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The Right to Be Obese

Pat Hartman July 29, 2025 No Comments

It is actually pretty amazing how many times the alarms have sounded, just because some mathematicians practiced their trade and said, “Hey! What’s going on here?” Time and time again, experts have tried to get people to open their eyes and check their pocketbooks to see if what these highly educated individuals were saying made any sense. Why? Because the experts were saying things like, “Americans are doomed.”

Experts with advanced degrees and extensive experience in several fields, employed by universities and think tanks and medical institutions, and the government, to mention a few, have done their darnedest to try and make the public listen. Obesity is a very, very expensive condition, and the more assiduously the logisticians examine the problem, the more frightening it becomes… to anyone who is paying attention, anyway — which seems to be a vanishingly small number of folks.

Easy to ignore

Many Americans dismiss these warnings as “much ado about nothing,” but even into their resistant minds, it seems like some shards of light ought to have penetrated by now. Quite understandably, many patriots who love and praise the ideal of individual freedom have suggested that people should be left alone to pursue happiness in their own preferred manner, even if and when this includes a self-destructive lifestyle that also costs society a pretty penny.

This mindset does make a certain amount of sense, in a way. Of course an American should be allowed to eat whatever she or he prefers. On the other hand, we have rejected total acceptance of the doctrine that anyone should be allowed to drink whatever they want, whenever they want. Most jurisdictions within the United States have set age limits on who can buy, possess, and legally consume alcohol. So there actually is a rough consensus, in most states and cities, to the effect that rights are not without limits.

In fact, the law goes further, and is perfectly willing and able to prosecute people whose alcohol use brings harm to other Americans, or even just to themselves. Of course, many people experience inner conflict about this. Returning to the destruction that can be caused by careless, unheeding consumption of food — millions of Americans, whether volunteers or draftees, have fought and died for the cherished ideal of freedom.

Wakeup call?

But then, at a certain point, officials spoke up to say, “Attention! It appears that because of an epidemic of obesity, not enough Americans are fit enough to qualify to belong to the same military that is in charge of preserving our freedom.” What a paradox. What a debacle.

These are only two of the many strands that weave the tapestry of body weight disaster in our country… and nobody has finished talking about the subject. Earlier this week, Newsweek.com published ” ‘Extremely Severe’ Obesity on the Rise in US Children — Study” by Hollie Silverman. The journalist reports that…

Extremely severe obesity among American children has increased more than threefold over the past 15 years, with new research published on the JAMA Network, highlighting disturbing trends in prevalence and related health complications.

People between the ages 2 and 18 (in other words, the entirety of America’s youth) are busily increasing their obesity rates more efficiently than any other demographic. Analysis of 15 years worth of research has revealed a dismal picture. The study’s four authors use the expression “public health emergency” and also the phrase “urgent need for public health interventions against pediatric obesity.”

Silverman writes,

The sharp upswing in extremely severe obesity among children raises the risk of developing serious medical conditions — including type 2 diabetes, steatotic liver disease, also known as fatty liver disease (MASLD), metabolic syndrome, and cardiovascular disease.

And what have we been saying? Exactly — that the urgent need for public health intervention, caused by the aforementioned sharp upswing, comes at an enormous cost. Putting aside the drastically traumatic effects on the children and youth involved… and leaving aside the frustration and rejection and numerous other negative emotions experienced by these kids… and ignoring for a moment the immense physical suffering experienced by victims of the above-named diseases… all of this is horrendously expensive in sheer financial terms.

Okay, let’s get back to talking dollars:

In 2024, the CDC estimated the annual medical cost of childhood obesity at $1.3 billion…

Your responses and feedback are welcome!

Source: “’Extremely Severe’ Obesity on the Rise in US Children—Study,” Newsweek.com, 07/20/25
Images by FotoshopTofs, sedatgunduz/Pixabay

All Sorts of Prices

Pat Hartman July 24, 2025 No Comments

After the turn of the century, it became more evident every year that spending a smaller amount in the present could avoid much larger bills later on. Teenagers were shuffling around looking like pathetic retirees, and once America had become accustomed to the idea that there were not enough physically fit youth to make an army, it quickly became clear that a large part of the national workforce might lose the capacity to perform any work at all, due to physical neglect and a reluctance to acquire better habits.

Over the century’s second decade, it became clearer every day that the obesity train had jumped the track. Dangerous body weight became a common media topic. Percentages and ratios were calculated, and inventive minds conjured ways to impress audiences with shocking conclusions:

Some 40 to 50 percent of food eaten by kids is consumed at school, and school cafeterias, which have to be financially self-sufficient, push unhealthy, packaged food at kids.

The average teenager was daily gulping down four containers of sugar-sweetened beverages, which, as statisticians and journalists warned the public, are…

[…] the equivalent of an entire extra meal in terms of calories… With a 90 percent profit margin on their products, the soft drink industry can spend millions on hyperactive advertising.

Point being, obesity was getting more expensive every day. The Federal Trade Commission banded together with several other distinguished agencies in an attempt to make the food industry adopt a few nutritional guidelines, but this concept was shot down. Dire and unarguable predictions were made:

Americans are doomed to pay even more for the cost of treating obesity-related illness if the weight epidemic is not addressed. And unless we’re willing to respond to the timely wake-up call […] many of us — and many of our children — will pay with their lives.

Those remarks were made in response to the acclaimed four-part TV series, “The Weight of the Nation.” Journalist Molly Creeden compares the obesity alarm response to the time years before when people began to react against the dangers of tobacco smoking. Again, bad habits correlated obviously with huge expenses:

Nearly 69 percent of American adults and 32 percent of children are overweight or obese… The U.S. spends nearly $150 billion on obesity-related healthcare annually, and the affliction costs American businesses $73.1 billion a year.

Ouch!

Those sugar-sweetened beverages were not the only villain. Blame should also be laid at the feet of “conglomerate food companies, whose marketing of unhealthy choices —particularly to children — is painted as merciless.”

Of course, the available food itself is not the only source of blame. There is always a need to look at what inspires a child to eat too much. In various posts, Childhood Obesity News pointed out that sometimes a history of abuse causes a young person to deliberately become obese in order to deflect unwanted and unwelcome physical attention, and this can be true of both girls and boys.

A male child who was bullied in his younger years might grow to a massive size to intimidate hostile others by his sheer bulk. A youth who does not ever want to be inducted into the military might, consciously or subconsciously, decide to become obese to avoid that fate. When psychological depths are plumbed, anything might happen.

A child might feel that layers of fat provide a sort of cushioned armor that can protect her or him from the world’s perils. Sometimes a young girl will discover this on her own. In other unfortunate cases, there may be misbehavior or a threat of assault on the horizon. An anxious, misguided mother who holds the belief that chubbiness will protect her female child from unwanted male attention might purposely overfeed that little girl to provide protection in the only way she knows how.

Many different kinds of mistakes can be made, and they all come with a price attached.

Your responses and feedback are welcome!

Source: “’The Weight of the Nation’ review: Obesity crisis,” SFGate.com, 05/10/12
Source: “American Emergency: HBO’s The Weight of the Nation,” Vogue.com 05/11/12
Image by trtasfiq/Pixabay

The Link Between Sleep and Weight

Tatyana Meshcheryakova July 23, 2025 No Comments

For years, it was commonly believed that weight was determined solely by what you eat and how often you exercise. But modern research paints a more complex picture. Today, we know that weight is influenced by a combination of factors — including genetics, socioeconomic status, mental health, stress, environment, and sleep. Yes, sleep. How much (and how well) you sleep can significantly affect your ability to manage weight.

Sleep Foundation’s Senior Health Editor Alexa Fry looked at the link between sleep and weight gain, including in children and adolescents, and while some conclusions may seem obvious, studies back them up.

There’s a frustrating cycle that many people face: Sleep deprivation can lead to weight gain, and excess weight can contribute to poor sleep. Together, they can create a loop that’s difficult to break. The good news? There are ways to improve both sleep quality and weight-related health outcomes.

How sleep loss contributes to weight gain

Not getting enough sleep disrupts the body’s hormone balance. Two key hormones involved in hunger — leptin and ghrelin — are affected. Leptin helps signal fullness, while ghrelin triggers hunger. Sleep deprivation suppresses leptin and increases ghrelin, making you feel hungrier than you actually are.

Sleep loss is also linked to an increase in cortisol, the stress hormone, which is known to promote fat storage. Meanwhile, insufficient sleep can slow your metabolism and reduce levels of growth hormone, which helps regulate body composition.

On a behavioral level, lack of sleep increases cravings for high-calorie foods, especially late at night. Studies show that sleep-deprived people are more likely to choose energy-dense, nutrient-poor foods. They’re also less likely to exercise, often because they’re too fatigued. All of these factors can make it easier to gain weight — and harder to lose it.

The impact of poor sleep on children’s weight

Sleep plays a critical role in childhood development, including weight regulation. Children need more sleep than adults, and those who don’t get enough are at a greater risk for obesity.

Like adults, kids with poor sleep habits may experience hormonal shifts that affect appetite and metabolism. They may also feel more tired during the day and be less physically active.

Interestingly, bedtime matters too. Research has shown that children who go to bed later tend to eat more unhealthy foods and consume fewer fruits and vegetables. And for children who are already overweight, irregular sleep patterns and insufficient sleep can make matters worse — intensifying the long-term health risks.

Sleep disorders and health conditions linked to obesity

Being overweight doesn’t just increase the risk of chronic diseases, it also contributes to a range of sleep-related issues. Here are some of the most common sleep-disrupting conditions linked to excess weight:

Obstructive Sleep Apnea (OSA). OSA is a sleep disorder where the airway partially or fully collapses during sleep, causing loud snoring and interrupted breathing (including in children). People with obesity are up to seven times more likely to develop OSA. Excess weight around the neck and throat can further block the airway. In a significant medical development, the FDA recently approved Zepbound, a weight-loss medication, to treat moderate to severe OSA in patients with obesity. It’s the first drug of its kind to receive approval specifically for this purpose.
Gastroesophageal Reflux Disease (GERD). GERD is more common in people with excess weight. When stomach acid flows back into the esophagus, especially when lying down, it can cause sleep disturbances due to discomfort and heartburn.
Depression and obesity often occur together and can worsen each other. Up to 75% of people with depression experience insomnia or other sleep difficulties. And disrupted sleep can make depression symptoms more severe.
Obesity increases the likelihood of developing asthma and makes symptoms more difficult to manage. Many asthma patients experience nighttime flare-ups, which can significantly reduce sleep quality.
Excess weight puts extra stress on joints, leading to osteoarthritis. Joint pain — especially at night — can interfere with sleep. Over time, this creates a vicious cycle of pain, fatigue, and worsening health.

Tips for getting better sleep while overweight

Improving sleep starts with building strong sleep hygiene habits: daily behaviors and routines that promote restful sleep. Here are several strategies to consider (and this applies to children as well):

Stick to a regular schedule. Go to bed and wake up at the same time each day, even on weekends.
Create a calming bedtime routine. Wind down with quiet, screen-free activities before bed.
Be mindful of food and drink. Avoid heavy meals, caffeine, and alcohol close to bedtime.
Invest in the right mattress. Your bed should support your body comfortably, especially if you experience joint pain.
Exercise regularly. Physical activity helps regulate sleep and supports weight loss, but avoid intense workouts right before bed.
Watch late-night snacking. Try to avoid eating after dinner, especially foods high in sugar or fat.

Breaking the sleep–weight cycle

The relationship between sleep and weight is deeply intertwined, and breaking the cycle can feel overwhelming. But it’s not impossible. Through a combination of healthy sleep habits, medical support, and tailored lifestyle changes, you can improve both your sleep quality and your children’s.

Your responses and feedback are welcome!

Source: “Obesity and Sleep,” Sleep Foundation, 7/16/25
Source: “Mastering Sleep Hygiene: Your Path to Quality Sleep,” Sleep Foundation, 7/7/25
Image by cottonbro studio/Pexels

Obesity, Expenses, and National Security

Pat Hartman July 22, 2025 No Comments

In 2010, Air Force Major Gen. Frank R. Faykes made a speech in support of passing the Child Nutrition Bill, which was drafted with the intention of removing junk food from vending machines and taking other measures to improve nutrition in schools. The retired officer was anxious to bring certain facts to the attention of America: mainly, that one-fourth of all high school graduates in the country were too fat to be accepted into the armed services.

This stumbling block to the nation’s security and military readiness he characterized as “very troubling,” because once the 17-to-24-year-old high-school dropouts and people with criminal records were factored in, only seven out of 10 theoretically eligible recruits would actually be acceptable. In other words, the majority of the nation’s youth were not in good enough shape to be trained to destroy enemies while preserving their own lives.

Gen. Faykes also advocated for early learning opportunities that would result in improved graduation statistics, and also reduce teen criminal activity. Most importantly, he urged Americans to find the political courage to invest in people long-term. The news story concluded,

“You don’t see a return on it for a decade,” he said, but every dollar applied to early education results in a savings of $16 later in the criminal justice system. “Today’s military may be high-tech, but our real asset is our people.”

Around the same time, journalist April Wortham quoted U.S. Surgeon General Regina Benjamin on the subject of the U.S. workforce overall. Benjamin addressed a crowd in Nashville, Tennessee, a state in which more than one-third of the kids from 10 to 17 were either overweight or obese, on the specific subject of childhood obesity. One of her remarks was,

If kids are having high blood pressure or heart disease when they’re 19 or 20 years old, you’re not going to have a work force out there.

Two years later, many Americans watched with alarm the HBO four-part series entitled The Weight of the Nation. Its purpose was to inform Americans about the causes of the obesity epidemic, and which symptoms to look out for, what treatments and solutions were available, and what the future might hold.

The four episodes were titled “Consequences,” “Choices,” “Children in Crisis,” and “Challenges.” The challenges then were much the same as now. Obesity opponents are up against cultural factors, dieting myths, the inadvertent causing of harm in pursuit of improvement, the noisy debates against drug use, extreme dieting, bariatric surgery, and more. The series also took a hard look at the future of such professions and public services as soldiering, firefighting, police work, and other fields, in the face of ever-diminishing fitness.

Points were also made about popular preferences, industrial imperatives, and “government policies dating back decades.” The piece included the words,

The relatively inexpensive food that most Americans consume every day may seem like a good deal, but in fact is a very expensive proposition. Unaccounted for in the price are, among other things, the future health care costs associated with heart disease, diabetes, and other obesity-related diseases. This examines a long-term strategy for trying to improve the American diet.

SFGate reporter David Wiegand characterized the series as “a chilling look at physical, financial costs of a U.S. crisis.” Obesity contributes to five of the 10 leading causes of death in America, costs businesses more than $73 billion a year, adds $150 billion to health costs now, and may hit $300 billion by 2018.

Your responses and feedback are welcome!

Source: “Childhood obesity has huge impact on military readiness,’ PilotOnline.com, 11/10/10
Source: “Surgeon General: Childhood obesity endangers future workforce,” BizJournals.com, 11/16/10
Source: “The Weight of the Nation,” HBO Max, 2012
Source: “’The Weight of the Nation’ review: Obesity crisis,” SFGate.com, 05/10/12
Image by BrianPenny/Pixabay

Questions Cost Money and So Do Answers

Pat Hartman July 17, 2025 No Comments

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

Why Early-Life Factors Matter in Childhood Obesity

Tatyana Meshcheryakova July 16, 2025 No Comments

Childhood obesity doesn’t start in elementary school — it often begins much earlier, sometimes even before a child is born. A new study published in JAMA Network Open reinforces what health experts have long suspected: Prenatal and early-life conditions significantly shape a child’s risk for obesity later in life. These findings emphasize the importance of early intervention to encourage healthy growth patterns from the very start.

Early clues to a long-term problem

The study analyzed data from nearly 9,500 children between the ages of 1 and 9, tracking more than 53,000 BMI (body mass index) measurements. Researchers used a sophisticated modeling approach to uncover how BMI changes over time, not just whether a child is overweight at a certain age, but how and when those changes occur.

Children were categorized into two groups: those with a “typical” BMI pattern and those with an “atypical” trajectory — a group at higher risk for long-term obesity.

In a typical pattern (89% of children), BMI rose in infancy, dropped to its lowest point around age 6, then steadily increased through age 9 — a process known as adiposity rebound. In an atypical pattern (11% of children), these kids had stable BMIs from ages 1 to 3.5, followed by a steep increase through age 9. By age 9, their average BMI reached 26.2 — well above the 99th percentile.

The researchers noted that the timing of adiposity rebound is crucial. When this rebound happens earlier than normal, it’s considered a red flag for accelerated growth and increased risk of obesity and cardiometabolic conditions later in life.

Risk factors start before birth

The study also explored what environmental and biological factors were most predictive of a child following an atypical BMI trajectory. Several key prenatal and birth-related factors stood out:

High maternal BMI before or during pregnancy
Excessive weight gain during pregnancy
Smoking during pregnancy
High birth weight
Preterm birth

Each of these increased the odds of a child ending up in the high-risk BMI group.

What’s happening inside the womb can also influence a child’s long-term health in less obvious ways. For example, maternal obesity and weight gain have been linked to disturbances in the development of the infant’s gut microbiome — the ecosystem of bacteria that affects digestion, metabolism, and immune response. A separate study in Clinical and Experimental Pediatrics found that children born to mothers with high BMIs were more likely to have microbiota profiles associated with obesity by the time they turned one, especially if delivered via cesarean section.

Why this study stands out

Most past research could only offer snapshots — a child’s weight at one age, compared with a benchmark. What makes this new study different is the ability to chart the shape of growth over time and detect deviations from normal development earlier than ever.

The researchers used a novel modeling technique called multiphase latent growth mixture modeling, which captures not just the amount of weight gain, but its timing and rate of change. While the method is more complex and computationally demanding, it provides a clearer, more personalized picture of how and when a child might be veering off a healthy growth path.

A call for early action

The key takeaway? Obesity prevention may need to start far earlier than preschool. By understanding the early-life factors that shape growth trajectories, parents and healthcare providers have an opportunity to intervene during critical windows, even before birth.

Whether it’s supporting maternal nutrition and prenatal care, encouraging breastfeeding, promoting gut health, or simply monitoring weight gain more closely during early childhood, the message is clear: The earlier we address the risk factors, the better the long-term outcomes for children.

As the authors concluded:

We identified modifiable early-life factors that may place children at risk for or protect children from childhood obesity.

What can parents do?

Here are some actionable steps to reduce the risk of early-onset obesity:

Maintain a healthy weight during pregnancy. Work with a healthcare provider to stay within recommended gestational weight gain guidelines.
Avoid smoking during pregnancy. It’s a known risk factor for various childhood health problems, including obesity.
Encourage breastfeeding. It can support a healthy gut microbiome and reduce obesity risk.
Watch for early signs of rapid weight gain. Regular pediatric visits with growth monitoring are essential.
Support a healthy diet and active lifestyle from the start. Good habits formed early are more likely to stick.

While genetics and lifestyle are part of the equation, this study reminds us that environmental and prenatal factors play a powerful role. The good news? Many of those factors are modifiable. With greater awareness and proactive care (starting before birth), families and communities can help change the trajectory for the next generation.

Your responses and feedback are welcome!

Source: “Prenatal and Early-Life Contributors to Childhood and Adolescent Obesity,” The American Journal of Managed Care, 7/10/25
Source: “Early-Life Factors and Body Mass Index Trajectories Among Children in the ECHO Cohort,” JAMA Network Open, 5/22/25
Image by Leah Newhouse/Pexels

Put On Your Long-Distance Glasses

Pat Hartman July 15, 2025 No Comments

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 may 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 being 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

Pat Hartman July 10, 2025 No Comments

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

The Psychological and Social Complexities of GLP-1 Drugs

Tatyana Meshcheryakova July 9, 2025 No Comments

The last couple of weeks have been eventful in the realm of the ever popular GLP-1 meds, from positive news of yet another benefit to taking them (like lowering heart-related risks) to the sobering warning of a new, negative side effect on health, plus some substantial insurance coverage changes. Let’s take a look.

As has been established, GLP-1 receptor agonists (like semaglutide and liraglutide) and GLP-1/GIP combinations (like tirzepatide) help with weight loss by mimicking hormones that suppress appetite, slow digestion, and promote satiety. When paired with lifestyle changes, they can reduce body weight by 10%–20% over 9–15 months and improve cardiometabolic health. However, side effects like nausea, constipation, and loss of lean muscle mass are common and can prompt many to stop using the medication.

Psychological benefits and challenges

These medications can quiet obsessive food thoughts (“food noise”), reduce shame around eating, and give users a sense of mastery. However, they may also cause emotional side effects. Some users report a flattening of emotions or loss of pleasure in everyday experiences — possibly due to changes in the brain’s dopamine system. Studies show mixed results on whether GLP-1s increase depression or suicidal thoughts, with some linking them to mood issues and others finding mild improvements in depressive symptoms.

Psychologists are becoming essential in supporting GLP-1 patients by helping them adjust emotionally, manage disordered eating, and handle social stigma. Patients often face conflicting societal pressures — praised for losing weight, yet judged for using medication to do so. Therapy helps them navigate shifting body image, relationship dynamics, and grief over old habits or coping mechanisms (like using food for comfort).

Social and cultural complexities

The widespread use of GLP-1s brings up deeper issues around weight stigma, societal bias, and access. Some experts worry these drugs reinforce the idea that larger bodies are a problem to fix, potentially marginalizing people who are fat-positive or not interested in weight loss. Access is another concern: those with lower income or from marginalized communities may be less likely to afford or continue treatment.

Meanwhile, doctors may prescribe these drugs based on appearance, not medical need, and patients with eating disorders can misuse them. The rise of telehealth and loosely regulated medical spas also makes GLP-1s more accessible, sometimes in unsafe ways.

Role of psychology in GLP-1 use

Psychologists support patients by helping them:

• Develop sustainable, healthy relationships with food
• Prevent muscle loss through proper nutrition and exercise
• Strengthen body image and emotional resilience
• Navigate relationship changes and shifts in identity
• Cope with past trauma that may resurface with physical transformation

Some also use trauma-informed therapies like EMDR (Eye Movement Desensitization and Reprocessing) to help patients who used food to cope with abuse or fear the attention that comes with weight loss.

GLP-1s and addiction treatment

Emerging research suggests GLP-1s may help curb addictive behaviors, such as excessive alcohol use. A 2025 trial showed semaglutide reduced heavy drinking days and cravings in people with alcohol use disorder. The effect appears similar to how GLP-1s suppress appetite — by dulling the brain’s reward signals. More research is needed before these drugs are FDA-approved for addiction, but psychologists are encouraged to stay informed as more patients may use GLP-1s for this purpose.

GLP-1 medications offer significant promise for those struggling with obesity, providing both physical and emotional relief. But they also come with complex psychological and societal implications. Experts agree: The success of these drugs isn’t just medical — it’s behavioral. Psychologists play a vital role in helping patients navigate the inner changes that accompany dramatic outer transformations.

Alleviating migraines, but it’s a pancreatic risk

It’s been reported that in a small study, a GLP-1 drug shrank the number of days people spent with a migraine by almost half in a given month. However, the GLP-1 receptor agonists are under investigation by U.K. health authorities due to reports of serious pancreatic side effects, including nearly 400 cases of acute pancreatitis and up to 10 deaths.

The U.K.’s Medicines and Healthcare products Regulatory Agency (MHRA) and Genomics England are examining whether genetic factors may predispose certain individuals to these rare but serious complications. Tirzepatide-based drugs like Mounjaro and Zepbound appear to be more frequently linked to these reports.

While no direct causal link has been established, the investigation seeks to better understand who might be at greater risk. U.K. residents over 18 who experience severe reactions are encouraged to report them through the Yellow Card system and may be invited to submit further details and a saliva sample for research.

Experts stress that GLP-1 drugs remain approved and generally safe when prescribed and monitored by a doctor, but warn against obtaining them through unofficial channels.

CVS Caremark drops Zepbound from coverage, citing cost

Starting this week, CVS Caremark, one of the largest U.S. pharmacy benefit managers, will stop covering Eli Lilly’s Zepbound, a GLP-1 drug approved for chronic weight management, on its most common formulary, affecting 25–30 million Americans. Wegovy, a competing drug from Novo Nordisk, will remain covered, alongside a few less effective alternatives.

CVS says this move is designed to drive down costs by forcing drugmakers to compete, citing the high prices of GLP-1s as a major barrier to access. However, pharmacy benefit managers (PBMs) like CVS have been criticized for their role in rising drug prices.

Doctors and patient advocates argue that GLP-1s aren’t interchangeable, and abrupt coverage changes can disrupt patient care. Side effects, tolerability, and individual response vary, and switching medications mid-treatment can stall progress or worsen health outcomes.

Critics also say this move reflects a broader misunderstanding of obesity as a chronic disease, noting that insurance policies don’t treat obesity care with the same consistency or respect as other chronic conditions.

Providers report being overwhelmed with patient concerns and spending excessive time navigating insurance rules instead of delivering care. Another upcoming policy change: BCBS Massachusetts will stop covering GLP-1s for obesity in 2026, unless prescribed for diabetes.

In response, Eli Lilly is expanding access via its LillyDirect program, offering Zepbound for $499/month out-of-pocket. Still, many worry such policies will create greater inequality and care disruption for people managing obesity.

Your responses and feedback are welcome!

Source: “A new era of weight loss: Mental health effects of GLP-1 drugs,” APA, 7/1/25
Source: “Pill form of popular weight-loss drug lowers heart risks,” Harvard Health Publishing, 7/1/25
Source: “Popular weight-loss drugs show promising new power against debilitating migraines,” Fox News, 7/2/25
Source: “New Weight-Loss Drugs Under Scrutiny Amid Pancreas Concerns,” Science Alert, 7/3/25
Source: “Major insurance changes are coming to GLP-1 drugs for weight loss. Here’s how that could affect patients,” CNN, 7/1/25
Image by Leeloo The First/Pexels

Oprah and the Costs of Fame

Pat Hartman July 8, 2025 No Comments

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

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