on earth did he become famous as the guru who finally helped set her feet on the right path? Here is another puzzling question. Isn’t this exactly what we here at Childhood Obesity News are trying to get away from: the idea that, in order to lose weight, a person must have a huge supply of willpower — which some people simply don’t possess?

Say what?

Putting those questions aside for a moment, let’s get back to Oprah, who by the mid-80s had piled up gigantic accomplishments in many areas of both creative and material achievement. The idea that she lacked discipline, inner strength, or willpower is ludicrous. Nobody could do all that without heaps of those qualities. So, what is going on here?

Maybe, just maybe, a semantic problem is involved. People might talk about a concept using the same word, but actually hold radically different ideas about what it means. For instance, a patient with a severe eating disorder like anorexia is — even while institutionalized under strict conditions — capable of taking many actions to elude or sabotage treatment that is intended to help them get well. This definitely requires willpower, and lots of very sick people have a ton of it. So, obviously, willpower cannot be an unalloyed good.

But here is a spark of comic relief, thanks to Senior Specialist in Technical Training, Brian Lallatin, who collected an impressive number of lightbulb jokes for the University of Maryland’s website.

During a certain era, the lightbulb joke was all the rage, with the punchline based on an unflattering stereotype of some group. For instance, “How many stoners does it take to change a light bulb? Three: One to hold up the lightbulb, and two to turn the ladder.” The one that really applies here is,

How many psychiatrists does it take to change a light bulb? Only one, but the bulb has got to really WANT to change.

This is a self-evident problem with the whole addiction field. No program can help someone who really does not feel any need for change, and that includes addicts. Nobody is going to change unless and until they want to. But, difficult as this may be to believe, a professional expert might agree to the proposition that someone must sincerely want to change — and yet still insist that there must be a cure in which “willpower” is not a necessary component. However, those two beliefs cannot both be true, making this a case of cognitive dissonance that needs to be resolved somehow.

Will means want; willpower means wantpower.

But what is “will,” except another way of saying “want”? And just like wantpower, willpower can be applied to any project. It can be exercised on others, or on the self. Like fire, it can save a life or take a life. It can be applied consciously or unconsciously. Everyone is applying and exercising their will, all the time. Even the most profound apathy is basically caused by a want: The will to do nothing.

Allowing Nature or Fate to take its course is seen from some perspectives as the worst possible choice, and seen by other philosophies as the height of enlightenment. To abandon oneself, and refuse to exert want or will, is an attitude that can destroy the self or others. It can also be seen as the epitome of realization.

A person bent on self-destruction obviously wants to destroy the self, even if by doing nothing. This is all very confusing. What, for instance, is a hunger strike? It is the refusal to eat, and an intention to do nothing instead. Literally, suicide. But surely, for a political prisoner to discipline herself or himself to refuse food, in order to protest conditions or support a cause that one believes in with all one’s heart… Doesn’t that require a considerable exertion of will?

(To be continued…)

Your responses and feedback are welcome!

Source: “Lightbulb Jokes,” cs.umd.edu, undated
Image by Jay Gooby/Attribution 2.0 Generic

Oprah Through the Years, Part 7

“You can have it all, you can’t have it all at once.” A lot of people other than Oprah Winfrey have said this, sometimes in slightly different words. A variation is, “You can have it all, but you can’t do it all.” The meaning is the same, because among the things a person wants to have are the freedom and capacity to do the things a person wants to do. Anyway, most of the people who say these things are women — but that is a whole different essay.

Among others, writer Katie Fox has expanded on the concept:

The pressure to seize the day and make the most of every moment can rob us of our joy in the present. But it can also destroy the measured, patient hope we have for our future, looking ahead at other seasons to come and trusting that the dreams we’ve had to put up on the shelf will still be there waiting for us when we’re ready to dust them off again.

Of course, if an idea has any validity at all, surely more than one person will have thought of it. And another person has probably already said it out loud, only the time wasn’t right, or some other circumstance prevented the world from noticing the glaring importance of the concept. It would be interesting to trace back through the archives of history and learn who is credited with the very earliest known use of the thought, “You can have it all, just not all at once,” whichever way it is expressed.

But the important point here is that everyone who ever expressed this thought has been a link in a chain of humans who carry forward the message: You cannot eat a lot, or the wrong things, or a lot of the wrong things, and also possess a slim figure.

Way back in 1977, the co-anchor of a news show at WJZ TV in Baltimore made her first visit to a diet doctor. The 23-year-old Oprah weighed 148 pounds when a doctor placed her on a 1,200 calories-per-day program, and in two weeks she had lost 10 pounds. And in two months, she had regained 12. This started a revolving-door existence through all the popular diets of the time.

But, as she later learned, “I was starving my muscles, slowing down my metabolism, and setting myself up to gain even more weight in the end.” By 1984, she was up to 200 pounds, and in 1986 told the public that she hated herself for it.

In an interview the same year, she said,

All the fame and the success doesn’t mean anything if you can’t fit into the clothes. If you can’t fit into your clothes, it means the fat won. It means you didn’t win.

Then came the infamous “wagon of fat” episode when Oprah thought she was cured, but immediately, relentlessly, the weight came back. As she later said, “You have to find a way to live in the world with food,” and it was in 1992, at her 237-pound heaviest, that the star met the exercise physiologist and personal trainer who helped her find that way and turn her life around.

As we have seen, Bob Greene has been a marvelously helpful influence on Oprah Winfrey through the years, and thanks to the power of her endorsement, has also been immeasurably helpful to thousands of other people too. One feature of his method is to stop someone in their tracks and insist on examining basic questions, the ones that must be addressed whether you are a butcher, baker, or candle-stick maker; a stay-at-home mom, or one of the wealthiest women in the world:

1. Why are you overweight?
2. Why do you want to lose weight?
3. Why haven’t you been successful?

It took Oprah a couple of years to have an important epiphany:

I finally realized that being grateful to my body, whatever shape it was in, was key to giving more love to myself. Although I’d made the connection intellectually, living it was a different story.

(To be continued…)

Your responses and feedback are welcome!

Source: “You Can Have It All (But Not All at Once),” TheArtOfSimple.net, 06/11/14
Source: “The Highs and Lows of Oprah Winfrey’s 50-Year Weight Loss Journey,” MSN.com, 2024
Image: internet meme

New Year’s Resolutions and Healthcare Predictions

Happy New Year from all of us at Childhood Obesity News! What a year it’s been in the realms of childhood obesity issues and treatments, and in the ever-expanding world of weight loss drugs. Here is the outlook for the GLP-1 drugs markets heading into 2025, and a quick rundown of what Americans wish to improve for themselves and their families in the year ahead.

The GLP-1 receptor agonist market will keep flourishing

Yahoo Finance Senior Healthcare and Business Reporter Anjalee Khemlani dove into the details, analyzing the outlook for GLP-1 drugs as markets head into 2025. According to the video commentary,

GLP-1 weight-loss drugs have dominated healthcare headlines in 2024, marked by expanded employer coverage, dynamic pricing changes, and pharmaceutical giants like Novo Nordisk and Eli Lilly exploring broader applications beyond weight management, including heart disease and sleep apnea treatments.

Khemlani thinks all these trends will continue well into the future, and depending on the government regulations, will reshape our thinking of weight loss treatments.

Also, according to Khemlani, the biggest catalysts for the healthcare industry in general, expected in the new year, are GLP-1 weight-loss drugs and proposed regulations on pharmacy benefit managers (PBMs) from the second Trump administration.

New Year’s resolutions: the poll

According to a recent poll by The Associated Press-NORC Center for Public Affairs Research, many Americans are focused on improving their health, fitness, and diet in 2025. These types of resolutions top the list of changes they hope to make in the new year. Additionally, goals related to finances and relationships also rank highly among the 1,251 adults surveyed. The survey, which used a representative sample from NORC’s AmeriSpeak Panel, has a margin of error of +/- 3.7 percentage points. Newsweek reported on the poll results, with commentary.

Why It matters

This poll, released last Saturday, comes at a time when obesity continues to be a major health concern in the U.S., contributing to rising rates of heart disease and diabetes. By 2035, global obesity rates are expected to affect 1.5 billion adults.

Obesity rates in the U.S. have been steadily climbing for years, but the trend reversed last year for the first time in over a decade. The national obesity rate dropped slightly from 46% in 2022 to 45.6% in 2023.

A recent study in the JAMA Health Forum also showed that between 2013 and 2021, the average body mass index (BMI) of the U.S. population increased. However, this trend plateaued in 2022 and dipped slightly in 2023.

Part of this change may be attributed to the rise in popularity of weight-loss medications like Ozempic, which are particularly common in the Southern U.S. and are believed to have played a role in the national decrease in obesity rates.

Poll results

The new poll reveals that over half of Americans plan to set at least one resolution for 2025, with younger generations — millennials and Gen Z — showing the most enthusiasm. Around two-thirds of people in these age groups say they intend to make resolutions, compared to about half of older adults. Women are also more likely than men to set goals for the year ahead.

Among the types of resolutions, nearly 30% of adults are focused on exercise or healthier eating. Around 25% aim to lose weight, while similar percentages are planning financial or mental health-related resolutions.

Newsweek quoted Andres J. Acosta, M.D., Ph.D., associate professor and consultant in the division of gastroenterology and hepatology, Department of Internal Medicine at Mayo Clinic:

With an influx of new weight-loss drugs poised to enter the market, the trial-and-error process (for obesity treatments) will likely intensify. Patients will face an overwhelming list of choices — and bear the burden of figuring out what works for their bodies. While more treatments may seem like progress, it risks turning obesity care into an endless experiment.

Ohio GOP U.S. Representative Brad Wenstrup and Wisconsin Democratic U.S. Representative Gwen Moore also expressed their opinion:

There is now a consensus in the medical community that obesity is a complex and chronic disease that can be caused by many factors. This new understanding of obesity means we must change how it is treated, especially when we have new tools to treat it. This starts by expanding access to treatments such as intensive behavioral therapy (IBT), comprehensive nutritional and mental health treatment and new, highly effective, anti-obesity medications.

What’s next?

Looking to the future, researchers behind a September CDC study predict that the obesity crisis in the U.S. will worsen without significant intervention. They project that by 2050, nearly 260 million Americans will be overweight or obese.

Your responses and feedback are welcome!

Source: “What’s next for GLP-1 weight-loss drugs in 2025?,” Yahoo Finance, 12/24/24
Source: “3 biggest catalysts expected for healthcare in 2025,” Yahoo Finance, 12/24/24
Source: “Here’s How Americans Want to Change Their Lives in 2025: New Poll,” Newsweek, 12/28/24
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Oprah Through the Years, Part 6

Oprah Winfrey’s drug of choice is reportedly the humble potato chip, or rather, plenty of potato chips — an obsession that is all too easily, understandably, and regretfully shared. At one point, she confessed to having been “controlled by potatoes for 40 years.”

Now, we have just finished up a year during which the star appeared in headlines because of admitting that she used a popular weight-loss drug. Many of her fans felt somehow betrayed, while others experienced relief, as if their mentor had personally given them permission to do the same. Oprah had previously spoken to the press about a realization she came to when moderating a panel about weight.

Calling it an “aha moment,” she said,

I realized I’d been blaming myself all these years for being overweight, and I have a predisposition that no amount of willpower is going to control. Obesity is a disease. It’s not about willpower — it’s about the brain.

For NPR, Vanessa Romo reported that Ms. Winfrey intended to elevate the conversation, advocate for health equity, and work to reduce stigma. In particular, her intention was to be finished with shame, whether flung by others or self-inflicted. She was done with five oppressive decades of “feeling like, ‘Why can’t I just conquer this thing?’, believing willpower was my failing.”

She also said,

All these years, I thought all of the people who never had to diet were just using their willpower, and they were for some reason stronger than me. And now I realize: y’all weren’t even thinking about the food! It’s not that you had the willpower; you weren’t obsessing about it!… I’m not constantly thinking about what the next meal is going to be.

Oprah was referring to the well-known effect achieved by the GLP-1 drugs, of silencing the “food noise” that constantly besieges the brain of a person who tries to cut calories. Of course, it should have been bountifully obvious already that no one who didn’t have a ton of willpower could have chalked up so many First, Best, Most and Only citations.

You heard it here

This blog has mentioned the 2003 TV broadcast during which Oprah gave a Porsche to a man who had lost more than 300 pounds. In a later interview, she explained why that was, for her, such a power moment — because “I know what it takes to lose that much weight… What he did was incredible.”

Years later, her life coach Bob Greene talked to a journalist about Oprah’s accomplishment in being on the cover of Shape magazine, despite her naturally slow metabolism. “She can look at food and put on weight… I know how hard she needs to work. It’s harder than (it is for) 99 percent of the people.”

Regarding the ability to feel this much empathy and share the same quality of awareness, it might lead to a question like, “Who learned what from whom?” To have an alert and untiring pupil is a boon for the specialist in any field. The student’s questions are the opportunity to spell out things that perhaps the expert takes for granted, but which are nowhere near obvious to the novice. It presents an opportunity for the expert to refine the thought and discover exactly how a precept can best be articulated. The teacher also learns.

For a large part of their time together, Greene spent 10 months of each year with Oprah, considering himself to be “on call” pretty much always. To be available for psychological support can be very useful to the counselor as well as the subject. With every out-of-hours request for a listening ear, the helper gets to hear what is going on, from the patient’s perspective, in real time, before there is a chance to edit, embroider, or re-consider. Really, what more could an ever-curious professional ask?

Your responses and feedback are welcome!

Source: “After nearly a decade, Oprah Winfrey is set to depart the board of WeightWatchers,” NPR, 3/1/24
Source: “Oprah Winfrey reveals she starved herself ‘for nearly five months’ in ABC weight loss special,” USA TODAY, 3/18/24
Source: “Oprah Winfrey says she has released the shame of being ‘ridiculed’ for her weight for 25 years,” ABC News, 3/19/24
Source: “It’s Not Who You Know… It’s Who You Train,” Chicago Tribune, 8/19/21
Image by Edgar Zuniga Jr./Attribution-NoDerivs 2.0 Generic

Oprah Through the Years, Part 5

It should be mentioned that the historical notes are not here to boost the ego of a lady who is already about as revered as any human being ever has been. No, the purpose of recalling events is to lay a basis for meaningful questions about what was going on during different stages of an exceptionally well-documented life.

If research means anything at all, it means gathering a ton of facts. Granted: While reporting on one of the most recognizable humans on the planet can generate falsehoods, it also provides a certain amount of hard evidence. The mere awareness of the subject’s life circumstances at any given time can help us ordinary folk to pinpoint the circumstances in our lives that exacerbate or alleviate our personal struggles.

The short answer is, this is someone who managed to lose plenty of weight, and we know a lot about her. And not least, Oprah seems to be an exceptionally self-aware person and a reliable narrator. It is totally possible that she might have something to say that proves to be at least as useful as what a member of our therapy group might offer. It might do us some good to know what decisions Oprah came to, and why, and what resulted.

Sometimes connections are difficult to make because observers and theorists, amateurs and experts, use different vocabularies to describe the concepts that excite them, and sometimes those concepts don’t translate between disciplines. Much transpires beneath the surface. The previous post mentioned a few of the “Mosts” that Oprah Winfrey has accomplished throughout her stunning career, and this one looks at some of her “Firsts” and “Onlies.”

Firsts

In 1975, as a college sophomore, Oprah became the first and youngest African American woman to anchor a show at WTVF in Nashville. In 1988, she became the first woman ever to own and produce her own TV talk show, and the youngest person (and only the fifth woman) to be named “Broadcaster of the Year” by the International Radio and Television Society.

In 2002, at the Emmy Awards, she was the very first recipient of the Bob Hope Humanitarian Award. The following year, with a net worth of around $1 billion, she showed up as the first African-American woman on the Forbes “World’s Richest People” list. By 2003, she was America’s first Black American woman billionaire.

In 2018, she was the first Black woman recipient of the Golden Globe’s Cecil B. DeMille Award, which is given to “a talented individual for outstanding contributions to the world of entertainment.” This next mention is not quite a first, but Oprah was only the third woman in American entertainment (after Mary Pickford and Lucille Ball) to own her own studio.

Onlies, Others, and Philanthropy

According to the Harpo Inc. site,

Five presidents, five first ladies, one reigning queen, one former queen, six princesses, seven princes, one earl, one lord, one count and one duchess have graced The Oprah Winfrey Show stage…

… Which frankly sounds like a probably unmatched record. In another field, Oprah is almost certainly the only individual to have founded a school in Africa that educates 152 students. She has reportedly poured at least $40 million into The Oprah Winfrey Leadership Academy for Girls. Here at home, in 1993, she…

[…] initiated The National Child Protection Act and testified before the U.S. Senate Judiciary Committee to establish a national database of all convicted child abusers. On December 20, 1993, President Clinton signed into law the Oprah Bill.

The cover of O Magazine was relinquished to someone else only one time, when a portrait of Breonna Taylor by digital artist Alexis Franklin appeared in the September 2020 issue. Oprah wrote:

What I know for sure: We can’t be silent. We have to use whatever megaphone we have to cry for justice.

And that is why Breonna Taylor is on the cover of O magazine. I cry for justice in her name.

In 1985, for her portrayal of Sofia in The Color Purple, Oprah was nominated for both an Academy Award and a Golden Globe Award for Best Supporting Actress. In 1996, she received the George Foster Peabody Individual Achievement Award, which is as prestigious as a broadcasting award gets. In 1999, there was the Emmy lifetime achievement award, and in 2011, the Academy of Television Arts and Sciences “Chairman’s Crystal Pillar Award” for her overall television career that had spanned decades.

In 2013, Oprah Winfrey was awarded the Presidential Medal of Freedom, and in 2016, she won a Tony Award for Best Revival of a Musical for “The Color Purple.” Ten years later, a painting of her was installed in the Smithsonian’s National Portrait Gallery. The following December, Forbes certified her as the world’s 14th most wealthy self-made woman.

In the general category of philanthropy, Oprah, often named one of the world’s most generous celebrities, has an outstanding record. There have been indirect moves, like ceasing to submit her TV show for Emmy awards except in the technical categories. This was done as a generous gesture to help others achieve the recognition they deserve.

In 1997 she started the charitable foundation, Oprah’s Angel Network. She has donated over $400 million to charity and has been called “probably the most significant humanitarian in the history of television.”

Your responses and feedback are welcome!

Source: “Source: “Harpo Inc.,” Company-Histories.com, undated
Source: “10 Longest Running Talk Shows on US Television,” WondersList.com, undated
Source: “Why Oprah Gave Up Her Cover for the First Time Ever to Honor Breonna Taylor.,” OprahDaily.com, 07/30/20
Image by Paul Sableman/Attribution 2.0 Generic

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources