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

Oprah Through the Years, Part 1

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

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

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

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

The big oops

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

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

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

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

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

The more things change, the more they stay the same

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

According to the written description of the episode,

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

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

(To be continued…)

Your responses and feedback are welcome!

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

A Probiotic, and a GLP-1 Non-Substitute

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

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

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

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

Gut bacteria can significantly impact weight, independent of genes. Transplanting the microbiome from an obese twin drives obesity. Conversely, transplanting the microbiome from a healthy twin drives weight loss.

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

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

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

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

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

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

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

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

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

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

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

Your responses and feedback are welcome!

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

Are GLP-1 Receptor Agonists Safe for Children?

Weight loss medications like Ozempic and Wegovy are becoming increasingly popular, especially as alternatives to the traditional and often ineffective advice of “eat less and exercise more.” These drugs, known as GLP-1 receptor agonists, have gained favor among adults but are also becoming more widely used by children and teenagers (here’s a good rundown on their types, benefits and side effects).

Adolescent use of GLP-1 medications surges

A recent article published on the MedicalXPress website cites a CDC statistic that roughly one in five children in the U.S. is affected by obesity. And, according to a University of [BLOCKQUOTE] study,  the use of GLP-1 medications among adolescents has surged, with over 30,000 young people aged 12 to 17 taking the drugs in 2023.

Are weight loss drugs safe for children under 12?

Doctors generally agree that addressing obesity early can prevent future health problems, but prescribing weight loss drugs to children brings its own set of challenges. Dr. Chris Straughn, a pediatrician in Dallas, explains that while research indicates that GLP-1 medications can be effective and safe for children and teens, the available studies only track their effects over a few years. As these drugs are relatively new, more time is needed to fully understand their long-term impact.

Wegovy, a version of Ozempic, is FDA-approved for children as young as 12, though it has not been approved for those younger than 12. There are ongoing studies on its use in younger children, and some research on Saxenda (a precursor to Wegovy) shows it can be effective for kids aged 6 to 12. This kind of research is promising for the potential use of GLP-1s in younger patients.

The study, which included 82 participants, found that when children discontinued Saxenda, their BMI began to increase once more. This suggests that to maintain the weight-related benefits as they grow, children may need to stay on the medication. The findings were presented Tuesday at the annual meeting of the European Association for the Study of Diabetes in Madrid and were also published in the New England Journal of Medicine.

Dr. Dan Cooper, a pediatric researcher at UC Irvine, agrees that GLP-1 medications can be useful in certain cases, such as when a child is already developing or has developed diabetes. However, he cautions that the risk-benefit balance is less clear in other children, especially since there is limited research on the long-term effects of GLP-1 use in growing bodies. Puberty is a critical period for bone, muscle, and brain development, and Cooper warns that altering a child’s energy balance during this time could have lasting consequences.

Dr. Cooper reminds parents not to feel ashamed if their child struggles with obesity or weight-related issues. He says,

No one should feel ashamed… Obesity is often driven by biology, and it’s not something to blame yourself or your child for.

The need for alternative solutions

As obesity rates continue to rise, many people are turning to prescription medications like Ozempic for weight loss. However, these drugs come with significant side effects, accessibility challenges, and high costs, highlighting the need for alternative solutions. We’ve discussed them before, including berberine and natural supplements.

A new natural treatment emerges

Researchers at the University of South Australia have developed a new, natural, food-grade treatment for obesity that not only helps reduce weight and improve metabolic health but allegedly does so without the negative side effects commonly associated with other medications.

The new treatment, called InuMCT microcapsules, is made from a combination of plant fiber (inulin) and MCT oils derived from coconut and palm kernel oils. This formulation helps reduce inflammation and improve key metabolic markers, such as blood glucose levels.

In a 21-day study, the InuMCT microcapsules demonstrated several significant benefits:

  • Weight reduction: The microcapsules led to a substantial decrease in weight gain caused by a typical western diet, which is high in fats and linked to obesity.
  • Blood sugar control: Blood sugar levels were reduced by 15%, an important factor in managing both obesity and diabetes.
  • Reduced inflammation: Inflammatory markers dropped by 78%, which is crucial, as inflammation is a major contributor to obesity and related diseases.
  • Liver health: Liver enzyme levels decreased by up to 47%, as high liver enzymes are often associated with poor diet and obesity.
  • Gut health: The microcapsules improved protective gut bacteria by 8.3-fold, supporting the gut lining and helping prevent conditions like “leaky gut syndrome.”

 

Amin Ariaee, a Ph.D. researcher at UniSA, explains that InuMCT offers a natural solution for obesity and related metabolic conditions:

Obesity is a global epidemic with many complex health issues beyond just weight gain… It’s a state of systemic inflammation driven by complex biochemical processes, rather than just excess calories. Unfortunately, current treatments often overlook the role of the gut microbiome, focusing instead on symptoms like weight and high blood sugar. Additionally, anti-obesity drugs can harm the gut microbiome, leading to unpleasant side effects like nausea, stomach pain, and diarrhea, and potentially making long-term inflammation and weight gain worse.”

Our research is different. The InuMCT microcapsules are made from natural, food-grade ingredients that support a healthy gut microbiome, reduce inflammation, and effectively address excess weight. The results have been very promising, both in terms of weight reduction and overall metabolic health.

Your responses and feedback are welcome!

Source: “Are weight loss drugs like Ozempic, Wegovy safe for kids?,” MedicalXPress, 12/9/24
Source: “Obesity drug worked in children ages 6 to 12, study says, raising hopes and concerns,” StatNews.com, 9/10/24
Source: “New food-grade natural solution created for tackling obesity,” News-Meidcal.net, 12/2/24
Image by Mika Baumeister on Unsplash

The Inevitable Growth of Companion Products

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

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

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

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

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

All is not well

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

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

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

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

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

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

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

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

(To be continued…)

Your responses and feedback are welcome!

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

Many-Sided Problem, Potent Solution

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

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

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

A cautious approach

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

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

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

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

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

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

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

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

Possible solution: May we suggest?

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

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

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

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

 

Your responses and feedback are welcome!

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

Study Finds That Weight Loss Drugs Reduce Alcohol Craving

A recent study found that many people using medications for obesity, such as Mounjaro or Wegovy, report a decreased enjoyment of alcohol.

The study, which surveyed WeightWatchers members on obesity medications, found that around half of those who previously drank alcohol reduced their consumption after starting the medication. As was reported by NPR, Tamara Hall, 45, a mother of three, is one such example. She began using Mounjaro in 2023 as part of a WeightWatchers program to manage her obesity and elevated blood sugar. Hall has since lost over 100 pounds, and although she was never a heavy drinker, she now consumes significantly less alcohol.

Hall, whose blood sugar levels have improved, was a moderate drinker who previously enjoyed wine or cocktails at social events. Hall found that her tolerance for alcohol dramatically decreased after starting the medication. One drink would make her feel full and dizzy, an effect she hadn’t experienced before. As a result, cutting back on alcohol was easy.

She said:

I feel amazing… It’s life-changing… I didn’t know it would have this effect — I just don’t crave alcohol anymore, and that’s a huge benefit.

The findings align with a new study published in JAMA Network Open. The study, “Alcohol Use and Antiobesity Medication Treatment,” explored the impact of anti-obesity medications (AOMs) on alcohol use among people in the WeightWatchers telehealth weight management program (January 2022–November 2023). As reported by Medical Xpress, participants had a mean age of 43 and were primarily female (86%). They were prescribed various AOMs, including GLP-1 receptor agonists (e.g., liraglutide, semaglutide), metformin, and bupropion/naltrexone (Contrave).

Of the 7,491 participants who used alcohol at baseline, 45.3% reduced their consumption, while 52.4% showed no change, and 2.3% increased their intake. Those with higher obesity levels and baseline alcohol use were more likely to reduce alcohol consumption. Notably, those taking bupropion and naltrexone had the greatest reduction in alcohol use, likely due to naltrexone’s ability to reduce cravings and rewarding effects, though this effect seemed tied to weight loss rather than the medication itself.

When adjusting for weight loss, the effect of bupropion and naltrexone disappeared, suggesting weight loss as a key factor in alcohol reduction. If AOMs reduce alcohol use through weight loss (e.g., via GLP-1 RAs), adjusting for weight loss might obscure the true contribution of the medications.

Interestingly, the reduction in alcohol consumption was observed across both newer obesity medications like Mounjaro and older drugs like metformin. “What surprised me was that alcohol consumption decreased among people using all types of anti-obesity medications,” says study author Lisa Matero, a health psychologist at Henry Ford Health. One possible explanation is that being part of a weight management program could encourage overall healthier behavior changes.

The study’s results add to a growing body of evidence suggesting that GLP-1 drugs, such as Mounjaro, have wide-ranging effects on behavior. Clinical trials of these medications have shown that participants report changes in their habits, such as drinking less or shopping less. Dr. Robert Kushner, a researcher at Northwestern University, explains that these drugs influence both appetite and the brain’s reward system, which may explain why many people also experience reduced cravings for alcohol.

While research on the topic continues, the findings highlight the potential of weight-loss medications not only for weight management but also for altering lifestyle habits like alcohol consumption. This comes at a time when there’s growing cultural awareness around the benefits of reducing alcohol intake for overall health and wellness.

Your responses and feedback are welcome!

Source: “Dizzy after one drink? Social drinkers on obesity drugs lose the taste for alcohol,” NPR, 12/2/24
Source: “WeightWatchers combined with weight loss medications may alter alcohol consumption, study finds,” Medical XPress, 12/1/24
Image by Heshan Perera on Unsplash

Weight-Loss Drugs and Human Subjects

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

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

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

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

You lookin’ at me?

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

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

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

Academia = intellectual rigor in lab coats

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

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

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

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

Your responses and feedback are welcome!

Image by Beckie/Attribution 2.0 Generic

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Profiles: Kids Struggling with Weight

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The Book

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

About Dr. Robert A. Pretlow

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

Presentations

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

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

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

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

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

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

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

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

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

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