Pat Hartman | Childhood Obesity News

Oprah Through the Years, Part 5

Pat Hartman December 31, 2024 No Comments

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

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

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

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

Firsts

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

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

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

Onlies, Others, and Philanthropy

According to the Harpo Inc. site,

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

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

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

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

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

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

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

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

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

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

Your responses and feedback are welcome!

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

Oprah Through the Years — Part 4

Pat Hartman December 27, 2024 No Comments

In keeping with the holiday spirit, a pause would be appropriate during which to recall some of Oprah Winfrey’s Firsts, Mosts, Onlies, and other remarkable achievements, and this is by no means a complete list. We are looking at, let’s face it, a very unusual situation.

Aside from being female and Black, which are both disadvantages in some situations, and perceived as disadvantages in others, there is an aspect which almost always disqualifies a person from any sort of public acclaim: size. For most of her long and spectacular career, Oprah has been (depending on who makes the call) thick, chunky, fat, overweight, or obese — and yet, adored.

About this larger-than-life show-business personality, for whom the term “influencer” was seemingly invented, many things have been said. The main information trove for this series of posts is Harpo Inc., and other sources are also noted.

Mosts

In 1984 the TV show A.M. Chicago was in last place among local talk shows, until Oprah Winfrey began hosting, and within weeks it rose to the top of the rankings.

After its 1986 inception, The Oprah Winfrey Show took only a year to become the top syndicated talk show in the country. During its lifespan it consistently appeared at or near the top of various polls, like Best Daytime Talk Shows, Best 1980s Talk Shows, and so forth. By the turn of the century, it could be seen in around 140 countries. At its height, the show’s viewership was said to be 48 million in the U.S. alone. Over its lifetime, approximately 1.3 million people participated as live audience members.

At the 2004 People’s Choice Awards, Oprah was awarded the title of “Favorite Talk Show Host;” and somewhere along the way, became a first-name celebrity, not just in her native land but around the globe. In 2018, the National Museum of African American History and Culture engaged the public with an exhibit demonstrating how Oprah influenced the culture through TV.

Also, Apple announced an Apple TV partnership. A press release said,

The Oprah Conversation debuted on July 30, 2020, with Winfrey “[continuing] to explore impactful and relevant topics with fascinating thought leaders from all over the world…”

When after 25 years The Oprah Winfrey Show ceased, it had become the nation’s longest-running daytime talk show, and maybe even the number one talk show, period. It has even been called the highest-rated talk show in history. It won 47 Emmy Awards, and the 1993 interview with Michael Jackson was the most-watched interview in TV history (90 million viewers) and the fourth highest-rated television program of all time. After 4,561 episodes, Oprah was firmly entrenched in America’s brain. In 1996, TIME magazine designated her as one of America’s 25 most influential people.

Mental Floss says,

The show didn’t enter into licensing deals or paid endorsements, even though she had plenty of companies banging at her door to become one of her “Favorite Things” or to see their latest releases as part of her Book Club. But Winfrey’s recommendations were all her own.

Of course, this multi-talented, infinitely compelling woman had other projects underway. In 1997, Newsweek named Oprah Winfrey “Most Important Person” in the books and media category. She was selected as TV Guide’s “Television Performer of the Year,” and also was given a People’s Choice Award for “Favorite Television Performer.”

In this century’s first decade, Oprah was being called the “Queen of All Media,” though the origin of the nickname is obscure. From the moment she was first named “the most influential woman in America,” that assertion would have been hard to disprove.

She and personal trainer Bob Greene co-wrote a health guide, and sold the rights in 2005 for an amount that was rumored to be the world’s highest-ever book advance fee. Generally acknowledged as one of the most powerful and wealthy show business figures, by 2007 she was known in some quarters as the most influential woman in the world.

The current Forbes.com list of the world’s most powerful women places Oprah at #33, in a field of 100. (She is, incidentally, one of the oldest.) Along the way, she has often made another Forbes roster, that of the highest-paid entertainers.

(To be continued…)

Your responses and feedback are welcome!

Source: “Harpo Inc.,” Company-Histories.com, undated
Source: “15 Chatty Facts About The Oprah Winfrey Show,” MentalFloss.com, 09/08/16
Source: “Smithsonian’s ‘Watching Oprah’ a powerful reminder of why we miss her,” ChicagoTribune.com, 07/20/18
Source: “Oprah Winfrey launching new show on Apple TV+,” CNN.com, 07/28/20
Source: “15 Most Popular Daytime Talk Shows Ranked,” ScreenRant.com, 07/15/24
Source: “Oprah Winfrey Biography,” IMBD.com, undated
Source: “The World’s Most Powerful Women,” Forbes.com, 12/11/24
Image by spablab/Attribution-NoDerivs 2.0 Generic

Oprah Through the Years, Part 3

Pat Hartman December 24, 2024 No Comments

Harpo Productions Inc. began in 1986, and much of what will follow here comes from the Harpo Inc. website. In the same year, The Oprah Winfrey Show won three Emmy Awards. Ten years later, Oprah’s Book Club was formed, and astute readers purchased millions of books on her recommendation. The turn of the century marked the premier of O, The Oprah Magazine, which was published for 20 years. In 2007 the star was troubled by medical problems including confusing diagnoses first of hyperthyroidism, then of hypothyroidism.

In 2009, an episode of the TV show consisted of a hardcore intervention session for 16 obese teenagers led by medical professionals and counselors, and it brought a lot of attention to an under-recognized problem. Having already learned many things from the fitness guru Bob Greene, Oprah remarked about the adolescent guests, “How they got here goes way beyond junk food.”

Focus on the young

Before too long, another episode featured formerly obese young people, their parents, and grownup experts who spoke, complete with animated graphics, about the difference between gastric bypass and Lap-Band® surgery. A friend of the show Dr. Oz opined that the great majority of obese people eat to satisfy emotional need, and the huge advantage they have over other types of addicts is the legality of their preferred substance.

Eating is a socially acceptable addiction, and he is absolutely correct about that. One thing we know for sure about the earliest humans is that they shared food. Social eating has always been acceptable, since forever, in every dwelling place of humankind.

Dr. Diana Farmer, very wary of potential long-term problems, expressed reluctance about letting adults influence a child’s surgical fate. One of the dangers of bariatric surgery is the tendency of post-op patients to find other substances or processes to replace their food addiction. Some will instead take up drinking, which is especially dangerous because their drastically re-engineered interiors now respond to alcohol differently from how other people’s organs deal with it.

There is some speculation that bariatric surgery makes it impossible to cheat by routinely consuming too much. But that isn’t true, because a patient who is dedicated to self-destruction can easily eat their way over, under, around, and through what the doctors did, and mess themselves up big time.

And what about the star?

In his book Oprah Winfrey: The Real Story, CBS journalist-turned-biographer George Mair mentioned his subject’s several romantic disappointments, like a very sad parting in the early 1970s. Then in New York, there was a long affair with a married man over which, in 1981, she seriously considered ending her life, and to which she later attributed much of the blame for her weight problem.

Speaking of other loves, she referred to herself as having been addicted to various men. But at the base of that was an insatiable need for approval, because she really did not approve of herself, and wearing a layer of fat helped to “cushion herself against the world’s disapproval.”

How long has Oprah Winfrey been talking to the public about her weight, and the endless conflict caused by trying to keep it under control? Fifteen years ago, she observed that while her TV show and magazine were all about showing people how to live their best lives, her own behavior was far from exemplary. Here are two quotations from that era and one from 2010:

I was talking the talk, but I wasn’t walking the walk. And that was very disappointing to me.

I don’t have a weight problem — I have a self-care problem that manifests through weight.

My drug of choice is food. I use food for the same reasons an addict uses drugs: to comfort, to soothe, to ease stress.

There she was, one of the wealthiest women on earth, able to afford quality groceries, a personal trainer, spa retreats, a home gym, and virtually anything else that might help the slimming process — and her best efforts led to dismal failure. Having previously been able to get down to 160 pounds, she was unpleasantly surprised when one day the scale read 200. That kind of joke, no one has the sense of humor to handle.

In 2011, The Oprah Winfrey Show ended, and right around the same time, something pretty terrific happened — the publication of Bob Greene’s book, The Life You Want: Get Motivated, Lose Weight, and Be Happy. It wasn’t the first Oprah-related book that someone who worked for her had published. In 1994, there had been “In the Kitchen With Rosie: Oprah’s Favorite Recipes,” by Winfrey’s former chef, Rosie Daley.

Greene had always been wary of attributing too much importance to food, because “Weight is a symptom of something that needs to change. It’s usually not simply about food.” He formulated three questions that a person needs to answer if the weight-loss commitment is sincere:

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

It is necessary to identify the life circumstance that needs change, and the answer is highly individual. And, what if the answer is “I want a divorce” or something equally incendiary? Ideally, a person wants a better life, but defining that is an art form in itself. Also, it is necessary to name the factors that led to failure in the past, because they will certainly recur unless and until the person just figures out how to come at it in a different way.

All of which helps to explain why Oprah said of Bob Greene, “This guy has changed my life — affected my life — more than any other person on the planet.”

Your responses and feedback are welcome!

Source: “Harpo Inc.,” Company-Histories.com, undated
Source: “On abandoning “fattertainment”: Why the way we talk about childhood obesity matters,” Salon.com, 03/22/24
Source: “Oprah Winfrey: The Real Story,” by George Mair, 1996
Image by Richie Diesterheft/Attribution 2.0 Generic

Oprah Through the Years, Part 2

Pat Hartman December 19, 2024 No Comments

As a young woman, Oprah scored a great media job as a local news show co-anchor, but to witness the tragedies of people’s lives every day was emotionally demanding, and in terms of job satisfaction the experience wasn’t the greatest, either. Consequently, she learned how easy it is to bury problems under a ton of food.

By 1986, with her own national TV show, she had the opportunity to meet quite a number of relatives, many who whom had fallen on hard times. There was a basic desire to help family members, as well as a need to ask many hard questions in the process, and the conflict between those conditions was an emotional stumbling block. Then, there was guilt for feeling bad, which must be a sign of ingratitude. Shouldn’t her fabulous luck and newly won fame be enough to vanquish all anxiety?

In 1988 came the “biggest, fattest mistake” of Oprah’s public life so far. It was all part of creating 200 TV episodes per year, throughout several years of 16-hour workdays, and diet efforts that didn’t stick. And then at her heaviest, over 230 pounds, she met personal trainer and exercise physiologist Bob Greene, the person who taught her that while eating was a band-aid that could cover up any wound, it did not have to be the guiding force in her life.

“The answer to my prayers”

Greene didn’t judge; he didn’t label. Pointing out that the fabulously successful Oprah, of all the people in the world, was uniquely positioned to have the life she wanted, he asked the right questions:

Why don’t you do it? What do you really want? What is the best life possible for you?

She got down to seriously working out, and paying attention to her food intake, but focused most keenly on those life questions that concerned both her outer manifestation in the world and her inner relationship with herself:

You cannot ever live the life of your dreams without coming face-to-face with the truth. Every unwanted pound creates another layer of lies. It’s only when you peel back those layers that you will be set free… Tell the truth and you’ll learn to stop eating to satisfy emotional hunger and to stop burying your hopes and dreams beneath layers of fat.

Perhaps because Oprah never thought solely of herself, things only got better. In 2003 she described what had been one of the most satisfying experiences of her career, dealing with a show guest named David Caruso, who had lost over 300 pounds. He had always wanted to be able to sit behind the wheel of a Porsche automobile — so she gave him one, and later commented,

One of the reasons that moment was so powerful is that I know what it takes to lose that much weight. Do you know how many carrot sticks you have to eat? What he did was incredible.

By 2005, Oprah was down to a “toned 160 pounds.” In 1996, she and Greene had published a co-authored book, Make the Connection, and in 2007 they collaborated on Greene’s “Best Life Weight Loss Challenge” TV show, bringing six contestants to public attention. The doctors almost disqualified one man because he was in such terrible shape, but he ended up losing 71 pounds — more than any other participant — and no longer needed pharmaceutical intervention to maintain his health.

By 2008, Oprah’s weight had bounced back up again, and the medical profession was confused. She was diagnosed with hyperthyroidism, and then with hypothyroidism, and the whole situation was really starting to get to her, causing emotions that included anger. The fat had won.

There may be people incapable of embarrassment, but Oprah is not among them. Being such a highly visible public figure, she had to try on clothes in front of a whole team, and spent the year as “one of the most visible people in the world, trying not to be seen on the cover of my own magazine.” She felt defeated but still, deeply influenced by Greene’s teachings, realized that it wasn’t about the food:

It’s about using food — abusing food… Too much work. Not enough play. Not enough time to come down. Not enough time to really relax… I am hungry for balance. I’m hungry to do something other than work.

(To be continued…)

Your responses and feedback are welcome!

Source: “When Oprah Met Bob,” Oprah.com, January 2007
Source: “Oprah’s Top 20 Moments,” Oprah.com, undated
Source: “The Final Weigh-In,” Oprah.com, 11/28/07
Source: “Oprah’s Weight Loss Confession,” Oprah.com, 01/05/09
Image: Make the Connection/Fair Use

Oprah Through the Years, Part 1

Pat Hartman December 18, 2024 No Comments

The entire world is familiar with Oprah Gail Winfrey’s early biography. Born in the deep South; constantly shuttled from one relative to another; abused, molested, and impregnated as a child; a bereaved mother herself at age 14…

This all seems like the standard first chapter in a sordid tale of ruin. But no. Somehow, this extraordinary woman became a media professional before age 20, won awards for both her beauty and her brains, and went on to earn for herself a long list of descriptors that included the word “first” or the word “only.”

In 1986, she was nominated for both an Oscar and a Golden Globe for her performance in the role of Sofia in The Color Purple. The press mentioned her hefty figure as often as her multiple talents. In the mid-eighties, her weight often topped 200 pounds, and TV fans adored her.

The Oprah Winfrey Show, which had begun as a tabloid-type production, evolved into a venue for more serious topics. Some criticized the host for giving a platform to medical professionals with less-than-stellar credentials, while others admired her taste in literature. In any case, she became a trendsetter of unrivaled influence.

The big oops

In 1988, after existing for four months on a liquid protein diet and losing 67 pounds, Oprah acquired the equivalent number of pounds of animal fat and loaded it on a little red wagon. Wearing size 10 designer jeans and a form-fitting top, she pulled the wagon out onto the stage to graphically illustrate just how much of her former self no longer existed. The jeans were legit — her own pair that had actually been worn back in her Baltimore show-biz days.

It was an audacious stunt, but one that she later came to regret. In a 2005 interview, the star admitted, “Two hours after that show, I started eating to celebrate. Of course, within two days those jeans no longer fit!”

The episode was incredibly popular with audiences everywhere, but a few months later, Oprah had to admit that she had regained almost 20 of those pounds, and as time passed, the situation became much worse.

Years later, in a 2005 interview, she acknowledged what an embarrassing gaffe the stunt had been — “my biggest, fattest mistake.” Fat had become her trademark, a combination of a curse and a blessing. On the plus side, she was doing what she has always done best — looking after other people. She recalled the red wagon fiasco, using the ineradicable memory to grab attention for her current charity fundraising:

Winfrey has released a six-disc DVD collection of her biggest moments and interviews during the past 20 years of her show, with net profits going to Oprah’s Angel Network, a charitable foundation dedicated to helping educate and advance women and children around the world.

The more things change, the more they stay the same

Weight remained both a personal and a public issue. Many fans unburdened themselves by writing to Oprah, including a trio of young girls who appeared on the show along with their mothers, these live appearances presented along with candid films of moments in their daily lives.

According to the written description of the episode,

The children and their mothers address the emotional roadblocks that contribute to childhood obesity. By providing solutions, rather than showcasing problems, the show hopes to use the power of broadcasting in a positive manner.

Overall, a useful service was being performed. Audiences were being enlightened and delighted. Thanks to Oprah Winfrey, millions of Americans were learning things about which they might never have become aware, including the fact that a woman can be intelligent, talented, philanthropic, beautiful, successful, and overweight — all at the same time. Meanwhile, fate had something wonderful in store for the star.

(To be continued…)

Your responses and feedback are welcome!

Source: “The Stars of The Color Purple, Past and Present,” OprahDaily.com, 12/15/23
Source: “Oprah’s ‘Fattest’ Mistake,” CBSNews.com, 11/16/05
Source: “Oprah’s Top 20 Moments,” Oprah.com, October 2005
Source: “Oprah Winfrey laments her ‘biggest mistake,’” TODAY.com, 11/15/05
Source: “On abandoning ‘fattertainment’: Why the way we talk about childhood obesity matters,” Salon.com, 03/22/24
Image by get everwise/Attribution-ShareAlike 2.0 Generic

A Probiotic, and a GLP-1 Non-Substitute

Pat Hartman December 12, 2024 No Comments

For months, we have been hearing claims concerning the importance of GLP-1 and the expensive process of injecting a substance that acts like it into the body. Meanwhile, some researchers work on ways to induce the body to make more of its own hormone, right inside the gut microbiome, where it does the most good. The concept is to get in there where food cravings originate and stop them in their tracks.

According to an illustrated explanation, here is what happens. In the distal colon, beneficial bacteria go to work on fiber and metabolize it into butyrate, acetate, and propionate, meanwhile secreting P9 and other essential proteins, and stimulating mucin rejuvenation. All this activity in turn stimulates the production of GLP-1, which tells the pancreas to make insulin, which then alerts the brain to deactivate the mouth from eating, and instructs the stomach to hold onto its contents and not empty so fast. Et voilà! Food cravings are vanquished!

Now, this is based on preclinical studies, a phrase which often translates as, “Come back in a year, when we have solid results.” But the makers of this “powerful, multi-strain probiotic” sound very sure of themselves. The whole secret to their product or, to be fair, any similar products that might come along, is to encourage the thriving of the very best, most helpful and efficient strains of gut bacteria — in this case, a strain called Akkermansia and another known as Clostridium butyricum.

Here is the paragraph that catches the reader’s attention and encourages the eternal springing of hope:

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.

Moving on… A previous post took a deep dive into berberine, which turns out to not be everything that some folks say it is. The longer the subject is pursued, the more it seems that debunking berberine has become a minor industry. Yes, the substance appears to lower fasting blood sugar levels, and even to reduce BMI in some cases. And it does seem to encourage beneficial gut bacteria while suppressing the harmful kind.

On the other hand, it also produces unpleasant side effects like nausea, constipation, and diarrhea, just like the expensive injectables. Also, the list of people who should avoid it altogether includes “children and adolescents, pregnant and breastfeeding women, diabetic individuals and individuals with liver or heart disorders…” — so there’s that. On the third hand, unlike the GLP-1 RA drugs, berberine has not been observed to cause mental health issues, which would be a definite plus, if only it actually did a useful job.

In France, the agency that looks into food, environmental and occupational health, and safety, is called ANSES, and it…

[…] draws the attention of healthcare professionals to berberine’s ability to interact with numerous drugs, which could compromise the efficacy of certain treatments… [C]onsuming berberine-containing food supplements in combination with a drug treatment can inhibit its effects or lead to adverse effects… [T]he safety of use of these food supplements cannot currently be guaranteed.

Via a website in the business of selling a brand of semaglutide that costs only a fraction of what Ozempic does, Dr. Melissa VanSickle says this of berberine:

A significant challenge is its poor bioavailability; only a small portion is absorbed into the bloodstream when taken orally… Human clinical trials are few and often lack robustness. Some studies indicate that Berberine can lower blood sugar and improve cholesterol in type 2 diabetes patients, but these results are not definitive enough to recommend it as a standalone treatment.

A McGill University article comes right out and uses the H-word in the title: “Berberine. Don’t swallow the hype. Or the pill.“:

Berberine may indeed be “natural,” not that this has any relevance… Berberine has nothing to do with GLP-1.

The piece scoffs at the barely relevant studies found in “low-impact journals” with wildly varying dosages or the inclusion of other substances; or which have not tested the substance in subjects whose only problem was extra weight. Via another source, Dr. Lisa Kroon, who holds a very high academic position, confirmed:

It’s absolutely not nature’s Ozempic and does not work like Ozempic… It is a completely different mechanism… I think people are just grasping here and manufacturers of these supplements are just kind of creating a hype to try to be appealing for people looking for a magic potion to help them lose weight.

So. Definitely not a substitute for the GLP-1 drugs.

Your responses and feedback are welcome!

Source: “The Science Behind GLP-1 Probiotic,” PendulumLife.com, undated
Source: “Use of berberine-containing plants in food supplements,” Anses.fr, 11/25/19
Source: “Berberine vs Ozempic®: Understanding the differences,” BMIDoctors.com, 01/12/24
Source: “Berberine. Don’t swallow the hype. Or the pill.,” McGill.ca, 06/22/23
Source: “Berberine Isn’t ‘Nature’s Ozempic.’ But It May Help Manage These Conditions,” VeryWellHealth.com, 06/08/23
Image by NIH Image Gallery/Attribution 2.0 Generic

The Inevitable Growth of Companion Products

Pat Hartman December 10, 2024 No Comments

Way back in 2017, for DiabetesJournals.org, Deborah Hinnen noted that in a non-diabetes situation, expectations concerning weight loss should be realistic. This, she defined as looking to lose maybe 6 to 8 pounds altogether. Such a modest hope is quite different from the extravagant losses that have, since the advent of GLP-1 RA drugs, been reported in subsequent studies.

But the writer also noted that greater weight loss can be achieved, especially if the patient experiences the “feeling full” effect, and consequently eats less. And — here is the condition that, for the most part, is easier said than done — if the patient exercises conscientiously.

In those days, the potential of this genre of weight-loss drugs was not fully envisioned, and certainly not realized. But even back then, we can safely bet that the idea of “companion” products was a gleam in somebody’s eye.

A lot is going on today in the multifaceted world of seemingly magical weight-loss drugs that include semaglutides or GLP-1 RA drugs, such as Ozempic and Wegovy, as well as tirzepatides like Mounjaro and Zepbound. Will the questions ever end?

One very relevant query is, how many friends will the GLP-1 drugs eventually succeed in bringing to the party? We have discussed the companion candies that are meant to get some valid nourishment into the patient, in order to lessen the expected loss of lean muscle mass. This is only one of the ever-growing variety of supplementary foods created to make sure that enough of the right stuff gets into the diet of folks on the new drugs.

All is not well

By January of this year, it had been determined that a whopping 68% of patients were giving up on the GLP-1 meds before even 12 months had gone by. Even worse, by the 24-month (two-year) mark, six out of seven patients had flat-out discontinued the use of their GLP-1 medication.

But that is not all. Even though they had lost both fat and muscle mass, (and in some cases, muscle would constitute as much as 40% of the loss) the weight had a tendency to come back as pure fat, leaving them, for all practical purposes, worse off than before.

Even the CEO of digital health company Noomy warned that the drug alone is not enough. A regimen is needed too, a strong program incorporating a lot of changed behavior including a high-protein diet and some muscle-building exercise, or else…

[…] they risk losing a significant amount of muscle mass, strength, and bone density, which can result in lowered resting metabolic rate and worsening insulin resistance. All together this may lead to a complication called sarcopenic obesity, which is associated with worse prognoses from chronic disease and higher all-cause mortality.

In fact, Noom, the “highly-adaptable behavior change platform,” offers so many potentially helpful bells and whistles, to stay fit while shedding pounds could easily become a full-time job.

In February, Herbalife introduced its Nutrition Companion Classic, a product line that includes a shake mix, a protein drink mix, and a fiber drink available in a variety of flavors and designed to address the problems of malnutrition and decreased muscle density. These offerings are described as “low-glycemic, suitable for diabetics and vegetarians, presenting an opportunity for the development of diverse and accessible nutrition options for individuals on weight-loss regimens.”

Then in May, Nestlé, which had already quite definitively entered the companion product market, introduced a line called Vital Pursuit. It appears to consist of supplemental foods in the familiar guise of sandwich melts, pizzas, and bowls; described as high in protein, fiber, and nutrients, served up in budget-conscious portions “aligned to a weight-loss medication user’s appetite,” meaning, quite small.

In the following month, for Reuters, Jessica DiNapoli explained thoroughly how Nestlé avoids legal entanglements by not naming on the packaging the drugs to which its Vital Pursuit items are meant to be companions. Nestlé executive Tom Moe communicated that rather than mention the drug connection on wrappers, the company would do its marketing via social media. Other brands are more forthcoming, and will tell customers that their companion product might alleviate the nausea that many people experience from “the shot.”

(To be continued…)

Your responses and feedback are welcome!

Source: “Glucagon-Like Peptide 1 Receptor Agonists for Type 2 Diabetes,” DiabetesJournals.org, 2017
Source: “Noom GLP-1 Companion to Add “Muscle Defense” to Promote Safer GLP-1 Use,” BusinessWire.com, 01/19/24
Source: “Herbalife Debuts GLP-1 Nutrition Companion Classic,” TrendHunter.com, 02/15/24
Source: “Nestlé launches frozen food brand aimed at weight-loss drug users,” Axios.com, 05/21/24
Source: “Food companies wade carefully into weight-loss waters,” Reuters.com, 06/20/24
Image by David Shankbone/Attribution 2.0 Generic

Many-Sided Problem, Potent Solution

Pat Hartman December 5, 2024 No Comments

Today it is fashionable to assume that Artificial Intelligence will swoop in like a flying superhero and solve all the world’s puzzles. That hypothesis is far from proven. Another common belief is that the presumptive saviors, the new weight loss drugs, can and will be the answer for everybody with every type of counterproductive eating pattern.

Not so fast, starry-eyed optimists! Some cautious professionals are still, and quite appropriately, hung up on other basic questions, like who should decide which individuals really and truly need the GLP-1 RA drugs? Are children part of that population? For the young, shouldn’t other approaches be tried first? Especially an approach that involves neither surgery nor medication, because neither of those has proven to be totally harmless over the long term.

How much of what we categorize as dangerous obesity might actually be not-so-bad? Critics maintain that to categorize someone as in need of weight loss is often a matter of opinion. In this whole area of human experience, the wide variety of experiences is a minefield of possible error. Even adults who have logged plenty of miles and years are rarely able to control their eating habits, so how can we expect better from children? Even grownups need to be wary of solutions that seem too good to be true.

A cautious approach

An over-eater may coast along for many a year without feeling a serious need to address their issue, but could this be true for a professional actor vying for international prizes? A recent interview with Kathy Bates revealed interesting details of her experience, although not saying much about her weight status as a child. In fact, to search for evidence that obesity was a factor in her early years could occupy a solid chunk of time. It has, however, been documented that the mother-daughter relationship was far from ideal.

The photo on this page is from 2015 and the important thing is, even carrying a lot of extra pounds, Bates created a stellar acting career.

As time passed, some things happened, like major surgery, and type 2 diabetes. Eventually, and much to her credit, the artist did a self-appraisal and got serious. Over an approximately six-year period she lost 80 pounds, and then used Ozempic just long enough to shed another 20, landing at 145, which was 100 pounds less than her heaviest weight.

One drawback of Ozempic is that anyone who uses it (or similar drugs) and then quits will regain the weight. But maybe this is not an ironclad rule. In the course of vanquishing those 80 pounds, Bates had changed both the “what” and the “how” of her eating habits thoroughly enough to overcome that probability. It all paid off with a great new career opportunity, about which she says,

I wouldn’t have been able to withstand the long hours and the discipline of learning lines that a series requires. I can tuck in my shirts and close my jackets on set. I can stand all day and move in ways that were previously restricted by my weight.

I know it’s hackneyed, but for the first time in my life, I feel free of the sorrow and the burden […] of dealing with being a woman who can’t move and breathe.

After that segue to the “drawbacks” side of the equation, it is only fair to note that currently, what with one thing and another, many patients tend to have a miserable time with the GLP-1 RA drugs:

Perhaps these individuals could be better served by spending that money on psychological counseling, or any kind of therapy, rather than ingesting substances that may not offer permanent health, and indeed might cause actual harm.

Possible solution: May we suggest?

A recent article by Steve O’Keefe examines the concept of a universal addiction recovery program, giving BrainWeighve as an example, and asking and answering some questions:

Can it be fun? Can you turn recovery into a game? A challenging game? One with contests and conquests, rewards and disappointments, teams and fans? Can you make it a game where persons or teams are compensated with points, merchandise and prizes when they contribute solutions or assistance that other persons or teams find valuable?

It sounds like the universal addiction recovery program involves flipping the tables and using the mechanics of addiction to beat addiction. If you can make recovery self-directed, social and fun, the patient becomes addicted to recovery. And that’s a much healthier, happier affliction to deal with.

To dig into the question of whether BrainWeighve can be the answer for obese children and youth, here is a partial collection of our previous descriptions of various aspects of that program:

Your responses and feedback are welcome!

Source: “Kathy Bates at 76: What I Know Now,” AARP.org, 09/27/24
Source: “Toward a Universal Treatment for Addiction,” AddictionNews, 09/23/24
Image by Gage Skidmore/Attribution-ShareAlike 2.0 Generic

Weight-Loss Drugs and Human Subjects

Pat Hartman December 3, 2024 No Comments

In regard to GLP-1 RA drugs, a previous post asked a lot of questions about which questions most urgently need to be asked. That was only a few months ago, and maybe nothing major has happened, but the briefest web search assures us that plenty of people are working on it, and coming up with some startling possibilities.

The type of long-term research needed to settle all the questions must, obviously and unfortunately, be carried out over the long term — and by looking at the case files of many thousands of patients. Depending on variables, it must in some instances be extremely difficult for researchers to keep track of so many facts about so many people, over a span of years.

It may happen that some of the people under scrutiny develop conditions that take them outside the predetermined research parameters. They get pregnant, or move halfway around the world. Communication becomes difficult, or they just get tired of being totally conscious of and recording every detail of their existence.

Subjects may develop a reluctance to overshare, which morphs into an intense craving for privacy, especially if they are children entering adolescence, or teenagers turning into adults. Any individual might fall into a delusional wish to make the scientists happy; or feel the need, for whatever reason, to be less than honest with them.

You lookin’ at me?

When a subject is recruited, the research concerns literally every cell of their body. Tracking what they put into it and what comes out of it, is only the start. To live under a microscope can be taxing in ways that the subjects did not anticipate. Under those circumstances, some folks get antsy. They can fall into, or away from, religious or political convictions, or be caught up in an unhealthy emotional relationship, or be influenced by an individual who exerts control. They might be drafted into military service. In the worst case, some subjects die.

Over the long months that such observations should be expected to take, even the experience of mental or emotional growth could shake a person loose and make them unable to tolerate their participation for one more day. Just as some citizens will go to great lengths to avoid jury duty, a person who is really fed up with being part of an experiment will find a way out.

Ideally, a significant long-term study encompasses a very large number of participants. They might need to give up many informational tidbits, starting with simple ones like, “How much did your mother weigh when you were conceived?” and, “Now, 30 or 50 years later, how much do you weigh?” But gathering basic data is only the beginning.

Academia = intellectual rigor in lab coats

It all becomes fiendishly complicated, with linear miles of charts and suchlike. Another layer of complexity includes underlying philosophical assumptions and aspirations. According to what standards and rules must medical research be performed? What is seen as important, and what should be treated as even more important?

One thing we discover from research is how to do better research. Does the thinking on these matters advance, or has it solidified? When researchers write up their results, can they weasel without actually telling a lie? Why would anyone do that?

For a scientific researcher or anyone else, questions should never cease. Once a large number of 20-year studies of semaglutide, for instance, have been compiled, someone will come along and say, “Not good enough. This can’t be definitively judged until more evidence comes in — like for instance, a pile of 30-year studies.”

And quite rightly. Mistakes have been made. Science does not always progress in an immaculate, untarnished linear fashion. There have been errors and oversights, and that is unlikely to change.

Your responses and feedback are welcome!

Image by Beckie/Attribution 2.0 Generic

Of Mice and Men and Women

Pat Hartman November 29, 2024 No Comments

Anyone in any of the health professions will necessarily be aware of, and often intensely involved with, the results of scientific studies. Systemic investigations in the hard sciences include research development, testing, and evaluation that hopefully will contribute to the general pool of knowledge for the benefit of everyone.

How often do we think about what is really behind the numerous studies that must be completed in order for a drug or other treatment to eventually become acceptable to and accessible by the general public? Observing a caged rodent is a whole different proposition from keeping tabs on a human being. What behavior of the human subject will be observed? Will they be following their natural, normal course and recording it? Or dealing with something different being done to the natural course, like taking a different medication?

Any objections?

To track the trajectory of a planet is one thing. To convince a person to, for instance, meticulously record every particle of matter that goes into them and comes out of them is a whole different situation. Even with the most cooperative subject, in the most meticulously conducted experiment, there will be times when the person just wants out.

On other occasions, it might be that the professionals doing the research will decide to end a subject’s participation. In either case, there are plenty of guidelines and multiple strict rules, declared by different agencies, concerning any possible circumstance.

For the benefit of scientists connected with the Marshfield Clinic, MarshfieldResearch.org turned its attention to research itself in a document by Lori A. Scheller titled “Withdrawal of Subjects from Research.” In some instances, the participation of a human subject consists of interaction and/or intervention with the research team.

Or, it might be that their identifiable personal information is used, whether that information consists of data only, or specimens obtained from them. A whole set of rules defines what is considered individually identifying information. This is one of the circumstances that can lead to the involvement of lawyers.

A person might discontinue participation in a research study through voluntary withdrawal, and the federal government requires that human subjects retain the right to withdraw their informed consent at any time. In other cases, the Principal Investigator (PI) might end someone’s participation, for the good of the project. Of course, in any case where the PI withdraws a subject, it is strongly urged that the reasons be explained to that individual.

To prevent trouble, regulations demand that any prospective research participant (or parent of a participating minor) must be fully informed of their rights before they sign anything. The information about withdrawal, voluntary or otherwise, includes…

[…] statements that participation in the research is voluntary, that participation may be discontinued at any time without penalty or loss of benefits to which the subject is otherwise entitled, a description of any circumstances whereby an investigator may terminate a subject’s participation, consequences of withdrawal, and procedures for orderly withdrawal.

Then, there will be another whole set of rules about what happens to the data already generated by their previous involvement. For instance,

According to the guidance, a biological specimen collected but not analyzed prior to a subject’s withdrawal may not be analyzed following a subject’s complete withdrawal from a study…

The guidance states that an institution may choose to honor a subject’s request that his or her data be destroyed or excluded from further analysis at withdrawal, but only with agreement from the funding agency, and only if the research is not FDA-regulated.

Where the Food and Drug Administration is involved, however, there is a requirement for “all data collected on withdrawing subjects to remain as part of the study database or records after withdrawal.” This “ensures clinical study validity and prevents unreasonable risks to enrolled subjects, future subjects, and eventual users of marketed products”:

The FDA describes its concern that subjects who withdraw from research are more likely to have experienced adverse events or a failure of efficacy, and allowing exclusion of their data would increase the probability of introducing bias, and would negatively impact the scientific validity of the research.

What happens when a PI has to cope with a lot of the subjects quitting, or with the necessity to “withdraw” them through executive action? In that case, it might be time to fall back and regroup:

He or she should re-evaluate the protocol and determine whether changes are necessary to facilitate subject retention without weakening the scientific integrity of the research.

Your responses and feedback are welcome!

Source: “Withdrawal of Subjects from Research,” MarshieldResearch.org, 09/11/15
Image by Steve Jurvetson/Attribution 2.0 Generic

Oprah Through the Years, Part 5

Firsts

Onlies, Others, and Philanthropy

Oprah Through the Years — Part 4

Mosts

Oprah Through the Years, Part 3

Focus on the young

And what about the star?

Oprah Through the Years, Part 2

“The answer to my prayers”

Oprah Through the Years, Part 1

The big oops

The more things change, the more they stay the same

A Probiotic, and a GLP-1 Non-Substitute

The Inevitable Growth of Companion Products

All is not well

Many-Sided Problem, Potent Solution

A cautious approach

Possible solution: May we suggest?

Weight-Loss Drugs and Human Subjects

You lookin’ at me?

Academia = intellectual rigor in lab coats

Of Mice and Men and Women

Any objections?

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations

Food & Health Resources