Oprah Through the Years, Part 8

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

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

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

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

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

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

Say what?

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

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

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

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

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

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

Will means want; willpower means wantpower.

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

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

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

(To be continued…)

Your responses and feedback are welcome!

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

Oprah Through the Years, Part 7

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

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

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

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

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

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

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

In an interview the same year, she said,

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

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

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

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

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

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

(To be continued…)

Your responses and feedback are welcome!

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

New Year’s Resolutions and Healthcare Predictions

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

The GLP-1 receptor agonist market will keep flourishing

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

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

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

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

New Year’s resolutions: the poll

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

Why It matters

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

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

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

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

Poll results

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

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

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

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

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

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

What’s next?

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

Your responses and feedback are welcome!

Source: “What’s next for GLP-1 weight-loss drugs in 2025?,” Yahoo Finance, 12/24/24
Source: “3 biggest catalysts expected for healthcare in 2025,” Yahoo Finance, 12/24/24
Source: “Here’s How Americans Want to Change Their Lives in 2025: New Poll,” Newsweek, 12/28/24
Image by Arina Krasnikova/Pexels

Oprah Through the Years, Part 6

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

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

Calling it an “aha moment,” she said,

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

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

She also said,

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

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

You heard it here

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

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

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

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

Your responses and feedback are welcome!

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

Oprah Through the Years, Part 5

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

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

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

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

Firsts

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

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

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

Onlies, Others, and Philanthropy

According to the Harpo Inc. site,

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

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

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

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

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

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

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

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

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

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

Your responses and feedback are welcome!

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

Oprah Through the Years — Part 4

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

December Holidays Generate Half the Yearly Weight Gain

With the holiday season in full swing, let’s bring our attention to a study that specifically addresses how to handle the issue of overeating during the festive season that’s typically laden with rich foods, food-centric gatherings, tempting sugar bombs, and not necessarily focusing on healthy eating.

A recent systematic review and meta-analysis published in Obesity Reviews, highlighted and analyzed in a recent Medscape article, suggests that interventions during holidays and school breaks could help prevent weight gain in both children and adults. Research indicates that certain times of the year, including Christmas and summer vacations, are particularly linked to weight gain. For adults, nearly 50% of their annual weight gain happens during December.

Study overview

The study was led by Dr. Michelle Maree Haby de Sosa, an epidemiologist at the University of Sonora, Mexico. She explained that the research team first conducted a narrative review of weight gain during the holiday season. They found that the six-week period between December and mid-January is a critical time when people gain up to half of their annual weight. This finding emphasizes the importance of addressing obesity and overweight through lifestyle changes and prevention efforts.

The research team then performed a systematic review of global interventions aimed at preventing weight gain during these periods. They searched multiple databases, including Medline, EMBASE, and Cochrane, and focused on randomized controlled trials. Additional data were also gathered from gray literature and studies not included in the original search.

Key findings

The review covered studies from the United States (10), the United Kingdom (1), and Chile (1). The studies varied in their risk of bias, with two showing low risk, two moderate, seven high, and one critical. Most interventions targeted children and adults, and interventions for adolescents were particularly challenging due to the difficulty in changing behaviors at this age.

In children, interventions implemented during summer vacations (lasting 6-8 weeks) included physical activities, nutrition classes, and the provision of healthy meals. These programs resulted in slightly less weight gain compared to control groups. One meta-analysis of four studies found a small but significant reduction in body mass index (BMI) z-scores in the intervention group.

Among adults, interventions also showed positive effects, though results varied based on how the programs were carried out. A meta-analysis of five studies involving 462 participants indicated a slight reduction in body weight, although the result was not statistically significant.

Three main intervention areas were identified: nutrition, physical activity, and psychological support, including behavioral and cognitive strategies. Rather than strict diets, participants were encouraged to reduce their intake of high-calorie foods and sugary drinks and to increase vegetable consumption.

Promising interventions

The study highlighted effective interventions for both children and adults:

  • For children, 6- to 8-week summer camps with daily physical activities and nutritious meals proved effective.
  • For adults, daily weight monitoring, along with nutrition counseling based on social cognitive theory, also showed promise, especially during the critical holiday period between mid-November and early January.

Expert recommendations

Dr. Carlos Cristi-Montero, a researcher at Pontificia Universidad Católica de Valparaíso in Chile, emphasized the importance of portion control for children, particularly during the holidays when families often serve calorie-dense foods. He also recommended using tools like dual-energy X-ray absorptiometry to assess not just weight, but also fat and muscle mass.

Cristi-Montero also stressed the importance of physical activity and the need for education on healthy eating and weight management. Both he and Dr. Haby de Sosa agreed that teachers, parents, and primary care professionals have a crucial role in reinforcing healthy behaviors and driving effective interventions.

Future research

The University of Sonora team is currently conducting a controlled trial in Hermosillo, Mexico, focusing on adult participants. Early results highlight the effectiveness of strategies such as nutrition education, physical activity, regular weight goals, and psychological support in promoting long-term behavior changes.

The study’s authors concluded that interventions to prevent weight gain during the holidays and school breaks are crucial, and they call for more research to assess their effectiveness in different regions.

Your responses and feedback are welcome!

Source: “Strategies to Manage Metabolic Health During the Holidays,” Medscape, 12/19/24
Source: “Interventions for the prevention of weight gain during festive and holiday periods in children and adults: A systematic review,” Wiley Online Library, 9/14/24
Image by Adrian Vieriu/Pexels

Oprah Through the Years, Part 3

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

Is the U.S. Obesity Epidemic Finally Turning a Corner?

For the first time in more than a decade, there’s a glimmer of hope in the battle against obesity in the United States. According to a recent study published in the JAMA Health Forum, obesity rates in the U.S. have shown a slight but meaningful decline. After years of relentless increases, the percentage of American adults considered obese dropped from 46% in 2022 to 45.6% in 2023 — a small but significant dip that offers a new sense of optimism about the country’s ongoing struggle with obesity.

The study’s findings

For ABC News, Niki Iranpour, M.D., who is an internal medicine resident at New York-Presbyterian/Weill Cornell Medical Center and a member of the ABC News Medical Unit, took a look at the study’s findings and implications.

The study, which tracked the body mass index (BMI) of 16.7 million U.S. adults over a 10-year period, revealed an important milestone. After a decade of rising obesity rates, the average BMI, which reached 30.24 in 2022, plateaued and then slightly decreased to 30.21 in 2023. For many public health experts, this marks the first real sign that the alarming trend of rising obesity may be reversing.

John Brownstein, the study’s co-author, and a professor of pediatrics at Harvard Medical School, expressed cautious optimism about the findings. He said:

What we’re seeing for the first time is that curve is bending and shows a sign of hope for something that was really a threat to American public health for so many years.

While the drop is small, it’s still a hopeful shift in a battle that has been fought for decades. Since the early 2000s, the obesity rate in the U.S. has steadily climbed, contributing to a host of health issues including diabetes, heart disease, and certain cancers. A decline, even a modest one, suggests that something — perhaps multiple factors — is finally starting to make a difference.

The role of semaglutide and GLP-1 medications

While they’re still being evaluated for safety, especially for children, one factor that may be contributing to this positive change is the increasing use of weight loss medications, particularly semaglutide. Semaglutide, the active ingredient in the medications Ozempic and Wegovy, belongs to a class of drugs known as GLP-1 receptor agonists. Originally developed to treat type 2 diabetes, these drugs have been shown to significantly aid in weight loss, making them a game-changer for people struggling with obesity.

Between 2019 and 2023, the use of GLP-1 medications for weight loss increased by a staggering 700%, according to one study published in Annals of Internal Medicine. These drugs work by mimicking a hormone that helps regulate blood sugar and appetite, leading to reduced hunger and weight loss. Given their growing popularity and effectiveness, many experts believe that the widespread use of semaglutide may be helping to turn the tide on the obesity epidemic.

Brownstein and his team pointed out that regions in the U.S. where these medications have been dispensed most — particularly in the South — saw some of the most significant declines in obesity. The South also happens to be a region where obesity rates have historically been high, and the use of weight loss medications is rapidly growing.

Other factors at play

While semaglutide and other GLP-1 medications likely play a key role in the decline, experts caution that there are likely other contributing factors as well. For one, the pandemic had a profound impact on lifestyle habits, and as people returned to more normal routines after the height of COVID-19, some may have become more active and healthier.

Benjamin Rader, an assistant professor at Harvard Medical School and a co-author of the study, suggested that the emergence from pandemic isolation could be influencing this trend. He said:

People are potentially starting to be more active again, stopping the sedentary habits they picked up during COVID… This shift toward more physical activity, combined with a greater awareness of the risks of obesity, may be encouraging healthier choices.

Additionally, the South’s high obesity rate and increased use of weight loss medications were also accompanied by a disproportionately high number of COVID-19 deaths among people with obesity. This tragic impact could have prompted more individuals to seek medical intervention, including weight loss treatments, as a way to manage their health.

A long road ahead

While the findings of this study are encouraging, experts warn against jumping to conclusions. Anne Peters, M.D., a professor at the Keck School of Medicine, emphasized that it’s still too early to determine whether this slight decline in obesity rates will persist in the long term. She told ABC News:

We need to look at this as a positive indicator in a specific database… That may mean that people are doing better and that including therapies [is] helpful, but we need to see how that plays out over time.

Will the trend continue?

As we move into 2025 and beyond, all eyes will be on the U.S. obesity rates to see if this downward trend continues. The increased availability of medications like semaglutide, combined with a renewed focus on physical activity and healthier lifestyles post-pandemic, offers a glimmer of hope that the U.S. may finally be on the road to reversing its obesity epidemic.

For now, the slight decline in obesity rates is a reason to celebrate — but also a reminder that the journey toward healthier habits and improved public health is a long one. The real question is whether this momentary dip will continue into the future or whether the country will face new challenges ahead in the fight against obesity.

Only time will tell.

Your responses and feedback are welcome!

Source: “US obesity rates drop for 1st time in a decade, with possible help from weight loss medications,” ABC News, 12/13/24
Source: “Changes in Adult Obesity Trends in the US,” JAMA Network, 12/13/24
Image by Ketut Subiyanto/Pexels

Oprah Through the Years, Part 2

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

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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.