Oprah Through the Years, Part 14 — What’s in a Word?

Back in 2010 Oprah Winfrey admitted to her audience, “I’ve never liked the term ‘food addict.'” Of course, over time, she had casually referred to herself as one of them, because it was the hip terminology, and because this is what a popular personality and influencer does. It’s the first lesson a stand-up comic learns, too. Start out with self-deprecation. Make fun of yourself, and the crowd will be on your side. Oprah went on to say,

I realize that I really have been one. And believe me, I — like so many of you — have punished myself for that. But I know that I’m not alone, and I know that the battle hasn’t ended.

In late 2023 the star confirmed that she was taking something, and made a public statement about how her thinking had evolved:

I had an awareness of [weight-loss] medications, but felt I had to prove I had the willpower to do it. I now no longer feel that way.

Some critics objected to her breakup with WeightWatchers, seemingly on the grounds that nobody should ever be allowed to change their mind, even when they recognize that previous moves may have been less than brilliant. Many people, having dared to move in a new direction, have been shocked to find it was not tolerated by either friends or the public.

Oprah described the benefits of changing her mind about the medication. The widely-quoted statement says,

The fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for.

As part of the 2024 Teapot Tempest, Vanessa Romo of NPR reported that Oprah intended to elevate the conversation, advocate for health equity, and work to reduce stigma. In particular, her intention was to ditch shame, both the kind dispensed by others and the brand she manufactured herself. She was finished with five oppressive decades of feeling like, “Why can’t I just conquer this thing?,” and refused to believe any longer that a lack of willpower was a personal failure.

Meanwhile, she was hiking, hydrating, timing her meals more sanely, and still tabulating WeightWatchers points. Because, and this is a very important point that people would rather not acknowledge — you still have to do the work.

Further thoughts

A few years later, Oprah spoke of having had a revelation while moderating a panel on weight:

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

She then consulted a doctor and was prescribed one of the new meds. On the shame issue (and many other matters) we see how Oprah adjusts her mind around new information, and can bring a large portion of America along with her. She has become something far more potent than a mere “influencer,” and is perceived as a moral arbiter.

This too led to her separation from WeightWatchers, which is a whole saga in itself. She added, “For the people who think that this (medication) could be the relief and support and freedom that you’ve been looking for your whole life, bless you.”

The part about obesity being a disease in the brain, is complicated in and of itself. Ultimately, everything is brain-linked in one way or another. And the connection between obesity and lab animal brains is different in quantity and quality from the connection between obesity and human brains. A person can think, “As long as I will need to wash a bowl anyway, I might as well have a large serving of stew, because that will justify using up the dish soap to wash just one dish.” No lab rat is capable of that quality of reasoning!

In the 2024 TV special, Oprah revealed,

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

How many times have I blamed myself because you think, ‘I’m smart enough to figure this out,’ and then to hear all along it’s you fighting your brain.

Your responses and feedback are welcome!

Source: “The Highs and Lows of Oprah Winfrey’s 50-Year Weight Loss Journey,” MSN.com, 2024
Source: “Oprah Winfrey Reveals She Uses Weight-Loss Medication as a ‘Maintenance Tool’: ‘I’m Absolutely Done with the Shaming’,” People.com, 12/14/23
Source: “After nearly a decade, Oprah Winfrey is set to depart the board of WeightWatchers,” NPR.org, 03/01/24
Source: “Oprah Winfrey says she has released the shame of being ‘ridiculed’ for her weight for 25 years,” ABCNews.go.com, 03/19/24
Source: “Oprah Winfrey reveals she starved herself ‘for nearly five months’ in ABC weight loss,” USATODAY.com, 03/18/24
Image by Javcon117*/Attribution-ShareAlike 2.0 Generic

A “Strong” Study Looks at Pediatric Obesity Treatment

Children who respond positively to pediatric obesity treatment show significantly lower risks of health problems and early death in young adulthood, according to a study published on January 21 in JAMA Pediatrics.

The gist of the study

Led by Resthie R. Putri, Ph.D., and a team from the Karolinska Institutet in Stockholm, Sweden, the researchers analyzed data from 6,713 children and adolescents with obesity, drawn from Sweden’s Childhood Obesity Treatment Register (BORIS) and compared them to general population data. The study used baseline information collected between 1996 and 2019 and analyzed outcomes in 2023.

Study’s results

The study tracked health outcomes for young adults, ages 18-30, from 2005 to 2020. The participants included children aged 6-17 who had received at least one year of obesity treatment. These individuals were compared to a group from the general population matched for sex, birth year, and geographic location.

The research team categorized the participants’ responses to obesity treatment based on changes in their body mass index (BMI) standard deviation scores. These categories included poor, intermediate, good, or remission of obesity. Health outcomes in young adulthood that were assessed included type 2 diabetes, dyslipidemia, hypertension, depression or anxiety, and the need for bariatric surgery.

The findings showed that compared to a poor treatment response, those who achieved obesity remission or had a good treatment response were at much lower risk for early death. Additionally, a good response was linked to a lower likelihood of developing type 2 diabetes, dyslipidemia, and requiring bariatric surgery. Only the remission group showed a reduced risk for hypertension. However, treatment response did not appear to influence the risk of depression or anxiety, a noteworthy observation as it suggests that these mental health conditions need to be addressed separately from obesity.

The study’s large sample size and Sweden’s universal healthcare system, which facilitated continuous data tracking, were key strengths. The authors noted that the results may not be applicable to other countries, as the study’s findings are based on Swedish data.

The commentary

One of the study’s authors, Emilia Hagman, who is a principal researcher at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet, commented:

The results are very good news. Whether or not the treatment of obesity in childhood has long-term health benefits has been debated, since weight-loss is hard to maintain… This emphasizes the importance of providing early treatment, as we know that timely intervention increases the likelihood of success and helps mitigate the long-term health risks associated with obesity.

In an accompanying commentary, Leonard H. Epstein, Ph.D., and colleagues praised the study for its robust design and the insights it offers into how much weight change is needed for significant health improvements, which could inform future treatment guidelines. However, they pointed out that the study didn’t specify the types or intensity of treatment provided to the children, which makes it difficult to compare with U.S. guidelines from the American Academy of Pediatrics (AAP).

The commentary also highlighted a key finding: Younger children (ages 6-11) had a higher rate of achieving good responses or remission compared to adolescents (ages 12-17). This suggests that earlier intervention in childhood may lead to better outcomes, emphasizing the importance of starting obesity treatment early rather than waiting to see if the child will “outgrow” the condition.

The bottom line

The study also found no strong connection between obesity treatment response and anxiety or depression, thus suggesting that these conditions should be treated independently of obesity. The study provides important evidence on how pediatric obesity treatment affects long-term health, including risks for cardiometabolic diseases, the need for bariatric surgery, and even mortality. This information is vital for refining clinical guidelines and improving obesity treatment strategies.

Your responses and feedback are welcome!

Source: “Successful Pediatric Obesity Treatment Linked With Long-Term Health,” Medscape, 1/22/25
Source: “Effect of Pediatric Obesity Treatment on Long-Term Health,” JAMA Network, 1/21/25
Source: “Weight-loss treatment for children with obesity has lasting effects, finds study,” MedicalXPress, 1/21/25
Image by Ketut Subiyanto/Pexels

Oprah through the Years, Part 13 — As a Co-operative Endeavor

We were discussing the book It’s Not Who You Know… It’s Who You Train, which Oprah collaborated on with Bob Greene. It starts with “Oprah’s Story,” and she also wrote chapter introductions. The amount of impetus that she gained through association with him is incalculable, perhaps partly because it has been a learning process all around. With luck, nobody comes fully formed to any relationship. With more luck, and maybe one or two other conditions, a healthy relationship is beneficial to both parties.

Greene is quoted as saying, “Two of the most accepted ways to deal with stress are to overeat and be a workaholic.” And it sounds like Oprah had been doing both, for a long while. But even here, there is ambivalence. For many people, the workhorse lifestyle has its advantages. Labor is a socially acceptable displacement activity for excess brain energy, and is generally more beneficial than overeating.

The person’s health may suffer in either case, but at least a workaholic is probably able to keep up with the bills. But there is a catch. Displacement activity, even the culturally approved kind like overworking oneself, is not always helpful… not when it is the symptom of a problem which, sooner or later, some effort ought to be made to fix.

It had to end

Oprah had been falling back on what, if viewed in a certain light, might seem like the perfect excuse. For a long time, she simply believed she did not possess willpower, just like she didn’t have blue eyes or size 7 feet. Ever since Greene began to influence her life, Oprah was obliged to think about his questions like, “Why is food my drug of choice?”

But at some point, the cognitive dissonance must have become impossible to ignore. Perhaps one morning, she awakened to the stark reality that sometimes, two things simply cannot both be true at the same time. Eventually, this paradox would become impossible to ignore. There must have been a day when Oprah asked herself something like this: “Let’s face it, I am famous and wealthy and most gloriously loved. If I don’t possess willpower, then how did I accomplish so much in terms of tangible, recognizable, undeniable success?”

Maybe this opens up an entirely new realm of possibilities. Maybe having willpower is not enough. Maybe the whole issue of avoiding obesity isn’t even about willpower. Or maybe Oprah had as much willpower as anyone, but it just wasn’t being properly deployed. Or maybe, in this instance, willpower was basically not the right tool for the job.

When things don’t add up

In 1988, a slim version of her former self had told the worldwide audience, “If you can believe in yourself, and believe that this is the most important thing in your life… you can conquer it.” But four years later, her weight almost hit 240 pounds, so obviously, an element was still missing from the equation.

The international star had been working intensely for years on projects and programs, using her sharp mind and many talents, not only to further her own career but to help and honor hundreds of thousands of people in ways both tangible and inexpressible. Oprah was stepping up in a brave new role. Her relationship with the world was changing, and so was her relationship with herself.

In 2020 she took a gigantic step in a fresh direction by featuring someone other than herself on the cover of O, The Oprah Magazine. This was Breonna Taylor, the medical technician who had been killed by police under extremely dicey circumstances. It indicated a new direction.

It might be useful to understand some things about Oprah’s decision-making process and the values behind it and so forth. We also speculated on how the different vocabularies used in various academic disciplines could obscure the fact that sometimes, wise and learned people might be talking about the same thing, and possibly with basic agreement on some essential point, even on the verge of finding philosophical harmony — but language gets in the way.

When a huge number of people are in trouble for wanting what they want, such as to indulge an insatiable appetite; and if that seems to others to be an undesirable condition or outcome; then perhaps the trick is to figure out why the person wants what they want. Helping Oprah to decipher this vital matter might be the main function that mentor Bob Greene has served.

(To be continued…)

Your responses and feedback are welcome!

Source: “It’s Not Who You Know… It’s Who You Train,” ChicagoTribune.com, 08/19/21
Image by Gerald Mendoza/Attribution 2.0 Generic

Oprah Through the Years, Part 12 — Bob Greene, Willpower, and Motivation

The previous post included some of the thoughts Dr. Pretlow has published on the subject of will/willpower. Now we look at precepts passed on to Oprah Winfrey by her longtime health and weight management coach, Bob Greene.

As reported in a Good Housekeeping article by Kate Coyne, the first inquiry that one should make to oneself is, “Do I have poor willpower?” As suggested in Part 8, the answer to that, in Oprah’s case, must have been an overwhelming “No!”.

Then comes a harder question: “Why is food my drug of choice?” For everyone who has ever engaged in a battle with their own body fat, figuring that out is a much more complicated challenge, which most folks apparently never quite manage to meet.

Possibly that difficulty is connected with the second Greene precept — taking responsibility. No fair blaming of family members, or job stress, or any other external factor. “If you’re offering up a lot of excuses, you’re wasting your time.” What is the antidote to time-wasting excuses? Stating goals, and making a solid commitment to meet those goals. It might help to draft a contract with oneself, and officially sign it — with the same degree of seriousness that one would give to any other binding legal document.

Adhere to your contract

An interesting feature of Greene’s philosophy is that he emphasizes the concept of willpower — “Your inner strength is most important” — and as suggested previously, perhaps everyone is naturally endowed with a great amount of inner strength, and the problem lies in their tendency to use it for different purposes, such as resisting any change in lifestyle or behavior.

Greene realizes that behavior change might have a better chance if it is introduced gradually, so don’t embark on an ambitious structured workout plan right from the jump. Use stairs instead of elevators, and if there are errands you can accomplish on foot, do that rather than drive. Walk the dog twice around the block instead of once. Just kind of creep up on change at first, and that deep-down revulsion against exercise might remain dormant. Then, follow his plan for a gradual increase.

The same goes for food, he advises. At first, cut out about 10% of the customary caloric intake; start learning about simple versus complex carbohydrates; cultivate a taste for vegetables; and enjoy a little bit of fat. And then, look into timing. At least three hours before sleep, stop eating. And over the long haul, expect ups and downs. There may be discouraging periods when it seems like nothing changes, so rather than give in to hopelessness, figure out how to cope with that.

Who you know

In 2021, Greene published a book titled It’s Not Who You Know… It’s Who You Train, referring of course to Oprah, who also had a hand in the authorship. Weight loss isn’t the main thing, but wellness is. Achieve a higher level of general wellness, and most people will find that weight loss comes much more easily. A person can lay a solid foundation for success by identifying and dealing with their emotional issues, and by pinpointing their counterproductive methods of stress alleviation and substituting more helpful ones.

An uncredited Chicago Tribune reporter wrote,

Although he was schooled to treat weight as a physical problem, his experience working with overweight people made it clear to him that psychological factors are crucial. Greene learned to probe for the reasons people seek comfort in food. “We need to start thinking about their motivations,” he says.“When I started employing that philosophy, that’s when I started having extreme success.”

Actually, maybe the motivation question is not that mystifying. Even an amoeba knows enough to take action to avoid pain. It probably also seeks pleasure. At any rate, Green provides a list of 10 habits which, if followed, will make a significant difference. One can will oneself into doing some things. For instance: always look for a way to turn a minus into a plus. Greene recognizes, for instance, that Oprah faces a lot of obstacles, starting with an inherently slow metabolism.

But even that, he turns into a plus, by acknowledging the stumbling block she deals with, and praising her for overcoming it:

“She can look at food and put on weight,” he says… “That’s why I think she’s one of best examples for other people… For her to get on the cover of Shape, I know how hard she needs to work. It’s harder than [it is for] 99 percent of the people.”

Your responses and feedback are welcome!

Source: “The Healthy Way to Lose Weight,” GoodHousekeeping.com, 04/05/04
Source: “ It’s Not Who You Know… It’s Who You Train,” ChicagoTribune.com, 08/19/21
Image by Get Everwise/Attribution-ShareAlike 2.0 Generic

The “Miracle Drugs” Are Not Without Risk

A new study of glucagon-like peptide-1 receptor agonists (GLP-1RA) effects revealed that they have proven benefits for weight management. However, less is known about their impact on various organs and body systems.

Carissa Wong, New Scientist Health Reporter, in her recent article, offered her takeaway:

Drugs like Ozempic and Wegovy, called GLP-1 agonists, carry more benefits than risks when taken for their approved uses, according to a comprehensive analysis of their effects on 175 conditions. The same may not be true for people taking the drugs for other uses, however.

News Medical also reported on the study, mentioning that demand for weight-loss medications like Ozempic and Wegovy continues to rise, with one in eight Americans using (or had used) them to treat conditions such as diabetes, heart disease, or obesity. Often referred to as “miracle drugs” by the media, patients, and some doctors due to their significant weight loss effects, GLP-1RAs also include drugs like Mounjaro and Zepbound.

The study’s findings

A new study conducted by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs (VA) St. Louis Health Care System assessed health outcomes in over two million people with diabetes who were using these weight-loss drugs. The study found notable improvements in cognitive and behavioral health, but also uncovered potential risks, such as an increased likelihood of pancreatitis and kidney issues. The study was published on January 20 in Nature Medicine.

The study’s senior author, Dr. Ziyad Al-Aly, a clinical epidemiologist and nephrologist at WashU Medicine, emphasized the importance of thoroughly examining the effects of these drugs, given their rapid rise in popularity and relatively recent emergence.

For the study, WashU Medicine researchers analyzed de-identified health records from the U.S. Department of Veterans Affairs, comparing outcomes between veterans using GLP-1RAs for diabetes and those on traditional medications like Jardiance, Glipizide, and Januvia. The dataset included over two million veterans treated for diabetes between 2017 and 2023, spanning various ages, races, and genders.

The benefits and the risks

The results showed that GLP-1RA drugs were linked to significant improvements in mental and behavioral health, including a reduced risk of seizures, addiction to substances like alcohol, cannabis, stimulants, and opioids, and even a lower likelihood of suicidal thoughts, self-harm, bulimia, and psychotic disorders like schizophrenia. These medications were also associated with a decreased risk of neurocognitive conditions such as Alzheimer’s and dementia.

Dr. Al-Aly explained that these drugs work on brain areas involved in impulse control and reward, which could help explain their effectiveness in reducing both appetite and addiction behaviors. Additionally, they seem to reduce brain inflammation, which may contribute to improved brain health and a reduced risk of Alzheimer’s and dementia.

However, the benefits, while meaningful, are modest, with reductions of around 10% to 20% for most outcomes. Despite this, Dr. Al-Aly emphasized that even small improvements can be valuable, particularly for conditions like dementia, where effective treatments are limited. These drugs may also be more beneficial when combined with lifestyle changes or other medications.

The study reaffirmed previous findings that GLP-1RA drugs can lower the risk of heart attacks, strokes, and other cardiovascular issues. However, it also highlighted some negative side effects, including gastrointestinal problems like nausea, vomiting, diarrhea, and, in rare cases, stomach paralysis. These side effects are already well-known in the medical literature and have been observed anecdotally.

More concerning, though, are the potential risks to the pancreas and kidneys. While these adverse effects are relatively rare, they can be severe, and Dr. Al-Aly stressed that doctors need to monitor patients carefully for signs of pancreatitis and kidney issues, which can develop without obvious symptoms until they are advanced and harder to treat.

An unexpected self-reported side effect

Journalist Johann Hari was recently interviewed by A. Pawlowski, TODAY Health Reporter, about his journey of taking Ozempic and Wegovy. He was prescribed the drugs in 2023, for weight loss, as Hari weighed 203 pounds and had a body fat percentage of 32%. Eventually, Hari lost 42 pounds and wrote a book, “Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs.”

To the interviewer’s question about what specifically bothered Hari about taking the meds, he replied:

For myself, the one risk that I didn’t see coming was the psychological effect. That was really strange. For the first six months I was taking the drug, I was getting what I wanted — I was losing loads of weight, my back pain went away, all sorts of good things happened.

But I didn’t actually feel better in my emotions. If anything, I felt slightly worse. I realized it was about my inability to comfort eat, and how bad that was making me feel.

No longer being able to use food as a stress-coping mechanism, Hari had to face “the deep underlying emotional reasons why you ate in the first place.” He said,

I realized how much of my eating was about the need to comfort myself — stuffing myself to calm myself. And I couldn’t do that when I was on Ozempic.

The bottom line remains the same. While GLP-1RA medications offer broad health benefits, the study underscores that they are not without risks. Their potential applications are vast, but careful monitoring is essential to manage the associated risks.

Your responses and feedback are welcome!

Source: “How GLP-1 drugs like Ozempic and Wegovy affect risk of 175 conditions,” New Scientist, 1/20/25
Source: “Benefits and risks of popular weight-loss drugs revealed,” News-Medical, 1/20/25
Source: “Is Ozempic a ‘magic’ drug? Author who lost 42 pounds on benefits, ‘very real concerns’,” TODAY, 6/20/25
Image by Andres Segura/Pexels

Oprah Through the Years, Part 11 — Concepts of Will

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

Dr. Pretlow

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

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

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

… Which leads back to willpower

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

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

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

Stating this another way:

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

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

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

Your responses and feedback are welcome!

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

Oprah Through the Years, Part 10

This definition appears on many, many web pages:

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

A lengthy online search reveals two things:

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

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

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

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

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

Getting a grip on will

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

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

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

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

Your responses and feedback are welcome!

Image by aphrodite-in-nyc/Attribution 2.0 Generic

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

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

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

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

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

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

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

Positive experiences included things like:

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

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

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

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

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

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

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

Your responses and feedback are welcome!

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

Oprah Through the Years, Part 9

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

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

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

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

A mortifying fiasco

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

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

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

Messing with their self-esteem

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

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

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

Your responses and feedback are welcome!

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

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

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

The purpose of the e-health study

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

Methods of the study

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

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

The study results

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

Why it matters

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

Social media’s impact on binge eating, a study

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

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

Dr. Carnell said:

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

Carnell observed that social media use increased with age:

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

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

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

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

Your responses and feedback are welcome!

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

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

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

About Dr. Robert A. Pretlow

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

Presentations

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

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

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

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

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

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

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

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

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

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