Questions Cost Money and So Do Answers

This little side project focusing on financial costs will look back, starting from about 15 years ago, and notice some of the many and varied expenses associated with obesity. The citations will not be comprehensive but representative, pointing out examples of the many different ways in which global obesity costs a planetary fortune.

To pluck from history a random example in the 2010 news, “Battelle, universities win $72.5M to end childhood obesity” was the headline of a story about the awarding of $23 million by the National Heart, Lung and Blood Institute to Battelle’s Health and Life Sciences Global Business, and of $49.5 million to be shared among five universities, from which investigators would…

[…] collaborate with local, state and national organizations to test long-term interventions through several levels of influence — community youth organizations, schools, primary care providers, home and families.

The Battelle grant was also allotted for the same purpose — to study the effectiveness (or lack thereof) demonstrated by community programs in preventing childhood obesity. At the time, 17% of America’s children and teens were reckoned to be obese. In pursuit of a solution to this ever-growing problem, a lot of money is spent in the halls of academia, every year, by many of the world’s more solvent countries, and there is nothing wrong with that.

At around the same time, the University of Minnesota received a $7 million federal grant to create a childhood obesity center to influence the habits of hundreds of preschool children, while Oregon State University received $5 million from the National Institute for Food and Agriculture, with which to “develop strategies to combat rural childhood obesity nationwide.”

Intense curiosity

As promised, this financial curiosity is not even limited to the United States. In 2011, in Canada, the Toronto Area Research Group initiated a study (nicknamed TARGet Kids), which is not as sinister as the terminology implies. Its structure, being based on the already established network of family clinics, promised the continuity and integrity that is essential to meaningful record-keeping.

Apparently, a child is expected to show up for more than a dozen doctor visits before their sixth birthday. For their own good, and for the benefit of society, the system tracks every physical manifestation, including weight, waistline, and BMI. It set out, as one researcher clarified, to “define parameters of what normal is” — in the face of a new, pervasive, and potentially very damaging reality.

More than 700 children entered the database. By the two-year mark, 3,500 were involved. The people who ran the study were particularly interested in kids’ relationships with electronic screens. They already knew a lot about older children, but very little about the youngest ones. Already clear, however, was the close association between screen viewing time and the tendency to gain weight.

Of course, there is an upside. Such close observation and frequent contact also facilitate the ability to notice when a child is heading in a bad direction. Along with that comes another advantage: the likelihood that if a pediatrician spots the need for a behavioral change, it can be implemented on the spot.

Knowledge about how this or any particular program actually works contributes to increased awareness of how much it costs, and about how much it is likely to cost moving forward; information that is increasingly vital.

Your responses and feedback are welcome!

Source: “Battelle, universities win $72.5M to end childhood obesity,” MedCityNews.com, 09/09/10
Source: “U aims to head off childhood obesity,” StarTribune.com, 09/09/10
Source: “OSU wins $5 million grant for rural childhood obesity research,” GazetteTimes.com, 01/13/11
Source: “Doctors target roots of childhood obesity,” ParentCentral.ca, 05/05/11
Image by Quince Creative/Pixabay

Put On Your Long-Distance Glasses

Earlier this week, the Food Institute published a news story headlined “Crops Rotting in Fields With Undocumented Farmworkers Gone,” in which journalist Marcy Kreiter included such quotations as this one from farm owner Lisa Tate:

If 70% of your workforce doesn’t show up, 70% of your crop doesn’t get picked and can go bad in one day… Most farmers here are barely breaking even. I fear this has created a tipping point where many will go bust.

Here we are, once again living in a historical era where people think about money a lot. The topic of money and the subject of obesity impinge upon each other quite extensively. On the one hand, it looks like, for a while anyway, people will find their eating habits painfully costly, and that’s not even for occasional, treat-type eating — but for what used to be considered modestly normal fare, like maybe an omelet. Even way back in the 1950s, the phrase “What’s that got to do with the price of eggs?” could be heard, and it experienced a revival in the early part of this year when egg prices went bananas.

Now, the price of a fast-food drive-through lunch is more like what used to be dinner at a sit-down restaurant. So in a way, rising food prices many affect obesity rates simply because people will not be able to afford sufficient food. That definitely comes under the heading of “mixed blessing.”

On a related topic…

But what actually we hope to look at here is the overall cost of obesity to society as a whole, which is not negligible. Nor is the topic of only recent interest. Way back in 2012, for instance, journalist Jeff Springer compiled a very partial list of some of the ways in which obesity tends to cost everyone money, whatever their own personal weight might happen to be. For instance:

– Americans consume 938 million extra gallons of gas/year due to excess passenger weight which results in an extra $4 billion in obesity related gasoline costs.
– Airlines use an estimated 350 million additional gallons of fuel to handle excess weight in passengers (a cost which gets passed on to everyone)
– The estimated indirect cost of obesity in America is $450 billion per year

And all of that was more than a dozen years ago. On the individual level…

– Obesity costs the average man an extra $2,646 per year and the average woman an extra $4,879 on average

This could mean a lot of things, from the necessity to buy an extra airplane seat to the bespoke tailoring of plus-size shirts.

At any rate, in the following year, Cardiology Editor Chris Kaiser asked several sources about the government’s use of a 10-year window to calculate the amount of money it might save by projecting the cost of obesity prevention efforts into the future. Perhaps shockingly, a 75-year investment window has been suggested instead. Economist Alex Brill opined,

The 10-year window effectively distorts policymakers’ perspective on preventive health policies by focusing on the initial cost of the interventions and failing to capture the full scope of the policies’ impact in the long term… Properly modeled, effective obesity prevention measures will demonstrate their cost-containment effects outside the 10-year window.

Take, for example, one million American girls for whom early screening could catch their propensity for overweight before it is too late and potentially save, over time, more than 40 billion dollars. Similarly, participation in the Diabetes Prevention Program that steers a million women away from developing that condition could save, over time, nearly $20 billion. If a million older women were prescribed weight-loss drugs under Medicare Part D, the budget would experience a savings of more than $10 billion, over time. That in itself is a problem, as investors tend to want measurable results that manifest more promptly than “over time.”

The point being, when only a 10-year window of time is under consideration, only the costs for these interventions are apparent (not the payoffs), and interventions may tend to appear superfluous in the short run. By peering several decades into the future, it becomes evident that the savings would be considerable, and worth grasping for.

Your responses and feedback are welcome!

Source: “Crops Rotting in Fields With Undocumented Farmworkers Gone,” FoodInstitute.com, July 7, 2025
Source: “The Economic Costs of Obesity,” BusinessPundit.com, 08/15/12
Source: “Fighting Obesity Long Term Will Save Money,” MedPageToday.com, 04/27/13
Image by geralt/Pixabay

Oprah and the Price of Success

What if, every time you went to the kitchen for a snack, your phone blew up with a few thousand condemnatory messages? By the early 2020s, Oprah Winfrey was accustomed to the extraordinary fact that every ounce of her body had its own crew of both admirers and detractors. Late in 2023, OprahDaily.com articulated the goal of its online presence:

— To bust medical myths and legitimize obesity as a chronic disease that requires intervention like any other condition, rather than a failure of willpower
— To discuss the safety and efficacy of the new weight loss drugs, such as Ozempic, Wegovy, and Mounjaro
— To help surface and bridge the inequities and prejudices and remove shame and stigma of living in a larger body.

The website also states that the show aimed “to mainstream the science and psychology” pertinent to the obesity epidemic and to give its diverse and unique audience “all the tools they need to manage their own medical care and mental health.”

Oprah talked about how rough it was to recover from knee surgery while at the same time inevitably gaining pounds, meanwhile still believing the whole enterprise of weight loss depended on her ability to summon willpower. When she heard about the GLP-1 medications, her gut feeling changed and she expressed the determination to try something new, saying,

Whatever your choice is for your body and your weight health, it should be yours to own and not to be shamed about it. I’m just sick of it, and I hope this conversation begins the un-shaming of it.

The world held some solace for her body issues, of course. Unlike most of the population, she could afford to hire custom clothing designers with a genius for draping the generous figure gorgeously. Still, it must be difficult to become comfortable with the knowledge that every time you step up on stage or out in public, millions of eyes are out there ready to judge you, inch by inch. That stuff can mess with your head.

The revolution

Early in 2024 when Oprah announced the end of her association with WeightWatchers, some fans and some chronic critics were upset. People can be very judgmental about the kinds of non-essential drugs they approve of for other people, regardless of whatever pharmaceutical help they themselves may depend on. The GLP-1 products are a sterling example of that impulse. When Oprah revealed that she used that particular remedy, some folks were outraged and others were sorrowfully disappointed — just like when any celebrity turns up in a certain genre of “the news” for any reason.

When Oprah made a decision about how to resolve her lifelong struggle with obesity, fans were already upset because she had discovered something better for her needs, and she was excoriated for realizing what was best for her. It was an honest revelation: “I can’t accept myself if I’m over 200 pounds, because it’s too much work on my heart. It causes high blood pressure for me. It puts me at risk for diabetes…”

That isn’t fat hate, but a simple realization by someone who simply wanted to stay alive and continue to contribute to society by entertaining and educating the public and engaging in philanthropy. By generously sharing her own life experiences, the poor woman became guilty of upholding the standard of the fat-phobic imperative, to be harshly judged by people who were gleeful about what they like to call flip-flopping.

The New York Times described Winfrey as someone who “has spent decades as a dominant figure in the country’s conversations about weight and dieting,” which is one way of saying that perhaps the public should leave the beleaguered woman alone already, and go pick on somebody else.

Your responses and feedback are welcome!

Source: “Oprah Discusses Weight Loss, Obesity, and Ozempic in Her Most Candid Conversation Yet”, OprahDaily.com, 09/20/23
Source: “What Oprah Winfrey said about drugs used for weight loss like Ozempic, Mounjaro,” 09/21/23
Source: “Oprah to Leave Weight Watchers Board,” nytimes.com, 02/29/24
Image by U.S. Govt./Public Domain

Oprah and the Costs of Fame

In such a full and varied life as the one created for herself by Oprah Winfrey, there is a lot of sameness and also plenty of change. Against a backdrop of ongoing novelty, the media star worked hard to keep the content of her various productions fresh, relevant, and compelling. In 1998, Donald Trump was a guest on her show, where he hinted at perhaps having presidential ambitions.

The following year, Trump told the Larry King Live audience that if he ran for president, his VP pick would be Oprah, whom he described as great, terrific, special, fantastic, brilliant, wonderful, and exceptional (although perhaps not for the identical reasons that cultivate those adjectives from her fans). In social media posts, he quoted some of her original inspirational mottos.

In 2012, he announced “I adore Oprah,” and in a 2013 social media post, praised her for encouraging Lance Armstrong to say things on air that would “totally destroy his life.” The next year, Trump’s family was on Oprah’s show, not for the first time.

People who produce TV and people who like to be on TV really need each other, and all of show business is built on complicated relationships based on popularity, statistics, and many other factors. Status can fluctuate, influence can be resisted, and a lot of things can happen, especially when someone is a supremely multitalented woman who might even “beat herself up” to the extent of thinking, “Yeah, but I’m just basically famous for being fat.” It would not be unusual if such a thought crossed Oprah Winfrey’s mind. It’s all part of the struggle.

The weather changed, and a few years later, having been elected president without Oprah’s endorsement, Trump publicly described her as an asker of biased and slanted questions and a presenter of incorrect facts. Apparently she had said a few things that could be taken as roundabout criticisms. A poll said that if the presidential race was between the two of them, she would win. Before long, these two worldwide famous people had other disagreements as well, and Oprah urged voters to support the U.S. Constitution and the Democratic presidential candidate.

Celebrities everywhere

Around the same time, Oprah also talked with celebrities about weight issues. Actor Kirstie Alley, a veteran of a 30-year acting career, described herself as a food addict who had always been told that 135 pounds translated onscreen as “too fat.” She confided to Oprah and the audience, “I’ve hated myself. You beat yourself up.” Millions of the show’s viewers felt exactly the same — as did the show host.

Some time in 2022, Oprah showed the world a video in which she threw away a cake, symbolizing how she intended to “reset” her diet for the year. Apparently some viewers took that image as an admission that she hated all the overweight people in the world. This was read as her being a major contributor to “diet culture,” for which she was grudgingly forgiven a couple of years later.

Earthquake

Who can forget the huge controversy that ensued when Oprah quit WeightWatchers? The year 2017 had been a good year for both of them, with the program experiencing revenue growth, and her losing 42 pounds. Oprah was admired for her courage in admitting her problem and publicly working on it. But all along, there had been unease among some fans who felt put down or even betrayed. By literally buying into the company — she owned a lot of shares — it was almost as if their hero had become one of the oppressive fat-shamers making a profit from their misery. Some fans were never able to keep the different factors separate.

The situation became complicated when Oprah discovered the new weight-loss drugs and resigned from the WW shareholders board, and the organization reformed itself around a subscription telehealth platform through which members could be prescribed GLP-1 drugs, and things got crazy all over again and a lot of people had strong negative feelings about Oprah, even if they were not quite sure why.

Your responses and feedback are welcome!

Source: “Trump once said Oprah should be his VP,” YouTube.com, undated
Source: “The Long History Between Donald Trump and Oprah Winfrey,” Fortune.com, 02/19/18
Source: “Oprah to Leave Weight Watchers Board,” NYTimes.com, 02/29/24
Image by Pat Hartman

Oprah’s Ultimate Payback — Good for Bad

A 2017 article described Oprah’s concern for how girls born into poverty could be helped to achieve better lives for themselves and their families. It seems reasonable to assume that her own struggles contributed to forming her compassionate mindset.

She worked so hard to create a career and a presence in the world, it would have been only fair to assume that life would be smooth sailing from then on. But no. For decades, the weight issue hung around her neck like an albatross, causing her to be disrespected and even ridiculed. It is totally understandable that her ambition would be to help girls and young women chart their paths into lives that would bring them wisdom, success, and peace of mind.

Wouldn’t it be wonderful if adults could just dish out excellent advice and the young would unhesitatingly assimilate it? But to pass along wisdom is not that simple or easy. As Oprah said,

Every person has their own big questions that no one else can answer. One lesson I learned from all my years of interviewing is that the key to getting the answers you need lies in asking the right questions.

And nowhere is this more true than when a person questions herself! Some of the crucial queries are, “What makes you, you?” And, “Why does your presence on earth right here, right now, so truly matter?” Consequently, this leader created an institution where girls in grades 8 through 12 are given, along with a first-rate academic education, the opportunity to learn skills that will help them, their families, and their entire society — the Oprah Winfrey Leadership Academy for Girls.

Changing the world

In 2002, it started with a dream that materialized into a 52-acre campus in South Africa that includes 21 classrooms, a 600-seat theater, a 10,000-volume library, six laboratories, and very livable dorms whose design and fittings were supervised by the benefactor herself.

Each year, more than 6,000 hopeful candidates vie for the 60 places — meaning that only 1% of the applicants can be accepted. Oprah describes the student body as made up of individuals who possess resilience, courage, spirit, tenacity, charisma, and intelligence. OWLAG opened in 2007, and on the 10th anniversary, Malina Saval reported on it for Variety.com.

Up to that point, Oprah had invested $140 million in the school and its students. Saval wrote, “She pays for every sock, every uniform, every set of braces… When she visits, she spends at least a week on campus, conducting fireside chats with each student and teaching what she calls her Life Lessons 101 course. She is like a mother to these girls…”

The founder told the reporter, “When most girls come to my school they have suffered six major traumas on average… There was a time at the school during 2007, 2008, 2009, when we were losing a parent a week.” The reporter added, “Those same girls now attend top-tier universities… They’ve pursued post-doctorate degrees and secured prestigious jobs in major cities around the world.”

Rather than (like so many wealthy and successful people) turn her back and say, “I got mine, you go get yours,” Oprah Winfrey took her life experience, disappointments, aspirations, and ambitions as raw material and converted them into a powerful force for good. One final quotation from “Mom O”:

What poverty does is brainwashes you to believe that you are not enough. So what our school does is work at creating a foundation of worthiness. It’s a patriarchal environment, where they come from. Just being a girl makes you “less than.” I stand before them and tell them there is no bar, there is no ceiling. We’re not just going to crack the ceiling; it doesn’t exist.

Your responses and feedback are welcome!

Source: “What Oprah Knows for Sure About Life’s Big Questions,” Oprah.com, 12/12/17
Source: “Oprah Winfrey Leadership Academy for Girls,” OprahFoundation.org, undated
Source: “Oprah Winfrey’s Leadership Academy for Girls Marks 10 Years,” Variety.com, 08/03/17
Image by U.S. Embassy South Africa/Public Domain

The Privilege to Give

Most of us who are not doctors or professors do not keep up with the medical journals. But we are all familiar with the previous decades’ level of obesity awareness, because it has been extensively (some would say oppressively) personified in — tah-dah! Oprah Winfrey.

Make a movie about the atomic bomb, and call it Oppenheimer. Make a movie about the never-ending struggle against body fat, and call it… Oh, never mind, let’s get serious. As Oprah has said,

I’ve been on this journey for most of my life… I don’t know if there is another public person whose weight struggle has been exploited as much as mine over the years.

Oprah has talked about a 1990 incident proving there are some human frailties from which wealth and fame cannot shield a person. It was the sort of humiliating misconception that could happen in anyone’s mind, no matter what their scale of living. On the cover of TV Guide magazine, there was a picture of her with the text, “Best and Worst-Dressed List.”

In a regular person’s life, it could have been a neighborhood news-sheet. In either case, the surprise was pleasant for only a second, until Oprah realized she had not been chosen as best-dressed. Instead, she had been picked to represent being a terrible example: “bumpy, lumpy and downright dumpy.” How many dollars would compensate for that embarrassment?

No such thing as bad publicity

The life of a star has a lot of downsides. An aspiring professional entertainer gets used to attracting disrespectful comments from segments of the public. It just comes with the territory. To be publicly recognizable is no asset to most people who value their mental health. But there is a tremendous upside.

Not everyone out there is paying attention to you for harmful reasons (especially if you are as charismatic as Oprah!). Exposure is the price of attention, and attention can be a very positive factor, because when the admiring fans hear about what you are doing, at least a percentage of them will do it too. So a wealthy, famous person is not only able to contribute financial support to a favorite cause, but is also able to inspire others. If the beloved entertainer can donate millions, even if that is only a fraction of their income, the ordinary person feels more like “What the heck, I’ll kick in one-tenth of a percent of my income, too.”

Oprah Winfrey’s influence has been vast because people believe and trust her, and sense the importance she places on retaining a genuine self, amidst the glitter and acclaim. Her rough childhood counted, too. Oprah had enough experience with the serious problems of life to want to help other people who face frightening challenges.

An Oprah-approved institution

We mentioned Shades of Hope Treatment Center, where in 2011, Oprah produced the reality TV show “Addicted to Food,” which followed eight people through the program. Oprah had been familiar with the facility for years.

Since the fall of 2003, singer Wynonna Judd had been confiding in her, in front of the cameras, about her severe food dependency. Like the ordinary citizens who were later featured on Oprah’s network show, Judd checked into the residential treatment center.

When the songstress was later interviewed by Larry King, she described her problem:

It was consuming a lot of my life… I mean food to me is what alcohol is to the alcoholic… You know the business. One minute you’re number one. The next minute you’re number zero. And I had just been using food for every emotion I had. If I was joyful, we’d go out to eat… [I]t became too much, so I did something about it.

People are not born knowing how to fix themselves, but there certainly are learnable skills that can lead strongly toward wellness. In many cases, this happens for many reasons and in many ways. This is why we need such institutions, as well as the current technology that fosters sophisticated levels of self-help.

Oprah’s charitable contributions, even when they have nothing to do with obesity, all aim to help build people better lives. We will next take a look at another of her projects which, while not directly connected to obesity, is aimed at helping young women build lives so satisfactory that they automatically preclude a lot of the self-destructive psychological pain that brings on addictive behaviors or even just carelessness, either one of which is capable of leading to medically significant obesity.

[Note: The photo is a wax figure.]

Your responses and feedback are welcome!

Source: “Oprah Reveals The Secret Behind Her Recent Weight Loss,” Essence.com, 12/08/23
Source: “Change is here. Hope is here.,” ShadesOfHope.com, undated
Image by Petr Kratochvil/License: CC0 Public Domain

Oprah’s Perennial Appeal

Oprah Winfrey is a certain kind of icon. She is absolutely not just another self-destructive doomed genius; never was and never will be a psychological basket case like Amy Winehouse, for instance. Oprah is brilliantly intelligent, and glamorous, capable of being a force of nature when necessary, and clearly a natural-born leader. But none of that could have happened without her relatability.

The reason people follow her is neither that she is so glitteringly different, nor that she is so very typical, although both are true. Her existence and accomplishments have led her to become a sort of template. At one point, during a panel discussion on “The State of Weight,” Oprah confirmed that her highest number had been 237 pounds, and added, “I’m Oprah Winfrey, and I know all that comes with that, but I get treated differently if I’m 200-plus pounds versus under 200 pounds.”

In other words, despite being wealthy and famous, she could still totally connect with the millions of women who feel that more body fat makes them “less than,” which had become the enlightened way to say “inferior.” Sitting for a magazine profile, she told a journalist,

I don’t know if there is another public person whose weight struggle has been exploited as much as mine over the years… This is a world that has shamed people for being overweight forever, and all of us who have lived it know that people treat you differently, they just do.

This talking point shone a light on the psychological double-bind that imprisons women regardless of their situations in life. The ambient culture brainwashes us every day into believing that carrying extra pounds is unacceptable and probably even immoral. That cruel mindset leads women into feeling scorn, rather than compassion — not only toward other women — but toward themselves. Just to put the icing on the cake, so to speak, we are supposed to go whole-hog with that belief, and are expected to condemn our sisters for being in the same physical condition that we fear and dread — if we are not in it already.

Through keeping an eye on Oprah, we follow every important twist and turn of the obesity issue in the fin de siècle period, and in the early years of our present century. As surely as Willie Nelson is Country & Western, Oprah Winfrey is Obesity Awareness.

History

Our take on the saga began with “Oprah Through the Years, Part 1” and so far has progressed through Part 21, and this conscientiously thorough coverage practically guarantees that there is something in it for everybody.

Then, the Childhood Obesity News blog gave Ms. Winfrey a well-earned break for a while, pausing an overview of her career about 10 years into the present century. In 2011, she produced a TV reality show called “Addicted to Food.” The venue was the Shades of Hope Treatment Center, a place to exorcise pain from the hearts of people who grew up in families characterized by dysfunction and/or abuse and/or addiction.

The program relied on numbers less than some others have done. Clients’ weights could be usefully recorded for the sake of the science, but did not have to be shared. One of the most audacious features of this program was the no-entertainment standard, which precluded both printed and televised media. You’re there to feel things, as a route to fixing yourself — so no hiding out in any media la-la land. (It does seem like this principle could usefully be emphasized, in programs everywhere, a lot more than it is currently.)

Here is a typical Shades of Hope quotation:

Your body, mind, and soul were designed to heal. Because we are holistic beings, all of these aspects of ourselves come into play when we heal — no matter what you’ve been through or are going through right now.

Next time, we pick up with Oprah again. Meanwhile, it is worth mentioning what might be called a universal truth. When it comes to kicking a habit, one factor carries over into many different therapeutic approaches: Their most outstanding and characteristic feature is the emphasis on keeping the commitment every second of every minute of every day.

Some people just are not cut out for that. Recovery is a long-term condition if ever there was one, and the better at it you are, the more chance you have of living long enough to develop real expertise. People can be quite adaptive when they want to be, which is why a tool like BrainWeighve, for an excellent example, can be surprisingly useful.

Your responses and feedback are welcome!

Source: “Oprah Reveals The Secret Behind Her Recent Weight Loss,” Essence.com, 12/08/23
Source: “Change is here. Hope is here.,” ShadesOfHope.com, undated
Image by vargas2040 cropped by Machocarioca/Attribution-Share Alike 2.0 Generic

GLP-1 and Akkermansia, the Rest of the Story

A few more things remain to be said about the bug (and tenant of our intimate innards) called Akkermansia muciniphila. As previously mentioned, its sole purpose in life is apparently to ensure that the human gut lining stays nicely knitted together and does not spring any leaks. And this is a worthy existence.

A person who wonders if they are hosting a beneficial proportion of this bug can find out from a stool test. Some of the circumstances that harm the organism are age, antibiotic use, stress, and a diet containing insufficient fiber. Unfortunately, the presence of oxygen prevents Akkermansia muciniphila from growing, so it is not available in food — with the sole exception of human breast milk, which is a great reason to breastfeed a baby for as long as possible. What a wonderful and irreplaceable gift to pass along to a newborn child!

It is possible to encourage one’s personal stock of the helpful bacterium by eating its favorite foods, like high-fiber vegetation and nondigestible carbohydrates. Note: People who suffer from, or are at risk for, inflammatory bowel disease should use caution and check with their doctors.

Now, what about the GLP-1?

Dr. Michael Ruscio informs us that, “In animal models, Akkermansia appears to stimulate the secretion of a hormone known as glucagon-like peptide-1 (GLP-1).” In other words, it’s like manufacturing gold. Imagine saying, “Farewell, Eli Lilly; au revoir, Novo Nordisk. From now on, I’ll be producing my own GLP-1 — right here in my own innards!”

This appears to be a real possibility. At the very least, it appears capable of keeping a microbiome in excellent health. If it can help us shed fat, too, so much the better!

Of course, we have to discount for “novelty bias,” and recall that the allure of the new tends to make people overlook shortcomings. The results gained so far in petri dishes and lab animals do not necessarily apply to human beings in the wild. It will take some time and a lot more study to get a handle on some of these questions.

In animals, at least, too much Akkermansia is as bad as too little. We should know a lot more about the bug before going overboard with the prescriptions, or before allowing civilians to overdose on it.

Dr. Ruscio points out that, despite strong evidence, “[W]e don’t know if low Akkermansia levels actually cause illness or not.” He also reminds us that we only have one small study to go on, so far, and consequently are a long way from knowing if this bug is our best bet for acquiring GLP-1 in aid of weight loss.

As scientists so often and so rightly repeat, more research is needed. We do not know enough about the metabolic effects and blood sugar benefits. “For now, existing probiotics (like Lactobacillus–Bifidobacterium blends) have more research and are more effective.”

And what about those claims of healing the leaky gut? “Basically, higher LPS suggests gut leakiness, and lower LPS indicates tighter intestinal wall junctions.” One study says,

After the participants took Akkermansia for 3 months, the researchers found they had lower serum LPS. This suggests that the gut wall had become less leaky, analogous to those fence boards fitting together more tightly.

While probiotics in general are useful for intestinal health and healing, Dr. Ruscio reminds us that Akkermansia has not been proven special in this area, and that above all, “[W]e should be careful not to try and micromanage the gut microbiome.” In other words, considering our vast ignorance of the whole field, we would do better to foster nourishment and balance in the whole system, rather than trying to pick a favorite based on abysmally scarce data.

The average cost of Akkermansia supplementation would be in the neighborhood of $60 to $80 per month, which is inexpensive compared to the standard GLP-1 meds — but nobody knows yet how much would be needed, for how long, or what happens when the patient quits swallowing extra bacteria? Anyway, here is Dr. Ruscio’s specific advice:

We’ll get more information on Akkermansia in time. But for now, it’s probably better and more cost-effective for your gut health to stick to the three well-studied probiotic categories. These are a Lactobacillus and Bifidobacteria blend, soil-based probiotics, and the beneficial yeast Saccharomyces boulardii.

Your responses and feedback are welcome!

Source: “Getting To Know Your Gut Bugs: Akkermansia Muciniphila,” DrHyman.com, 07/25/21
Source: “What Is Akkermansia? Here’s Everything to Know Before You Start Taking Supplements,” GoodHousekeeping.com, 05/13/25
Source: “Fact-Checking The 4 Most Popular Akkermansia Claims,” DrRuscio.com, 10/07/24
Image by vocablitz/Pixabay

GLP-1 and Akkermansia, a Glowing Prospect

We left off by mentioning Dr. Mark Hyman’s explanation of how acquaintance with the mucus-loving bacterium Akkermansia muciniphila offers a glimpse of an exciting future, featuring drug-free therapy that achieves sustainable weight loss. (Today’s post follows on from a very recent one, so get up to speed here.)

And besides, there does not seem to be a need for age limits. Imagine an affordable obesity prevention solution, for kids!

The backstory: Confronted by a serious personal health situation, Dr. Hyman discovered in himself “gut infections and really low levels of beneficial bacteria.” The mucus-loving Akkermansia, which normally accounts for between 1% and 5% of a human’s gut bacteria, was pretty much missing in him. But emerging research showed promise for this life form as “the next generation of beneficial gut microbes.” The field was on the verge of “an explosion… It’s been linked to positive health outcomes like weight loss, improved insulin resistance, lower inflammation, and more.” He wrote,

Akkermansia muciniphila feeds on mucin, a glycoprotein that regulates the thickness of our gut’s intestinal mucosal layer…. Akkermansia produces propionate and acetate, two short-chain fatty acids (SCFAs) that feed other beneficial gut bacteria…. SCFAs strengthen tight junctions (the glue that holds our intestinal cells together) and prevent unwanted materials from passing through and into circulation.

Ideally, the only substances that should pass through are “macro and micronutrients from real whole foods.” Some of the icky substances we do not want circulating at will are food particles, allergens, endotoxins, and fecal matter. The very undesirable condition that allows other stuff to circulate is known as intestinal hyperpermeability or, informally, as “leaky gut,” and is recognized as the cause of many chronic diseases.

Having a leaky gut causes the immune system to go haywire and become hypersensitive, constantly reacting to antigens (foreign proteins from food and bacteria) that enter the bloodstream unannounced.

It became increasingly obvious that Akkermansia is a good thing to have a sufficient supply of, and studies of obese adults found that high levels of this organism correlate with “healthier metabolic status and better clinical outcomes (fasting blood sugar, body fat distribution, and insulin sensitivity).” In mice, high levels of it are also associated with lower blood lipid levels, lower insulin resistance, and less adipose tissue inflammation.

One way to encourage the good bugs is to avoid highly processed foods. Another is to take it as a supplement, and a very recent article from GoodHousekeeping.com explores the possibility.

From January 2004 to February 2022, the annual number of studies published on Akkermansia grew by 33.36%, and researchers say it “is likely to remain a research hotspot in the foreseeable future.” Journalist Kaitlyn Phoenix has studied the subject in depth and quotes Madiha Saeed, M.D., on the basic mechanism of this organism’s unique talent. Akkermansia eats mucin, a protein in mucus,

[…] and produces short chain fatty acids that “strengthen the tight junctions in between our gut cells, keeping the bad stuff out of our gut…. The more mucin Akkermansia uses, the more it encourages the epithelial cells to make more mucin, which then improves gut function and overall health.

Here is an interesting detail from Dr. Michael Ruscio, DNM, DC, a doctor and clinical researcher who explores the tireless ability of Akkermansia to populate the mucosal lining of the intestines, both small and large. It appears very likely that this life form exists for the sole purpose of reinforcing the intestines to prevent their contents from seeping into other areas.

(Please return next week for the rest of this fascinating story.)

Your responses and feedback are welcome!

Source: “Getting To Know Your Gut Bugs: Akkermansia Muciniphila,” DrHyman.com, 07/25/21
Source: “What Is Akkermansia? Here’s Everything to Know Before You Start Taking Supplements,” GoodHousekeeping.com, 05/13/25
Source: “Fact-Checking The 4 Most Popular Akkermansia Claims,” DrRuscio.com, 10/07/24
Image by BLASfemia8145/Pixabay

GLP-1 and Akkermansia

One of the interesting challenges taken up by scientists in the past few years has been how to convince a body to make more GLP-1 on its own, so overweight people do not have to spend enormous sums on monthly drug buys. And clues have been found. Take, for instance, this highly technical quotation indicating progress in that direction:

The newly identified protein P9 is secreted by Akkermansia muciniphila and binds to ICAM-2 to directly trigger the secretion of GLP-1 by the L cells, while P9-stimulated IL-6 secretion by macrophages and/or intestinal epithelial cells (via an unclear mechanism) further promotes GLP-1 secretion.

A more recent and more approachable piece of reportage brings us up to date on progress in this area:

Emerging research indicates that the metabolites produced by Akkermansia […] may play a role in modulating the secretion of GLP-1… This interplay highlights the potential for Akkermansia to indirectly affect glucose metabolism and appetite regulation, offering a novel approach to addressing metabolic disorders.

Imagine us having the power to stop food cravings before they even start, right there in our own digestive tracts! Instead of swallowing or injecting medicine, why not simply manufacture it from our own innate inner resources? How do we set up the ideal conditions to facilitate that process?

Fiber is the raw material that needs to be present for metabolizing into a bunch of different stuff that all facilitates the production of GLP-1 inside a person. Then the pancreas makes insulin, which directs the brain to tell the mouth to stop eating. It also tells the stomach to hang onto the latest meal, and savor that full feeling.

What we need the body to do is to facilitate the flourishing of the prime types of gut bacteria, like Clostridium butyricum. But above all, attention is focusing on the rock-star known as Akkermansia muciniphila, which has been making quite a name for itself, and is being strenuously marketed as an over-the-counter supplement that consumers may choose at will. As we have noted here before, “Gut bacteria can significantly impact weight, independent of genes. Transplanting the microbiome from an obese twin drives obesity. Conversely, transplanting the microbiome from a healthy twin drives weight loss.”

The popularity of RYGB (roux-en-y gastric bypass surgery) has led to interesting observations and hints about what goes on inside a person after this type of surgery:

A decrease in adiposity and body weight without a change in food intake suggests that the RYGB-associated microbiota may either reduce the ability to harvest energy from the diet or produce signals regulating energy expenditure and/or lipid metabolism.

As we have seen, the gastric bypass, or Roux-en-Y procedure, used for morbidly obese people, is an irreversible combination of restrictive and malabsorptive methods. Part of the stomach is cordoned off and the very minimalist remainder of it is routed directly to the small intestine, drastically reducing the amount of food the body can absorb. This can lead to some weird results, as detailed in an article about discoveries at the Cleveland Clinic related to Type 2 diabetes:

As a treatment for obesity, Roux-en-Y is effective. As a treatment for diabetes, it is extraordinary. In 80% of cases the condition vanishes within days. Experiments conducted on mice […] show that Roux-en-Y causes the composition of the gut microbiome to change. Dr Nicholson thinks this explains the sudden disappearance of diabetes.

DiabetesJournals.org said,

[A] possibility remains that the improvement of glucose homeostasis observed following bariatric surgery is mediated by a change in gut microbiota, leading to an enhancement of nutrient-sensing mechanisms in the jejunum and an improvement in glucose tolerance…

As more surgeons investigated associations between the successful post-op maintenance of weight loss after bariatric surgery and changes in gut bacteria and functional brain activity, the gut microbiome began to be perceived as a significant regulator of obesity.

All sorts of interesting observations began to appear in the literature. From UCLA came a report by Emeran A. Mayer, M.D., about the various mechanisms by which weight-loss surgery accomplished its purpose:

We know from several studies that surgically reducing the size of the stomach is not the main mechanism for weight loss. Surprisingly, several studies have demonstrated that weight loss surgery produces changes in food preferences and appetite. Our research aims to find out what causes these unexpected changes…

What was the brain doing about weight loss, appetite reduction and changes in food preferences in response to surgery? How could this information lead to the long‐term goal of finding non-invasive treatment “capable of reproducing these brain changes and associated reductions in appetite without surgical intervention”?

Akkermansia is an enriched bacterial group that can “work independently or interdependently to influence host metabolic improvements.” Several authors from the Obesity, Metabolism & Nutrition Institute and Gastrointestinal Unit, Massachusetts General Hospital, wrote of how the probiotic Akkermansia muciniphila is a beneficial strain that is alleged to increase GLP-1 production:

[I]t is possible that Akkermansia may have a substantial role in regulating host adiposity and weight loss. Akkermansia can use mucus as a sole source of carbon and nitrogen in times of health and particularly in times of caloric restriction…

It strengthens the gut lining and improves health by reducing permeability. In this region of the body, permeable is a dirty word. We have heard the slogan, “What happens in Las Vegas, stays in Las Vegas,” and the same ought to be true of the human intestine. What belongs in there should remain in there, not go leaking all over the place.

Your responses and feedback are welcome!

Source: “A newly identified protein from Akkermansia muciniphila stimulates GLP-1 secretion,” ScienceDirect.com, 06/01/21
Source: “Akkermansia’s Impact on GLP-1 and Gut Microbiota Dynamics,” BiologyInsights.com, 04/29/25
Source: “Conserved Shifts in the Gut Microbiota Due to Gastric Bypass Reduce Host Weight and Adiposity,” NIH.gov, 05/13/13
Source: “Me, myself, us,” Economist.com, 08/18/12
Source: “Nutrient-Sensing Mechanisms in the Gut as Therapeutic Targets for Diabetes…,” DiabetesJournals.org, September 2013
Source: “From the Desk of Emeran A. Mayer, MD,” UCLA.edu, Spring 2014
Source: “Conserved Shifts in the Gut Microbiota Due to Gastric Bypass Reduce Host Weight and Adiposity,” ScienceMag.org, March 2013
Source: ‘Getting To Know Your Gut Bugs: Akkermansia Muciniphila,” DrHyman.com, 07/25/21
Image by SamuelFJohanns/Pixabay

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Profiles: Kids Struggling with Weight

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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