Oprah’s plight

The media is alive today with advanced reports that the January issue of O magazine contains an interview with its namesake Oprah Winfrey in which she divulges that she has once again become obese. (here, here and here)

Apparently the queen of daytime TV (and my neighbor down the street) has ballooned up to 200 pounds.  And, if her statement on the cover of her magazine can be believed, she wonders how it happened. I’ve read a few of the articles, most of which quoted her from the advance copy of her January magazine.  As I read her quotes I realize that despite all her fame and wealth, she is basically just like any other middle-aged woman prone to obesity.  Let’s let her talk.

I’m mad at myself…

I’m embarrassed. I can’t believe that after all these years, all the things I know how to do, I’m still talking about my weight. I look at my thinner self and think, ‘How did I let this happen again?’

I was so frustrated I started eating whatever I wanted — and that’s never good.

I felt like a fat cow. I wanted to disappear.

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

When it comes to maintaining my health I didn’t just fall off the wagon. I let the wagon fall on me. I didn’t follow my own fundamental rule of taking care of self first.

Sound familiar?

During my recent Photo food diary blog, a number of people commented that I had it easy because MD prepares all my food, as if the only reason I can stay thin is that someone waits on me hand and foot.  Well, Oprah has an entire staff to prepare whatever she wants whenever she wants it, and it hasn’t helped her.  Apparently all the money in the world and all the ability to hand pick any expert or consultant she might want to hire have not done the trick.  What’s the deal?

Why does Oprah have such a problem?

As you might imagine, I have a few thoughts on the matter.

According to Oprah’s biography, she was born to a poor single mother in rural Mississippi.  I would assume that her mother, like most poor rural people, consumed primarily a carb-based diet.  Why?  Carbs are cheap.  One of the reason poor people are fatter in general than well-off people, is that poor people eat a lot more carbs for budget reasons.  Another reason poor people are fatter is a little less known, but surely applies to Oprah.

When pregnant women load up on refined carbohydrates during pregnancy, especially during the first trimester, they end up damaging the developing pancreas of the fetus.  The pancreas is pretty much developed during the first trimester, so a chronic high load of glucose in the mother’s blood that crosses the placenta ends up programming the fetal pancreas in much the same way that a huge chronic glucose load over a long time in adults creates insulin resistance.  This situation has been published about extensively in the medical literature.  The phenomenon is called fetal programming.  Babies born are basically  programed to become insulin resistant and obese.  These kids tend to develop obesity and insulin resistance more easily than others and have a tougher time dealing with it.  I’m sure that Oprah falls into this category.

Just like any adults who have glucose intolerance, insulin resistance, and/or diabetes, these fetally-programmed people tend to do better on low-carbohydrate diets than on low-fat/high-carb diets.

The only diet Oprah really did well on was the Optifast diet, the one on which she lost 67 pounds and looked great.  The Optifast diet is the high-protein, low-fat, low-calorie diet that Oprah followed for four months.  She then appeared on her show in a pair of size 10 jeans.  The problem with the Optifast diet is that people who finish the program are encouraged to begin following a low-fat maintenance diet.  Many people lose a lot of weight on the diet, then turn around and go face down in all the food they’ve been denying themselves while they lost.  Oprah is no exception. She speaks of her experience after the show with the size 10 Calvin Kleins.

I had literally starved myself for four months — not a morsel of food. Two hours after that show, I started eating to celebrate — of course, within two days those jeans no longer fit!

The only Oprah Winfrey show I’ve ever seen is this very show.  She looked fabulous, which is usually the situation when people lose weight while getting plenty of protein.  Her face didn’t look gaunt.  She didn’t lose her muscular tone – she looked tight and healthy.  She obviously does well on a low-carb, high-protein diet.  She just needed to be on a different one, one for the long term.

For whatever reason, Oprah fought the idea of a low-carb diet for years.  Then, when she decided to go on a low-carb diet, she ended up selecting probably the worst low-carb diet she could have chosen: the Carbohydrate Addicts Diet (CAD).  For those who don’t know, the CAD recommends that people follow a strict low-carb diet all day, then allow themselves to eat all they want of anything they want for an hour – the so-called Reward Meal.  I didn’t see the show, but I was told by those who did that Oprah said that she liked macaroni and cheese and wondered if she could eat that on the diet.  The authors of the CAD responded that not only could she eat all the macaroni and cheese she wanted during her Reward Meal hour, but that she should throw in some apple pie for dessert. (If any readers of this blog saw that show and have a different remembrance, set me straight in the comments.) This kind of eating is the worst possible way of eating for those with insulin resistance.  And those people who try it usually fail because what appeals to them is the idea that they can eat all they want of whatever they want for an hour a day.

Many obese people do this same thing without calling it the CAD.  They wake up in the morning, skip breakfast and head to work.  Then they eat a salad for lunch.  By the time they get home, they are starving, so they eat everything that’s not red hot or nailed down, then promise themselves that they will do much better tomorrow.  Then repeat.

It’s no wonder Oprah failed on the CAD.  She probably ate 300 gm of carb per day along with everything else.  Problem is, she thought she was on a low-carb diet when she really wasn’t.  She then made the pronouncement that she had tried a low-carb diet and it hadn’t worked.  She tarred every low-carb diet with the CAD brush when she really didn’t try a low-carb diet at all.  In fact, the only time she tried anything approximating a low-carb diet was when she did the Optifast program, and those results spoke for themselves.  She could do the same thing now with a good quality, whole-food low-carb diet.  It may take a little longer than the four months it took her on Optifast, but she could stay on the program forever.  Just like I do.  You saw my food diary.  Did it look like I was denying myself a lot?

The second major problem that Oprah has is directly related to her fame and position.  Because she is who she is, she can have access to anyone she wants to have access to.  And she makes the same mistake all people in her position seem to make.  When she has a health problem, she turns to Harvard or some other big-name institution to get advice.  The problem with that is that all the people at Harvard and other big-name institutions are as mainstream as mainstream can get.  They are also far removed from patients care.  They haven’t had an original thought in years.  I would be willing to bet that yours truly has more first hand experience taking care of overweight middle-aged females than the entire faculty of Harvard and Yale put together.  But when Oprah (or any other celeb) has a problem, where does she turn?  To Mehmet Oz, Harvard grad, and a low-fatter of the deepest dye.

She tries low-fat, stays hungry, and as a consequence binges or at the very least eats a lot of stuff she shouldn’t be eating.  She is never going to win the battle against hunger because it can’t be won.  Sooner or later, she (and anyone else) will give in to hunger.  Fighting it is a losing battle.  On a true low-carb diet she a) wouldn’t be as hungry, and b) could eat something filling if she were.

But, unfortunately, she’s tied into all these low-fatters with the big school reputations and she’ll never gain control.  And, sadly, she’s taken the tack of the chronically overweight.  She’s ‘accepting’ her obesity. According to the reports

Winfrey also writes that her goal is no longer to be thin; instead, she wants to be strong, healthy and fit.

Uh huh.  I’m not trying to be sarcastic because I think the situation is pitiful.  Here is a beautiful, intelligent, creative, talented woman who is giving up on a relatively easy quest.  All her other accomplishments were much more difficult than losing weight, but she knew what she was doing.  For weight loss, however, she is listening to idiots.  And their advice is wrong.  And she hasn’t lost.  So she’s giving up.  It’s really sad.  Especially since one can’t really be fat and be healthy.  She’s fooling herself.  If she’s overweight, she’s got a metabolic problem that isn’t being dealt with.

Like many unsuccessful dieters, she is blaming her glands.

during the spring of 2007, Winfrey reported that she developed an underactive thyroid problem.

Controversially, Winfrey suggested that she had chosen diet and stress reduction as her thyroid treatment approach, and emphasized that her dietary regimen relied heavily on soy products, antithyroid goitrogens which are known to aggravate and worsen thyroid conditions in some people. Winfrey did an episode of her show with Dr. Christiane Northrup, during which she again controversially signed on to Northrup’s belief that thyroid problems develop in women who suffer an energy blockage in the throat region, and result from a lifetime of a woman’s ‘swallowing’ words she wants to express. [Jesus wept.  God help us all.] More recently, Winfrey reported that she was going on a several week vegan dietary “cleanse,” but the diet included tofu, tempeh, soy sausage, soy milk, soy yogurt, and soy products on the menu nearly every day, sometimes more than once.  Oprah did not report any weight loss on this diet. To date, Winfrey has not reported receiving any medical treatment, or taking any prescription medication, for her thyroid.

She may well have an underactive thyroid, which may mean that she needs nothing more than a little iodine.  Or she may need some thyroid hormone.  What she doesn’t need is soy and a vegan cleansing diet.  Her thyroid problem, if she has one, can be easily dealt with.  What may be more problematic are her sex hormones.  She will be 55 in late January of next year, so she’s either menopausal or peri-menopausal, and as such probably needs to have a hormonal workup and bioidentical hormones.

Oprah may have to work a little harder to overcome her fetal programming than others who may not have had her in utero experience, but it can be done.  She needs to have a hormonal workup, get things balanced hormonally, get her thyroid dealt with, and go on a quality whole food, low-carb diet.  If she were to do this, she could lose the weight she wants to lose and become healthy.  There’s really nothing much to it, but if keeps on relying on the people she’s relying on…  Well, she’ll keep getting the same results.  For her sake, I hate to see it happening.

Oprah is viewing her situation as a hopeless condition and is obviously despairing.  I view it as the same problem presented to me by thousands of overweight middle-aged women in my own office. As I explained to them, it’s like any other problem.  It’s easy to solve if you have the knowledge and the right tools.  And as these patients proved again and again, with the right knowledge and the right tools it can be done.

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176 thoughts on “Oprah’s plight

  1. I’m not a dr., but I’ve known for years that Oprah desperately needed to follow a low-carb plan. Whenever she spoke about her pleasure foods they included potato chips, mashed potatoes, sweet potato pie, etc. For a while she was doing a low-ish carb plan and she looked better –not great, but better. And that magazine cover: artfully lit and, I suspect, photoshopped a bit. She looks far heavier on her TV show.
    It’s sad, because she could help sooo many people if she would just GET IT>

    • Who is anyone to say that she doesn’t look great but looked better?! Get off of people’s weight and concentrate on yourselves! Speaking from personal experience, you can look ‘heavier’ (heavy, heavier, what stupid words to use) in one photo than another when both photos were taken on the same day! What works when you are aged 19 does not usually work when you are 40. There is no ‘one way’ of eating for every single person. Each person has to change from what they did to lose pounds when younger and find what works for them. Why the doubt about anyone saying they have an over or under active thyroid if that is what the dr’s told them? Studies have recently been done that even show that obese bodies react differently when consuming certain products than thinner bodies do. There are many, many factors involved in weight gain, and it is NOT just ‘cut portion size and exercise more’. If that worked, then why did the woman who ate nothing in the hospital and was fed through IV’s gain 10 lbs in the hospital?!

  2. The first thing Oprah must do is dump her fitness guru, Bob Greene. I read his book at Costco (I wouldn’t consider buying it). His picture is on packages of cold cereal. Isn’t that a great foundation for good eating.

  3. I had tried Medifast in the past, which is very similar to Optifast. I spent almost two grands and failed liserably. I felt I was put through a torture chamber in Hell’s kitchen! So if Oprah did sustain optifast she will be so happy when and if she does regular low carb approach. There has got to be someone in her camp of friends who will shed the light. I just dont get it! I know a lot of people are petrified of low carb lifestyle for a reason of ignorance. The first thing that usually comes out of people’s mouth when you tell them about low carb is ” do you have a death wish ‘ or ‘ do you seriously think you will live long eating lard and swallowing bacon. I beleive a lot of people are so misinformed about low carb! I for one dont like lard or pork or bacon, for many reasons. I do eat a lot of fish, whey protein and vegetables. I aslo consume an enormous amount of nuts, flax and berries. So when people find out what I eat they right away say oh you are on meditarenian diet. I say, no, I am on low carb diet. And then I get a blank stare! even my cousin who graduated from John Hopkins and Albert Eishtein Medical school didnt know a lot about low carb way of living. So my point is that had more people been aware of low carb approach, including Oprah may be she would have been more open. I heard Oprah one time speak quite favorably about South Beach diet. And I can bet a dollar to a donut, that a reason she did was because low carb is right away painted with bacon and lard, whereas South Beach is recognized more like a meditarenian diet. I guess it was a genius of marketing South Beach under that pretense. So may be we need to put oprah on South Beach, no offence dr Eades and slowly, gradually get her to your camp. What do you think?

    it would certainly be better than the Carbohydrate Addicts Diet.

    • Medifast is soy based while Optifast is milk based. optifast isn’t a low carb diet.. it has 100 grams of carbs. I’m very happy with Optifast. Torture assumes you might be addicted to food. I know I am, which is why I do very well on it. Thing is like any diet.. once it’s over it’s not over… you will regain everything after you spend the next 6 months binging. On every single diet out there.

  4. Hehe, gotta chuckle at the “she wouldn’t be hungry on a low carb diet” line. That’s true, I suppose, if you’re still really fat (or at least, if you aren’t dramatically below your starting weight).

    I don’t know, maybe I eat too many carbs, but I don’t think 60-70 is too many. In maintenance. Protein makes me even hungrier, so trying to “fill up on that” is like p**ing in the wind. The only thing that doesn’t is fat, but even that doesn’t work and if I truly just eat whatever I want I gain weight.

    The only time I didn’t feel this way was when I hadn’t lost much weight yet (i.e. was still pretty close to starting weight) AND the few months where I was taking replacement leptin (i.e. was fooling my body into believing I was still close to my set point).

  5. BTW comparing oprah’s failure to the “success” of someone who has never truly been overweight is like taking credit for maintaining perfect blood glucose when you have never had diabetes. It’s pretty easy to keep your a1c <6 if you make enough insulin and use it fairly well.

    It is an accomplishment to maintain any healthy way of eating, but staying away from bread and potatoes isn’t enough to get thin if you are a metabolically obese individual.

    I can tell you that I would easily become obese on a low carb diet if I didn’t consciously restrict how much I eat. Perhaps I’m forever programmed to be fat no matter what I eat, as you say. Personally I believe obesity in early life has created a glut of excess fat cells that drives my weight upward, and any attempt to dplete this fat tissue via low carbing merely triggers compensatory starvation response, thus the symptoms of hunger and infertility. Oh I take the fat out just fine via low insulin, problem is body is not working anymore after having done this.

    Low carb only *allows* me to be thin, the reason I actually am thin is because I restrict calories too. I have to restrict calories because my body drives me to gain weight, even on a low carb diet. I’ve spoken about this before but yea, my hormones are all messed up, in a way that is consistent with starvation/underweight/excessive weight loss. I am by no means underweight, I’m at an “ideal” weight according to graphs and stuff.

    It’s more than carbs. Carbs don’t cause obesity, it’s a combination of predisposition and it involves carbohydrate of course, but simply eating carbs (or not eating them) is not going to determine weight status.

    My point is we really don’t know how oprah regained her weight, or how oprah maintained her weight.

    We don’t know she gluttonously ate heaps of food… to someone used to starving/restricting gluttonous eating is actually far more moderate than the way most people eat.
    Just because she says she ate like a pig doesn’t mean that’s actually true. Anorexics will chastise themselves in disgust for losing control with sugar free jello. Chronic dieters are similar.

    If Oprah has to deal with the emotional sequelae of starvation-related hormone aberrations in the way I know I have had to, I can’t blame her for regaining. It’s really a whole different ballgame when you are suppressing your weight far below what is any sort of “baseline” for your body.

    If you don’t believe me, I invite you to try an experiment… low carb diet and deplete your body fat to a level where you are no longer making normal amounts of leptin. Try living this way for a few years and tell me how it’s just about carbs and insulin.

    It’s not necessarily all about carbs and insulin, but dealing with insulin can get one a long way toward solving the problem. I also mentioned in the post that she should have both thyroid and sex hormones checked and dealt with if necessary. If she were low in leptin, she could afford to buy it – others probably can’t. At this stage it is expensive and experimental. Whatever the case, she’s not going to get better by the voodoo she’s practicing.

    I’ve never said it’s easy to lose weight. In fact, I’ve usually made the point that it’s difficult, which is why so many people are overweight. But it is easier to lose and maintain on a low-carb diet than any other way. If she’s trying to lose with vegan cleansing diets and all the other idiotic things she’s doing, then she is pretty much doomed to stay where she is or get worse.

    You may have a different situation than most women, and, as such, you are viewing all women through the lens of your own condition. I have taken care of thousands of middle-aged, overweight women, and the vast majority do just fine on low-carb diets. They lose and they maintain. If they lose, then go back to eating whatever they want whenever they want, they regain. But if they continue to watch their diet and eat pretty much as I did last week, they maintain. I suspect Oprah would do the same.

    • In 2015 we are now told that there is no accurate hormonal workup for perimenopausal women, as there are too many factors that cause fluctuation.

  6. It makes me sad, because Dr. Oz and these fellows seem like they genuinely care, but the people following their advice don’t seem to be doing too well. So many people take Oprah’s word as gospel; if someone were to get her on a truly low carbohydrate whole food diet, she could kick start a low-carb revolution. I had never heard of Mehmet Oz until I saw him on her show… now I see his “You…” series of books everywhere. Bob Green is everywhere too. We must hope that Oprah sees the light, and gives the “Oprah bump” to a truly healthy lifestyle.

    Don’t hold your breath.

  7. Great post, the only issue I have is that I , too, am female and hypothyroid and just hit 60 yrs. You have no idea how hard it is to lose weight even on low carb for some of us in that situation. A, you’re a man and B, most doctors still rely on bad training about bloodwork tests for this. I had to find a thyroid patient advocate who taught me to get a TSH and Free T3 and FreeT4 tests to correctly figure out how I am optimizing my med which, BTW, is now Armour NOT Synthroid.
    Wish you lived in my city, I’d book an appointment with you! 🙂

    I have no idea how hard it is to lose weight? I have only counseled with thousands of overweight middle-aged women in my career. I think I know how difficult it is. And I know all about how to understand thyroid tests correctly plus how to check for low iodine, which few doctors do. I always -always – put my patients on Armour thyroid, even if I had to take them off of Synthroid to do it.

  8. That’s a joke, right? Christianne Northrup. If true, like so many others, she’s blinded by desperation.

    It’s no joke. Actually, it is a joke, a sad but true one.

  9. I saw the Oprah show with the Hellers. On a table onstage, there was a vast spread of things you can eat on their low-carb diet, including cheeses, olives, meats, and nuts. It was quite a spread and I don’t remember what else was on there or if they included any of the types of food one might eat for the “reward” meal.

    I do remember that Oprah looked it all over and was very skeptical about the whole idea, especially the cheeses and olives. She didn’t believe it would work. At that time my husband and I had tried the CAD diet and didn’t like it because that reward meal made our hearts pound for hours and/or caused a carb crash that we didn’t like. We had already switched to Protein Power (and loved it, of course). I watched that Oprah show and suspected that if she tried the CAD version of low-carb, she would fail.

    There is so much misinformation about low-carb diets and such dysfunction in people’s food habits. The notions that fat makes you fat and that you must exercise vigorously to lose weight are so deeply ingrained that they have become completely unquestioned “facts” in news stories, as unnecessary to dispute as that the sky is blue. The longer that goes on, the less likely it seems it will ever change.

    I keep hoping Oprah will go on a good low-carb diet and see the light — get some good, real information that she would then pass along to her millions of viewers. She would find it is easy to “walk the walk” on low-carb. But as long as Dr. Oz is her current guru, that won’t happen. Her pattern is that she finds somebody to listen to and to tell her what to do and hangs on his/her every word for years, with the expert meanwhile raking in millions in book sales and/or getting their own TV show. Unfortunately, in the area of diet and nutrition, she hasn’t found the right expert, the one who might actually allow her to finally drop her obsession with food and maintain a weight she’d be happy with.

    Thanks for this post and for the photo food diary. I very much enjoyed that look into your day-to-day life and diet. –Anne

    Glad you enjoyed the food diary. Too bad about Oprah, but you are right. She’s pretty much doomed unless she changes her team.

    • I haven’t normally dieted, but after I had my first child I couldn’t seem to lose the weight. I tried the early version of the Heller’s CAD diet, when it had aspartame and creme of tartar for the so-called bread recipe (Yuk!), and I found that it did, in fact, work for me. I lost 30 lbs in a couple of months. I told my doctor about it and she suggested that it should tried for only a few months.
      I did see the Oprah episode with the Hellers. She ruined them! Although the audience in total lost over 300 lbs, Oprah whined that she ‘just wanted an apple’. I thought, ‘that’s typical’; – sometimes you just can’t have the apple without consequences. It’s as simple as that. The Hellers, red in embarrassment on stage, tried to explain that some additives such as msg or sodium nitrate, specifically in bacon, (and probably something Oprah’s ‘chefs’ weren’t aware of) may cause carb cravings. Again, Oprah whined, ‘But I just wanted an apple! Why can’t I just have an apple(pie)!?’ Well, the same reason you can’t eat a tub of ice cream in secret and in your car after the Oscars! I think Oprah’s in denial. Perhaps you are right about the fetal programming. When you mentioned it, I started trying to remember exactly what I ate during my first trimester of each of my children. But anyway, my children are 16 and 10 and neither have a weight problem.
      I have started the Heller’s CAD diet again, but am having a more difficult time now than I did 13 years ago when I first succeeded. The weight is just not coming off as quickly and I find I have to work out 3 times as much just to lose 1 lb a week!.
      So, Doctor, if you could please recommend a good low-carb diet (not the Optifast) then I would be very appreciative.

  10. Bravo couldn’t have said it better myself. I totally agree with you on the whole Oprah assessment!

    I also agree with Marlly, Bob Greene does not help Oprah and her followers, he’s stamping his label on processed foods and saying they are healthy all in the name of financial relationships he’s formed with the food industry.

  11. I’ve watched Oprah a few times, only because there was nothing better on TV when i lived in a college appartment that got very few channels. Many here might disagree, but i don’t get the fascination with Oprah. Sure, she had a tough upbringing and struggled through adversity, but i can’t stand how she over-exaggerates almost every body gesture as well as almost every sentence that leaves her mouth. And, of course, all the women in the audience burst into laughter when she does so; they’d probably act the same way, like drones, if the teleprompter wasn’t even telling them to laugh. It’s sad, it’s almost as if millions of American women can’t think for themselves. If Oprah tells them to read this, buy that, eat this, they appear to do so, as evidenced by ratings.

    As for Bob Greene, i think he is as corrupt as they come in the health and fitness industry. But again, Oprah endorses him…

    As for Dr. Oz, at least he is an advocate of eating nuts. He also offers some good information from time to time.

    I don’t think Oprah is as smart as many think. For instance, if she was, she would study nutrition herself and not rely upon so many other people. She would then discover where she has been going wrong. Or, someone could just send her the link to this blog post.

  12. “Many obese people do this same thing without calling it the CAD. They wake up in the morning, skip breakfast and head to work. Then they eat a salad for lunch. By the time they get home, they are starving, so they eat everything that’s not red hot or nailed down, then promise themselves that they will do much better tomorrow. Then repeat.”

    They don’t even have to be obese. I’ve heard this scenario described to me so many times by new clients it’s astounding. And of course, when confronted about it they will say, “But I’m eating healthy; I had a salad for lunch. So why aren’t I losing weight?”

    We seriously need to change the narrative on low-carb eating in this country.

    Agreed. Oprah could go a long way toward doing that, but it’s doubtful that she will.

  13. Irony of ironies, the first Google ad that happened to appear at the bottom of this blog post was:

    “O. Winfrey Acai Diet Lose 25 Lbs In 20 Days With O. Winfrey’s Acai Weight Loss Diet!”

    So sad that she lives so nearby a couple who could point her in the right direction, and yet she chooses to continually seek LF diet after LF diet (Oz is bad enough, but vegan?!), probably because of her addiction to potatoes and mac’n’cheese. The prospect of giving up the carbs is frightening to most carb addicts, especially those who don’t understand that it’s not “comfort food” any more than another hit of crack is “comforting” to a crack addict, it may make you feel better for a while, but it just reinforces the addiction.

    Maybe you and MD should be good neighbors and drop by Oprah’s with a copy of one of your books for Christmas. 😉

  14. Oprah is the most famous yo-yo dieter. All her diet gurus are obviously failures. Yet people are buying their books. Suckers!!!!

  15. Amen Doc!

    As one of those perimenopausal, middle aged, thyroid obese woman you speak of….it’s ALL in the hormones. I take thyroid now, I DID take bio identicals, and now the hcg IS doing it for me. Hands down.

    I’ve even tweaked the orginial protocol to be more PP like, and it’s falling off me. I’ve lost 37.5lbs in 38 days of treatment.

    How can we get YOU on her show?!?

    It’s almost impossible. Because so many women follow whatever Oprah says, any book or diet recommendation from her sends the book soaring onto the bestseller list. Authors and publishers know this, so they all send books to her show in an effort to get on. I would guess that she probably gets 100+ books per week and countless calls from book company publicists. These books are all evaluated by 20-something production assistants who don’t know squat. They are the filters. They know that Oprah has Oz, Greene and her other pets that she relies on for advice, so anything these production assistants see that is diet or exercise related, they take a pass on.

  16. How Oprah (and most of the rest of the mainstream media) can stay away from stories like Dr Jay Wortman’s study in an aboriginal community with a low carb diet and type 2 diabetes, or Barry Sears’s work with Manuel Uribe, or Dr Davis’s claims of actually reversing heart disease (an awfully important story whether true or false!), is beyond me. If low carb were really without merit, or even dangerous, more intense scrutiny from the media would be in order at least to educate people about the dangers.

  17. Dr. Eades,

    Your assessment of Oprah’s situation is dead on. Can you imagine the popularity a well designed, low-carb/high-protein diet (cough cough) would get if she followed it and was successful?

    On the topic of fetal effects from the mother’s carbohydrate intake, I never knew about the pancreatic issues, but it makes sense. My mother said I was made of Dr. Pepper (it helped her with morning sickness), McD’s french fries and Wendy’s frosties – a recipe for disaster. I’m sure that didn’t help with the fact that I have struggled most of my life with weight issues and with insulin resistance (though it is certainly not the only factor). Another interesting article I found on maternal diet also indicated that protein intake (or lack thereof) affects placental size and development.


    This strikes home even harder for me as I had my son in May, and we had placental issues. Early on in the pregnancy I craved meat enough to make PETA cringe, but had issues with the taste of reheated meats and wanted to save money so I ate a lot of veggie soup for lunch at work. Long story short, the placenta had a stroke and gave out for no reason (I was otherwise healthy and gaining weight at a perfect pace), and what was supposed to be a 9lb baby was a 6lb 13 oz baby. Looking back, I have to wonder if my dietary habits early on didn’t contribute to that since my blood pressure was just fine (usually the main issue in placental problems). Next baby I know to definitely change my eating patterns (and listen to my cravings for steak).

    Additionally, PPLP has helped me get rid of a lot of the weight that I gained on bed rest AND gain back the muscle I lost. Family members that gave me guff about eating low-carb in the beginning are now asking to borrow my books. Oprah doesn’t know what she’s missing!

    Fetal programming is a large factor in what happens later in life. It’s one of the reasons many of us have more difficulty in losing than others on low-fat diets and probably even low-carb diets. Unfortunately, it can’t be changed – only dealt with. It’s why maternal nutrition is so important. Stay away from a lot of refined carbs in the first trimester and work to keep protein intake up in the third trimester.

  18. The CAD is no solution for carb addiction. The only way is to cut carbs cold turkey until the cravings subside.

    I’m sympathetic to her plight. After years on Weight Watchers and a weight rollercoaster, I gave up on trying to lose weight and just accepted that I was going to be fat. A diagnosis of type 2 diabetes changed that and brought me to my senses. She needs to get on a true low carb plan and stick to it. Sadly, she won’t get that advice from her diet gurus.

  19. The saddest thing about Oprah’s situation is that she drags millions of devotees down with her. Imagine the societal shift she could create if she was on our side.

  20. Oprah is probably too addicted to carbs to be able to give them up, that’s probably why she did the Carbohydrate Addict diet, so she could still eat them. Instead of saying she can’t give them up she just says she’s tried it and it didn’t work…an easy out!

    My mother loves her bread and chocolate, and pasta, all that. This summer she managed to cut out the carbs for about a week and lost 10 lbs. She looked so much better just right away, I know she would have amazing results if she would just stay on it! She eats out so much and can’t say no to the yummy looking bread, etc… What you said about pregnancy and carbs in the first trimester makes sense for me. I’m sure my carb-loving mom probably ate tons of carbs while my pancreas was being formed. She was out in Nebraska at the time with 2 little kids and no car while my dad was at the church. (pastor) They were broke and probably ate lots of tuna casserole, etc. It’s no surprise I have to work so hard, even on low carb, to be thin.

    I’m in the 7th week of my 3rd pregnancy (thanks for the advice from before) and I’m hoping I can help make it easier for my child in the future when it comes to this! I haven’t really been eating much because not much is appealing right now (your food diary made me a little ill!)

    COS: Have you read this article? http://www.newsweek.com/id/172561?from=rss&referer=sphere_related_content (never say die) They don’t mention low carbing as a way to live long but from other things they said it’s easy to see that low carbing would do the trick. Except for the part about IGF-1 and how it can’t get low because of the amount of protein. What do you think about that?

    If read a lot about the IGF-1 issue. It’s a much more complex issue that the Newsweek article would have one believe. I’m not so sure that IGF-1 works the same way in humans as it does in worms. When laboratory animals go on calorically restricted diets, the macro nutrient reduced the most is carbohydrate, not protein. As a consequence, it’s difficult to make the case that protein restriction does the trick.

  21. I’ve really enjoyed reading this piece. Like everyone else, I’ve watched Oprah’s struggles with weight and secretly rooted for her to be ‘the one’ to finally get control of a lifelong problem, to be the poster child for those of us who have tried so much, lost again and again, but never been able to maintain (all on low-fat/low-cal diets of course). I’ve been in the resigned stage for some time, tired of spending money and energy on something I see as perpetually temporary (weight loss), figuring if not even Oprah with her unlimited resources can do it, it just can’t be done.

    But I have also have never stuck with a low-carb for very long, and those that I did try were not high in fat. This gives me some motivation to try again. I struggle with whole foods suggestion because of IBS, but I am an board with high-protein.

    I especially want to thank you for mentioning fetal programming. My mother was a Type I diabetic before she became pregnant with me in the late 60s, and her insulin was poorly controlled for much of the time she carried me. I have yet to develop diabetes, but now that I’m 40 I am taking on the body shape and general ‘puffiness’ of a person with metabolic syndrome, and have been for the last 3 years or so. My doctor tells me to exercise and accept that I’m aging. Weight loss by conventional means has always been an especially-hard struggle for me in comparison to others of similar sizes using the same workout/diet plan, and your words here give me new insight. As a child of a Type I diabetic, am I already predisposed to insulin issues?

    Thanks so much for this.

    You’re not necessarily predisposed because you are the child of a Type I diabetic. Your mother probably was the victim of a virus that destroyed the beta cells in her pancreas, making her a Type 1. Your problem arises from her elevated blood sugars and poor insulin control during her pregnancy with you, starting you off with a pancreas more like a person who has developed insulin resistance.

  22. What’s really frustrating is that the answer lies with her neighbor right down the street. Maybe you could print out the above, crash her next party, and leave a copy on her coffee table ;0 I know, wishful thinking.
    It’s frustrating when you have the answer, but don’t get asked the question. I think that’s one of the reasons why Atkins became so loudspoken.

    • Hey, that’s a great idea! I read in one of Oprah’s issues that she had never had a sense of ‘community’ and now that she does, she is reveling in it. So, be part of her ‘community’ and ring her doorbell with book-in-hand.

  23. 1. If that photo is accurate, Oprah is a little chunkier, but she still has a “pear shape,” and perhaps that extra subcutaneous fat is helping to protect her from diabetes. She doesn’t have the “beer belly” so many postmenopausal women develop.

    2. Why don’t you make prints of your week’s eating, paste them up in a scrapbook, and deliver them to Oprah as an example of what she could eat on a high-protein, low-carb diet. True, she might never seen them if her staff dump them in the garbage, but it might be worth a try. As a neighbor, you could offer to be available for “neighborly advice” if she had questions.

    That’s probably not going to happen. This is where Oprah comes to get away from it all, and, apparently, she isn’t coming to Santa Barbara as often as she used to. I think she’s spending most of her time now in Hawaii. I always know when she’s in town because I see Steadman all over the place – he and I seem to run in the same circles. I haven’t seen him lately.

    If you look closely at her photo, she’s got plenty of abdominal fat. And I would bet that a whole lot of it is visceral.

  24. Why can’t they seem to get it? All the studies and test groups are there in plain site. Gosh, I’ve been living the PP life for 10 years now and it’s the easiest thing I’ve ever done! It just seems so typical of our country these days. We’ve got 10% of the people pulling the wagon and the rest are along for the ride. It’s time to blow out the idiot lamp and go home.



  25. Hi Dr. Eades,

    This is a great article – informative and compassionate. I’m sure it will give other women who have eating disorders and continually blame themselves some sense of hope and self-forgiveness.

    One thing though: Isn’t the Optifast diet a liquid diet? And isn’t that why people gain most of their weight back once they start eating whole food again?

    Thanks, Stephanie

    Because they don’t start eating low-carb food. Optifast recommends (or at least used to – I haven’t seen their info lately) a low-fat diet for maintenance.

  26. If I remember correctly, in the Hellers’ Lifespan Program, the last CAD book published, they had “changed” their recommendations for the reward meal to a salad on the side and a plate comprised of 1/3 protein, 1/3 low-starch veggies, and 1/3 starchy foods including desserts. It seems like I also remember they said that many people had “misinterpreted” the reward meal as a binge fest, which was not their original intention. They say that you can eat as much as you want but when you “return for seconds or thirds”, it must still be in the same proportional breakdown as your first plate (1/3, 1/3, 1/3). It seems like I also remember their advising to keep carbs around 5 gm (10 gm max) for the other meals and snacks. I also remember they promoted the idea of choosing complex carbs for the starchy portion of the reward meal over simple ones. They also say to eat the salad first. The Lifespan book gave me the impression that you fill up so much on salad and protein/veggies the majority of your meals that by the time you “get around” to your starchy treats at the reward meal, you can’t eat very much.

    The problem I found with trying the plan was that while I was very dedicated in the beginning, I wound up eating more and more starch and adjusting my protein and low-starch veggies intake downwards. And then I started skipping the salad. And when I would go back for seconds and thirds, it would be for starchy foods only.

    More than anything, I had trouble with the concept of a “reward meal”, which to me implies I get a treat for doing something right, as though I were a trained dog. If I do something “wrong”, then no treat. Over time, I felt like it didn’t really promote responsible eating. I think it’s also important to remember that the Hellers are not medical doctors. The covers of their books with their wearing white lab coats, I believe, is somewhat deceiving.

    But like Jimmy Moore says so often on his blog, if you find something that works for you, then by gosh stick with it. What works for one person may not work for another.

    I don’t think the Carbohydrate Addicts Diet worked for many.

  27. I’m so frustrated with my doctor. I tried a new one, and she threatened me with a heart attack, basically, because I told her I went off Lipitor and refused to take a statin. How do I find a doctor who knows about bio identicals and won’t just recommend the standard protocols? I am in Central Massachusetts.

    Unfortunately, I don’t know any doctors in Central Massachusetts. Readers? Anyone know a good doc there?

  28. Yes, Christiane Northrup really said that.

    Actually, she WROTE it for the world to see. That exact line is in her book, “The Wisdom of Menopause.” A friend encouraged me to buy the book, and I’m sorry I did. What a crock! True, there are some good points in it, but she basically says men are the root of all of our (women’s) problems. She even goes so far as to imply that most women should ditch their spouses and move on. Her marriage failed, and she implies this is normal and most women would be better off doing the same thing she did.

    She wrote many other “jewels of wisdom” in the book, but I didn’t mark them all so I can’t quote them.

    She is the founder of Women to Women in Maine. The next thing you know, Oprah will be touting every-other-day colon cleanses and HCG injections ala Kevin Trudeau.

    Just because you’re rich doesn’t make you smart.

    Hmmm. That explains a lot. MD and I had a very nice dinner in Maine several years ago with Dr. Northrup, her husband and daughter. We discussed diet, overweight and a host of medical problems, and she seemed so very normal at that time. Maybe the dissolution of her marriage affected her more than most.

  29. Here is a quote for Mark Sisson of Mark’s Daily Apple:

    “…here’s my challenge to you, Oprah: give me 60 days with the Primal Blueprint and I’ll give you your life back. Period. Guaranteed.”


    Truth be told, I think he could do it.

    I’ll make her the same guarantee. Problem with these things is that the person undertaking the program has to be committed, and often in these situations that person isn’t. He/she says, Hey, you guaranteed me success. Make me thin.

  30. great blog post,

    really appreciate the work you do on this site dr.

    if Oprah were to do a low carb diet and successfully loose weight a total sea change would occur in america. she is the closest thing to a modern-day Jesus for american women,
    and even if she were to try a low-carb diet, i suspect the political implications of it would prevent her from advertising it to the public without adversely affecting the entire body of work she has done up to date about the right diet.

    i could see now the headlines if Oprah was to fall ill for any kind of reason on a low-carb diet, the press would have a field day with a steady-stream of talking head doctors villifying low-carb. too bad this doesnt happen when her myriad of health-problems occured while on low-fat/alternative diets.

    i think her course is set, and her money-making machine and doctrine are too aligned with mainstream nutritional advice to reverse course. its a shame her own fame makes a healthy path out of reach for her.

    mabey you can end up running into her in your neighbourhood and talk her into considering low carb without her getting offended.

    Getting Oprah on a low-carb diet would be a two-edged sword. If she did well and had no problems, it would be a boon because women everywhere would be low-carbing. If, on the other hand, she had problems, i.e., dropping her potassium (and not taking her supplements) and becoming fatigued or having muscle cramps, or having orthostatic hypotension and falling out because she wasn’t taking enough sodium, or any of the other minor problems one can have early on on a low-carb diet, she might ruin low-carbing for years. She would have Ornish, Oz, Barnhard and every other low-fat/vegan idiot out there telling her she was killing herself, and she would probably be scared to death. Every heartbeat she could feel might be a sign that she was having a heart attack. She would have to have total faith in me or MD or whomever she might choose to monitor her during the process and refuse to listen to the others. I don’t think she could do it.

  31. If enough of us band together, we could write letters to Oprah, and/or take out an ad in the Times, or whatever else one can think of to get her attention urging her to talk to Dr. Eades or read Good Calories, Bad Calories, or read Protein Power, etc.

    On the surface I think the idea sounds a little silly, but if Oprah switches to a low-carb diet, and gets thin and stays thin and touts the diet’s virtues on a daily basis, it could bring about a cultural change like nothing else.

  32. No offense Dr. Eades but sorting out the thyroid is not “easily dealt with”. If she has had the thyroid problem for years she will need to get her adrenal function tested via salivatory testing to see how much cortisol she is producing. If she is low in cortisol thyroid medicine will not work as cortisol is needed to get thyroid hormone to the cells. So she may need to take some hydrocortisone until her adrenals are stengthened. This takes time. Then she has to add in Armour very slowly. Finding the optimum dosage for Armour also takes time and is not always that easy unfortuantely.

    Many thyroid folks also find their ferratin, B12 and sex hormone status (particularly progesterone) interferes with their ability to use thyroid hormones so these must be checked also.

    Basically figuring out the thyroid can take quite some time and is not as easy as you say.

    http://www.stopthethyroidmadness.com has fantastic information on this topic.

    I beg to differ. I’ve had a ton of experience dealing with thyroid problems – both real and imaginary. In the vast majority of cases it isn’t all that tough. And I do use salivary testing for cortisol levels, but I’m not much of a believer in adrenal fatigue.

  33. I love the bottom left corner of the O cover… “Making Weight loss stick. Bob Greene’s simple plan”

    Oh yeah Bob? Prove it. We’re still waiting.

    As for the photographs on the cover, there’s hardly a magazine in the world that doesn’t do a little Photoshop “surgery” to them. My guess is that she might be a little chunkier than the “2009” photo illustrates. And equally she most likely wasn’t as buff as the 2005 photo showed. For a powerful demonstration of what a talented photoshop professional can do check out http://www.youtube.com/watch?v=pZ0adXaY_bs (**It is suggested for adults since there is an exposed buttocks in the shot being photoshopped. It is rather tame IMO.)

    I feel for her though. In the past 3 years I’ve lost 80 pounds. Recently I have started to gain again, but I’m not panicking because I know the reason. It’s a lack of discipline. Fortunately, because of people like you Dr E. and some other folks like Adam Campbell, I have the tools to get back on track. Whereas Ms. Winfrey is stuck on the side of the road with a spare tire but no jack.

    Fascinating video. Does it really work this way? I’ve never used Photoshop, so I don’t have a clue. Maybe we should all go on the Photoshop Diet. It’s a lot quicker and would leave us looking a lot better.

    Stuck on the side of the road with a spare tire but no jack, indeed.

  34. I’ve been getting a kick out of reading about Oprah’s latest weight gain. Found one website (Oprahcide.com) that made the following statement:

    “Mehmet Oz is one of Oprah’s diet experts, possibly the most prominent among them.

    Further, she has anointed him as a medical expert. He has been made “America’s Doctor” by Oprah.

    As you will soon see, when it comes to diet and weight loss, he is “America’s Doctor” as Jack Kevorkian is “America’s Doctor.”

    The only difference is that when you see Kevorkian coming, you have an idea of what is about to happen”

    Did a spit take when i read that.

    Would be funny if it weren’t so sad.

  35. For whatever it’s worth, I used to watch Oprah back when she did Optifast (now I can’t stomach that she acts like the female messiah) and I decided to do a similar fasting diet through our local hospital. I thought I was obese and I was beside myself for weighing 165 after my son was born. ( Jesus wept… as you would say). Meanwhile I ballooned up to 190 eating a last supper every night in anticipation of fasting for 6 months. (Sorry about all the religious references… tis the season.) The diet worked like a charm but it was torture. It is a very low fat diet even though it is high protein. After all the weight was lost I almost had a nervous breakdown, I think from the lack of calories and fat. Afterward solid food was introduced as all carbs. I could eat oatmeal, corn, pasta but curiously no bread, no fats. I continued to loose, surprisingly.

    The big push with this diet company was exercise. They claimed that success was proportionately due to amount of exercise you did and had to be done at least 6 days a week. I’ve got to say that was my experience. The whole time I fasted, I walked 2-4 miles a day. I became an exercise nut, weight lifting, walking, stair stepping, you name it. My diet progressed to eating all the junk foods I adored… nachos, ice cream, pasta etc. I never gained a lb. while I was exercising; I hate to disclose this being as how it’s not that hip a concept right now… I also remember Oprah running around 6 miles a day when she was thin. Didn’t she claim recently that she stopped running because of the thyroid thing.

    I am now a believer in LC with intermittent success. Only because sometimes it is easy; sometimes feel like it is an addiction, this food thing, so I sympathize with Oprah there. I do believe she has tried every diet to come down the pike though and probably had a bad result with LC. From my experience, if you have insulin resistance and can’t keep away from the carbs diligently, I think a LC diet can fail you, sort of a catch-22 I guess… just my humble, uneducated opinion.

  36. I don’t know who Bob Greene is, except for references on this page that he is her adviser/guru/whatever, but look at the other story mentioned on the magazine cover: “Making Weight Loss Stick” by Bob Greene. The people making the magazine and the people buying it won’t see the huge dissonance of putting both stories on the same cover.

    Anyway, I don’t see why anyone should be surprised that Oprah keeps getting fat. She’s just an entirely average person, with a food obsession. How does that make her not-fat? She also does admittedly have some large gift of gab, and is obsessed with politically-correct victimhood at a time when that really, really sells. As a multi-billionaire, she’ll still claim to be oppressed at the drop of a hat. How does that make her not-fat? She is spoiled by riches and adoring masses. She is emotionally but not rationally driven. She is considered to be an “expert” on relationships though she’s never had a real one. How does any of that make her not-fat and not-deluded?

    (And conversely: she is in menopause and maybe also her thyroid is now off. How does that make her fat in a way that she already wasn’t her whole entire life? Why look for new reasons?)

    Her only hope is that one day by chance she chooses the right person to tell her what to do… so maybe if somebody writes a book that “the oppressors” want people to eat carbs? 🙂

    Hmmm. That’s a thought.

  37. Imaginery thyroid problems??? That is the sort of condescending attitude that leads to patients spending years undiagnosed. Have a read of these:

    Overreliance on laboratory tests without clinical evaluation may lead to considerable diagnostic errors:

    Nicoloff JT, Spencer CA. The use and misuse of the sensitive thyrotropin assay. J Clin Endocrinol Metab. 1990;71:553-8.

    De Los Santos ET, Mazzaferri EL. Sensitive thyroid-stimulating hormone assays: Clinical applications and limitations. Compr Ther. 1988; 14(9): 26-33.

    Becker DV, Bigos ST, Gaitan E, Morris JCrd, rallison ML, Spencer CA, Sugarawa M, Van Middlesworth L, Wartofsky L. Optimal use of blood tests for assessment of thyroid function. JAMA 1993 Jun 2; 269: 273 (“the decision to initiate therapy shoul be based on both clinical and laboratory findings and not solely on the results of a single laboratory test”

    This is written by a thyroid expert and is well worth a read: http://featherstone.bravehost.com/thyroid/peatfieldadrenal.html

    Discussions and controversy in medical associations and journals on TSH reference range:

    Dickey RA, Wartofsky L, Feld S. Optimal thyrotropin level: normal ranges and reference intervals are not equivalent. Thyroid. 2005 Sep;15(9):1035-9

    Wartofsky L, Dickey RA. The evidence for a narrower thyrotropin reference range is compelling. J Clin Endocrinol Metab. 2005 Sep;90(9):5483-8

    Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT. Subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab. 2005;90:581–5

    Surks MI. Commentary: subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab. 2005;90:586–7

    Ringel MD, Mazzaferri EL. Editorial: subclinical thyroid dysfunction: can there be a consensus about the consensus? J Clin Endocrinol Metab. 2005;90:588–90

    Pinchera A. Subclinical thyroid disease: to treat or not to treat? Thyroid. 2005;15:1–2

    I am also wondering why you bother to test for cortisol levels if you don’t “believe” in adrenal fatigue? I wasn’t sure about it either until I did a lot of reading on the subject. There are some great books out there such as Safe Uses of Cortisol by Jeffries.

    Thyroid hormones cannot get to the cells without cortisol. In fact the leaflet that comes with the thyroxine package actually STATES that physicians should test cortisol levels BEFORE treating the thyroid. Clearly there is something to this.

    I know many thyroid patients who had to be treated with small physiological doses of HC before they could get to an optimal dosage of armour. If adrenals are weak a person might be able to tolerate up to 3 grains but no more than that. Whereas thyroid patients all around the globe have found that 3-5 grains is what most people need. They won’t be able to tolerate this dose until their adrneals are strong though as they and their physicians will think they are becoming hypothyroid.

    It’s not my intention to be condescending. I have seen the horrible after effects of people treated for ‘adrenal fatigue.’ They are often morbidly obese and have physician-generated Cushing’s disease.

    I carefully evaluate thyroid status before putting people on thyroid hormone and I do it cautiously. I’ve had experience with thousands of overweight patients, many of whom are hypothyroid and on the wrong medication. Physicians are cautioned to test for cortisol first because so that physicians won’t prescribe thyroid for weight loss when it’s an overproduction of cortisol that’s the problem.

  38. Ok, this gets very intresting here! If I may add my two cents for whatever they are worth. As a chronic dieter, yo-yo and otherwise I must tell you guys that a lot of people treat weight issue as merely physiological phenomenon. I have yet to see any commenter say anything about cortisol, or stresss or psychological problems. As humans we are much more complex that merely hormones. Its not all about ghrelin or insulin or glycogen. We are a very complicated machine! Once I met a girl who was married to a very good guy. He was everything any woman would ever want. He had fortune, good looks and everyhting else for that matter. But she wasnt happy and her friends chastised her. I was the only one that could understand her. She was like a caged bird, living in a gold cage with no wings to spread! She and her husbands were just too different personality wise and she felt no emotional orgasm as I call it with him. How is it related to diets? Diets are like marriages, you have to have both, emotional orgasm and otherwise to make it work. Oprah has suffered from early on. She was raped by her relative, and went through other horrific ordeals. Noone talks here about her being an emotional wrech at times. She never had a family, or her own kids. Her weight issue could be ntohing more as masking for her emotional struggles. How many people do we know that eat when they are not hungry! Comfort food sprouts its root to childhood and deeply seeded in subconscious brain. I have yet to meet a person who eats a lot of steak with brocoli when they are distressed.

    Dr Eades she might not necessarily need to change Dr Oz or Green( who by the way has a few good advices ). What she needs is to get her emotional demons in check! I can tell you first hand when you are laying in bed at 12 am by yourself being emotionally upset, no doctor in the world can stop that subconscious mind from acting on comfort food. It takes a lot more than will power.
    I made a conscious effort to replace my comfort food with its close related cousins from low carb family. So instead of junk low fat high carb food I now grab low carb junk food and it works as far as my emotional demons are concerned. And I feel hundreds time better after low carb junk binging. Byt the weight stays same or even goes up a bit. So from that point she will no doubt benefit.

    Dr Eades you always recommend 300 mg magnesium at bed time for binge eating. MY emotional demons are not that easily fooled! May work for soe, not for me! So my advice to Oprah is may be just take off a whole year and do soem heavy soul searching as she does from time to time. Just get out of public spot, God she can afford to. And do something that birngs her pure love and joy!

    Dr Eades I highly value your opinion and think you are a very sharp guy! Dont you think her overeating stems from deeply rooted emotional issues and as such need to be dealt accordingly before she goes on any diet and maintains her weight successfully?

    She can have all the counseling and treatment of real or imagined emotional issues that she wants, but she’s still not going to lose weight and keep it off unless she’s on the correct diet.

  39. Would you recommend bioidentical hormones for someone who has two sisters with breast cancer?

    If that someone were going to use hormone replacement, I certainly would.

  40. …wake up in the morning, skip breakfast and head to work. Then they eat a salad for lunch. By the time they get home, they are starving, so they eat everything that’s not red hot or nailed down

    that sounds almost like my IF routine… no breakfast, have a protein shake around 3 or 4, get home, eat everything not nailed down. Yep, that’s me. Except I only eat low-carb not nailed down stuff. Mostly. Keeps me about 5-7 or less than my pre-IF low carb weight.

    The low-carb not nailed down stuff is what makes it work for you.

  41. Awesome post,

    my mom listens to everything oprah or dr. oz say and never listens to me. She eats low fat and juices greens and try to exercise to lose weight. My dad and brother listen to me because i am the only skinny muscular one in our family. My mom doesn’t lose weight but gains, and my brother goes from 235 to 190, my dad goes from 195 to 156!!! Now when i go out to eat with my dad and bro its alot of fun…we all eat low carb…and they ask me alot of questions about nutrition and strength training and they have taken sooo much more interest in there health and they are way happier, and i told them it would make them run there business better ounce they started giving there bodies the fat and proteins it needed, not the carbs. Well, there business turned a huge profit this last year!!! My mom is coming around finally, now since she was having gallbladder problem. I told her it was probably gluten from the bread messing with the digestion of fats. She cut out bread and no more gallbladder problems! Anyways…you should walk over to oprahs house and talk with her…then you could get on t.v. with her and rip dr. oz to pieces with nutrition and diet info.!!!!

    t r o y

  42. a long way off topic here, but you got any idea how come mayonaise doesnt have any protein? If you look at the lable for your typical standard mayo like Hellman’s, there’s no protein there! Mayo is just eggs and oil, where does the protein disappear to?

    There should be protein in mayonnaise. It’s made from egg yolks and oil. Egg yolks contain about 2 gm per, so any real mayonnaise should contain protein.

  43. speaking of supplements: dr. eades, is there on the site a summary of the basic supps a post-60, healthy woman should be taking while low-carbing? or are the directions in PP still applicable?

    We’ve made a few changes from PP in the PP LifePlan, but you won’t go wrong sticking with what’s in PP. I should do a post sometime on what I think is the ideal supplement regimen.

  44. To answer your question. I’m a professional photographer and while I am not the photoshop artist like the person in the video, I can tell you that I’ve retouched a lot of photographs using photoshop. The basics are relatively easy, i.e., double chins, bags under the eyes, the above mentioned spare tires, poor complexions and the like. I do not manipulate photographs that are for publication in newspapers or to be used for editorial purposes unless it is clearly stated as an “illustration” not a photograph. There is an ethics standard that I firmly believe in.

    Forget the Photoshop diet. I want to live in a beer commercial! All those young lithe bodies having all that fun…

  45. On Day 5 of my low carb odyssey (20 g/day) and intrigued by your Oprah comments. I’m an Optifast graduate who lost and regained close to 100 pounds. The amazing thing to me is how easily fat slips onto the body, how tenaciously the body holds on to it, and how slow going it is to finally budge it off. I imagine Oprah, like me, was probably surprised one day to turn around and *wake up* to find that she was a fatty again and ~~ heaven forbid ~~ has to lose it all again. Oh sigh. At least the low carb way you can actually get in a decent meal from time to time. Thanks for your posts. Enjoy ’em.

  46. “When pregnant women load up on refined carbohydrates during pregnancy, especially during the first trimester, they end up damaging the developing pancreas of the fetus. The pancreas is pretty much developed during the first trimester, so a chronic high load of glucose in the mother’s blood that crosses the placenta ends up programming the fetal pancreas in much the same way that a huge chronic glucose load over a long time in adults creates insulin resistance.”

    Yep. I was born near the end of WW II. During the war rationing of meat and dairy opened to the door to carbs like macaroni, noodles and potatoes as staple foods. Carbs became established in our diet as stand alone main courses. Breakfast cereals became the defacto breakfast replacing bacon and eggs and meats. In the early 50s drinks like Kool Aid made with 2 cups of sugar became cheap alternatives to soft drinks.

    Like most war mothers mine ate mainly carbs when she was carrying me. I survived an extremely difficult birth only to be raised on starchy high carb foods. looking back with that I know now it is apparent that I started showing signs of BG problems at an early age. In recent years I have found that I only do well on a LC diet of less than 40 carbs a day. Every once in a while I indulge in carbs. But I pay for it over the next few days.

    “One of the reason poor people are fatter in general than well-off people, is that poor people eat a lot more carbs for budget reasons.”

    And if you look at the trends in food sales in the economic downturn we are in people are eating more and more starchy carbs. This is not going to end well.

    No, I don’t think it is.

  47. You have to admit, Oprah always has a story line as long as she keeps gaining and losing. I think that is something like job security. And she has many people who can identify with her. I personally don’t watch Oprah, don’t vote the way she wants, don’t read her magazine, don’t care about her endorsements. She is ‘entertainment’ that people have turned into gospel.

    I also want to thank you for your food diary. I did find it helpful – and I think I still eat too much based on what you were eating. So, I decided to pretent that I would have to take a photo of everything I ate and found that I didn’t need to eat all that food. It’s still a mind over matter in some cases for me.

    Also, your comments about getting the hormones adjusted correctly and dealing with the thyroid for us post-menopausal women is correct. When it is adjusted correctly, I feel fantastic and losing weight is easy. However, finding a doctor who can do this is not easy in my neck of the woods. Don’t get me wrong, its not that we don’t have doctors who do it, they just don’t all do it well and they definitely don’t deal with the unusual.

    Thanks for all you do and I’m ordering your new book for my Christmas present (through your site, of course!).

    Thanks for the kind words. And thanks for any book orders.

  48. My concern is where is Oprah’s primary physician? After she announced that she was hypothyroid, she went on that vegan “cleanse” that was so high in soy–and soy is something that we hypos should avoid. In addition, unless my meds are adequately controlling my thyroid, I not only can’t lose, but I gain easily. And that requires regular monitoring. Oprah mentioned her thyroid issue but never addressed it again, and I wonder whether she’s following some weird advice from one of her “experts” rather than getting sound medical treatment.

    For a hypothyroid, Protein Power is the ideal diet, not just to lose but to maintain as well because we need at least 30g of carb a day. I fear that if Oprah decided to go low carb, she might do something like Atkins induction, feel awful (as I would on less than 30g of carb) and announce that low carb is dangerous.

    She needs some sound medical advice, and she certainly doesn’t seem to be getting any.

  49. Great insight into Oprah’s problem. Also, if you remember she went on a detox program last summer cutting out all gluten, alcohol, sugars etc. That may be part of the problem. I have read some articles claiming that Dr. Atkins was right, but for the wrong reason. The original Atkins diet (forget the shakes and bars) cut out grains and many people did great, but when they went off the diet they ballooned. Many of these people turned out to be gluten sensitive. That may be Oprah’s problem. After blood work, allergy testing, and Spectracell testing for nutrient deficienies I went on a plan designed by a nutritionist and lost 60 pounds in 4 months on a GF/CF diet. I was deficient in selenium, B-12, Magnesium and Carnitine. My thyroid function improved with the selenium supplementation. I was making reverse T-3. After genetic testing showed Vitamin D receptor variants they also insistied that I be tested for iodine deficiency. After adding Iodoral to the regime my throid panels are now normal and the weight has stayed off. Due to the genetic risk of developing diabetes I am will be on a low carb diet for the rest of my life. My carbs come from vegetables and low glycemic fruit/berries. I started the program at age 54 and am healthier now than I was 20 years ago.

    I’m glad you’ve done so well. Sometimes it takes this much fiddling to get all the little snags worked out. I’m happy you hung in there. Congrats.

  50. LOL, I’d love to go on a Photoshop diet. Magazine covers have been retouched for ages and lately there have been before and after pictures of covers floating around on the net. Just off the top of my head, I remembered the Faith Hill one for Redbook and found a site that has the photos:


    Take a look at her arm and the bulge over the back of her dress in the first photo and then look at what ended up on the cover.

    As for the assertion that Oprah doesn’t have that much weight around her middle, I’d bet even money that she’s wearing a spandex shaping garment underneath her clothes.

  51. Whatever her rationales any multi billionaire that has a TV show ( and presumably hundreds of investment portfolios and companies ? ) and Magazine bearing her name and her picture only ever on the cover is assuredly more rapaciously greedy than the ancient pharoahs and the most bizarre identity issues.
    And of course i would assume very if any of her confidents say to her ‘Oi fat lass the reason you’re a real porker despite all your gibberish about not meditating and falling off the wagon is that you’re a greedy cow who knows that when one eats x you’ll get fat and will not be satisfied but still you do it and then moan after it…4 years in the making..of putting on 40 poonds’
    And we’re the bloody idiots too as we’re talking about it too !

    More ice cream with chocolate sauce to her i say.
    The ways folks blow smoke up her arse one can almost assuredly assume that after she shuffles off folks with come forward and claim to have been cured(no ham jokes please !) of all manner of things by Saint O Patron Saint of Porkers
    I very much dislike all her posturing and the me me me-ness of it all which is assuredly a sign of her unwellness.

    The Wreckless Pen

  52. Coba said: “… her money-making machine and doctrine are too aligned with mainstream nutritional advice to reverse course. its a shame her own fame makes a healthy path out of reach for her. ”

    Smiling all the way to the bank. Fat or thin. There is more money in aligning with the huge mainstream. The red herring says it’s about her “struggle”, but really it’s about us consuming food and diet products and keeping the current advisors on the top of the advising ladder.

    Do we think her readers, viewers, and advertising revenue are going up or down with this latest revelation?

    What if she were an actor who would lose income if she got too fat?
    Would it play out differently?

  53. Ok, since we’re talking about the plight of middle-aged women, here’s my story. Low carb works great for me, the weight falls off and joint pain subsides, then insomnia hits and hits hard! If I let the carb creep begin, the weight comes back (to the tune of 5-6 lbs only, not 20) and the joint pain comes back, but I sleep like a baby. I have been keeping food and sleep journals for 3 years. It never, never fails. I’ve tried exercise, 5-htp, magnesium, Vit D3, you name it. All of them have seemed to work for a few weeks, then the insomnia comes back, like something out of a horror movie. Everything I read about low carbing and ketosis says that sleep will improve but I ALWAYS have the opposite experience. Have you ever heard of this before? Can you account for it? I feel doomed to choose between being pudgy or being exhausted.

    Strange as this may sound, why don’t you try some decaf herbal tea with a little sugar or honey in it at bedtime. Being in ketosis makes it difficult for many people (including yours truly) to get to sleep and stay asleep. A little touch of sugar or honey will kill the ketosis enough that many can get to sleep. And yet this small amount won’t really interfere with weight loss. Give it a try and let me know how it works.

  54. Photoshop is a powerful graphics tool, and like any tool, it allows you to do amazing things or amazing damage depending on the skill level applied.

    I worked for years in the graphics and publishing business, and it’s true that there are VERY FEW published photos in existence that aren’t manipulated in PhotoShop. The vast majority of the manipulations are benign ones, like colour correction, lighting tweaks, removing distracting objects, flopping (horizontal flipping), etc. But I was also regularly required to remove zits from cover shots, and there were only very occasional (and fun) assignments that involved anything more ‘creative’ than that.

    I now work in medical imaging where that sort of creativity isn’t much appreciated (for obvious reasons). “Just kidding. Here’s the x-ray without the tumor! Ha ha!”

    I miss the fun stuff.

  55. P. Singh – you’re brilliant! I love Mark Sisson and his blog. I absolutely believe he could do it. The Primal Blueprint is the best way to live… fat or not. Anyone know one of Oprah’s “peoples” to give her the suggestion?

  56. You wrote above : “and the vast majority do just fine on low-carb diets”….and then there are those woman, like me, that faithfully followed PP, balanced her sex hormones, regulated my thyroid, and STILL it refused to come off. I wasn’t cheating and I wasn’t fooling myself, nor lying. It took forever to get somewhere! I do believe you can MAINTAIN on PP..and it’s a wonderful and healthy choice…but for those of us in which our system is in need of something additional I think we NEED more information on this. I don’t NEED to maintain, I NEED to lose. Major difference.

    After a period of utter disappointment, disgust, discouragement and yes, GIVING UP.. I looked for additional answers. It happens to be in another hormone. Hcg. Take Kevin T and his line of bull OUT of the picture…and look at that hormone as it stands on it’s own. Northrup too, everyone seems to have their own SHTICK, as it was put. I mean, just because she obviously has some personal views she’s injecting??? I don’t know, I don’t have any idea about WTW?…but do you throw out the bio identicals that she’s also toting because you don’t agree with her?? no.

    I guess my point is that there ARE a group of folk who are falling through that difference between ‘all’ and ‘vast’. I know, I was one. It’s not do to noncompliance.

    Gary even mentions in his book GCBC that we obese often are disbelieved. That breaks my heart and adds to my own feelings of discouragement…especially when I KNOW I’m doing the right thing.

    Could it possibly be that there is MORE to learn/know for this category of woman? Obviously.

    There is always more to learn and know. Nothing works for perfectly for everyone.

  57. My goodness, thinking about fetal programming is depressing. My mom’s a total carb addict as well as a chronic dieter (sadly, one of my earliest memories is of her crying because she was “too fat” at 120lb.)…I’m sure none of this did me any good. I try to gently remind her that there are other macronutrients as well when I’m around.

    Incidentally, on the iodine front: I realized a few weeks ago that I was consuming trace amounts at best most days and started taking a kelp supplement. What a difference! I was feeling cold, tired, and sore all the time and sincerely considering dropping my sport for the winter. Now I’m back to my old self and back on the ice. My only concern is that I wish I could find a more standardized supplement, since I don’t want to OD by accident or something.

    Go to Amazon (through this site, of course 🙂 ) and get some Iodoral. It’s a good iodine supplement. I plan a post on iodine deficiency and iodine supplementation soon.

  58. This is fascinating, and informative. Being famous has its downside, with all and sundry able to watch your every move, but I suppose that Oprah has made a career of living her life in public, almost a one-woman reality show. I do not envy her.
    I am happily embarked, very privately, on a low carb way of eating, and it has helped me improve my health and fitness so much that I can see that it will be the way for me to go from now on. I came to it by accident, after reading an article in an English paper, via the marvellous book, The Idiot Proof Diet by India Knight and Nerys Thomas. It has swept around the world from here in the UK, and the forum of IPDers has people logging on from every country, finding common cause with their quest to find out the truth about low-calorie, low-fat diets – and why they never worked, but this does. Also, how to reclaim responsibility for yourself, imho.
    It is just common sense, and if you haven’t read it please do – it is so good on the head-stuff. I wish there was a way of smuggling a copy into Oprah, but sadly, as you have made clear, Dr Eades, there is a ring-fence round her by those who appear to have their own material interests as a top priority. I wish her well, but like you, I’m not holding my breath.

  59. Hi Dr Eades,
    Schadenfreude is, I think, a pretty lousy, low and petty reaction to have for anything. But, alas, I can’t resist having it in this case. It’s because, like so many husbands all over this world, I have no weapons against “the Oprah defense”. This is where a wife (OK, my wife) uses that clincher in an arguement: “But Oprah says…..” Naturally, husbands do not know the gospel according to Oprah, so the Oprah defense is hard to counter.
    But I did see my wife weaken when Gary Taubes did that gig on CNN’s Larry King show. And now, she’s on a low carb diet because her brother lost a ton of weight. (The fact that I’ve done the same is not relevant.)
    But on behalf of all husbands powerless against the Oprah defense (and only for that reason) I am allowing myself a few seconds of gloat. There….. Much better. Gloat over.

    Music stuff:
    Have not obtained any recording yet of Morten Lauridsen. But in listening to the 1 minute samples on Amazon or wherever, I thought that the 1st movement of Lux Aeterna sounded really familiar. Let’s see, D major clashing with C major. Yep, Ralph Vaughan Williams’ 5th Symphony! If you’ve not heard it, go for it. It’s SO beautiful. I don’t how much you know of VW’s symphonies, but I currently have this recording:
    But, besides Boult, they’ve also been recorded by Haitink and Previn. You can’t go wrong with any of these sets. The 4th is dissonant. The 6th ends in nuclear devastation (unforgetable). But the 2nd, 3rd, and 5th are incredibly beautiful and the rest are also merely very beautiful. The 1st is a massive choral piece called the “Sea Symphony”, words by Walt Whitman. And if you get the Boult set, you also get “The Lark Ascending”, “Fantasia on a theme by Tomas Tallis” (which you’ve surely already heard) and a piece so beautiful that, when it was premiered at a 1939 London Prom, Rachmaninoff was moved to tears — “The Serenade to Music”.
    I’ve not been able to find any decent audio clips. This link has a few, but they’ve not chosen the good “bits” and the tempi are soooooo slow.
    Michael Richards

    I’m somewhat familiar with Vaughan Williams. Thanks for the recommendations. I’ll give your suggestions a try. You must listen to the entire Lux Aeterna before judging.

  60. Hi Dr. Eades,

    I was wondering if you’re aware of a woman named Kat James, the author of a book called, “The Truth About Beauty.” In it, she describes battling weight issues and an eating disorder most of her life. What ultimately remedied her situation was a low-carb, high-fat diet, which she calls a “low-impact” eating due to the benign effects on blood sugar and insulin. She has sections in her book explaining the myths behind saturated fat and cholesterol and recommends real foods like full-fat dairy and coconut milk.

    So, guess who wrote the forward to this book? None other than Oz Garcia himself! In fact, a quote on the front cover by Dr. Oz says, “This book is a masterpiece.”

    Also, in the forward, Dr. Oz recommends Kat James’ book to health professionals everywhere. With such an enthusiastic endorsement, it boggles my mind that Oz doesn’t embrace James’ example and spread her message, particulary to Oprah herself.

    But I suppose he reaches a broader audience and sells more books by staying to the old song and dance of mainstream nutrition. Sad, indeed.

    I think you are getting Oz Garcia confused with Oprah’s guru Mehmet Oz. Different people.

  61. Don’t fret about Oprah. I just saw a video of Gayle King on the Today show talking about Oprah’s plight. All this blabbing about her weight every where you look is the marketing genius gearing up for a synchronized effort of shows in January which will feature her weight issue in her magazine, tv show and radio show.

  62. Oops! I just realized that Oz Garcia is not the “Oz” that we’re talking about here. Mehmet Oz is Oprah’s nutritionist — not Oz Garcia! My mistake. But I still highly recommend checking out Kat James’ book!

    Sorry. I already brought this up in my previous answer. I kind of deal with these comments as they come in and I got to that one first before I saw this one.



  63. Dr. Eades, thanks for the sane analysis of the latest Oprah pronouncement (and the attendant hype that always seems to go with the latest announcement by or about Oprah).

    She is the only person I’ve ever heard of who has been diagnosed as hypothyroid and chose a wiggy alternative doctor’s advice, and virtually no effective treatment, over a trial of Armour thyroid, or any thyroid preparation for that matter, which might actually do her a world of good. Effective treatment made a world of difference to me, and I have trouble imagining anyone choosing to continue to feel so bad. It’s a problem that doesn’t just go away… balancing her postmenopausal hormones with some bioidenticals wouldn’t hurt either.

    Also, wasn’t Dr. Oz the interventional cardiologist she had on her show waaaay back when she first became perimenopausal? She announced that she had an arrhythmia or PVC’s and that was her first symptom of perimenopause. And wasn’t he also the one who did, and interpreted her heart scan… the one that showed a good deal of plaque for a woman of her (then) age? According to Dr. William Davis at the HeartScan blog, without aggressive reversal treatment, plaque can be expected to increase at about 30% per year… and it was a few years ago that Oprah had that on her show. Lately, Dr. Davis has been saying that untreated or undertreated hypothyroidism is a potent accelerator of atherosclerosis.

    So Oprah may wish to think that she just has a weight problem… but I am sure it is far beyond that, were she to set the voodoo diets and strange advice aside and really assess her total health. I think she doesn’t exactly look the picture of health lately. Such a pity… so many “experts”, but so little result, except of course, exponential sales of books and such.

    I agree with most of the opinions here… I don’t think she is going to go low carb anytime soon. We will just have to soldier on without her!

  64. I remember when Oprah was doing that vegan detox diet, full of carbs and soy, and though, oh, no who are you listening to? I am sorry that she won’t consider a low carbohydrate diet. It would no doubt work for her.

  65. “she is listening to idiots”. They’re not idiots. If they were idiots, they could be easily refuted. Unfortunately, they are very smart people who apply their intellects to rationalizing their mistakes. When smart people are wrong, they are far more dangerous than any amount of stupidity. Cf the history of Communism.

    Not having much interest in dieting myself, I never heard of the CAD plan. It strikes me as guaranteed failure. One reason people eat too much is that they focus on food as their chief pleasure in life, especially their “favorite foods”. The “Reward Meal” is a perfect way to reinforce and intensify the desire for those foods – to convince oneself that those foods are what one really wants, what really gives pleasure. No one who does that will stop eating those foods for the sake of some other “reward” that is not half as gratifying (an abstract weight goal, for instance).

    The comment about carb-excess in early pregnancy is a good one. I wonder how many people now alive have been damaged by mothers turning to “healthy” high-carb diets.

  66. I appreciate your message about having her hormones checked. I am a 48 yo female still having cycles and have been struggling since March to lose weight on low carb. In the past I have had no problems losin but gained 55 pounds last year when put on an antidepressant. To date I have lost 17 pounds since March. I have tried everything, counting calories, more exercise, and the weight won’t budge. I have had my thyroid checked but the doctor would not do the T3 and Antibodies testing. The TSH was .59 (.35-5.5) FT4 1.06 (.9-1.8), Female Testosterone 25 (9-55), Estradiol 60 (63–165), and Free Testosterone 4.1(1.1-5.8). What do you think of these numbers. I know they are within “normal” limits but my symptoms are severe in addition to the weight (hair loss, chronic fatigue, chronic depression, cold, eyes dry and gritty, chills, memory loss, constipation, easily stressed..unable to handle any, severe panic attacks). I am hoping that she gives me BHRT and that she can do testing on my Adrenals and the other Thyroid testing…

    I hope that you are essentially saying that once everything is balanced out in terms of my hormones, that I should be able to lose the weight… I, too, have underlying issues but find that Omega 3 supplements have helped me with the cravings a great deal lately… Cake in the frig and haven’t had any or wanted too…

    Any suggestions would be greatly appreciated?

    P.S. I would be happy to forward your post to the Oprah site to see if you receive some sort of response….

    I couldn’t possibly comment on your condition because you aren’t my patient. I would need much more information than you have provided, and still couldn’t make specific recommendations over the internet. Based on your symptoms, there seems to be something going on. Given these symptoms, I’m a little surprised that your doctor didn’t do a more comprehensive thyroid workup and do a salivary test for cortisol. But, since I haven’t seen you and examined you, it’s difficult for me to second guess someone who has

  67. I remember reading that Oprah did try a low carb diet, she mentioned peeing on keotone sticks in Bob Greenes first Make the Connection book. Didn’t stick and I imagine it is because at that time low carb=quackery. Oprah is handling her weight like any other issue, she spends lots of money on the most expensive experts without analyzing whether they make sense herself. Leave carb aside,more troubling is that she binges. She binges because the diet recommended to her, even if it works,is a miserable experience. She wants to lose weight, she thinks to lose weight she has to exist on beans and quinoa, she gives up and pigs out because such food is nasty. Best to find healthy foods that one can actually like than try something that has failed and will continue to fail. Hats off to her for saying she hates these diets and is done with them. It’s a start.

  68. One very smart man once said that a if you keep doing the same thing all over again expecting different result you might be insane!

    Whats the difference between a mentally challenged person and a neurotic one? Mentally challenged person will keep insisting that 2 plus 2 is 5, but a neurotic person knows it is 4 but cant accept it! Dr Eades there are a lot of shleps in so called diet industry and some of them are either mentally challenged or neorotic! I dont know why Oprah didnt come to realization that low carb is the way to go. I still believe that her weight is much deeper than diets. With her money and fortune she still seems to be avery lonely person. look how many dogs she sleeps with. i love dogs, but sleeping with 3 of them suggests there is some big disconnect there! Dr Eades we need to get you on her show! You are a perfect person to convince her. I will bet you that had you had your opportunity to sit down with her she would listen to you. There got to be a way! I can only imagine how many people would benefit from it.

    One very bad german man once said that the bigger the lie the faster people will believe in it! Unfortunately he was right. And hence lots of neourotic people going around and around diet after diet!

    Oprah is a huge earth person, so how hard it is to convince her that low carb is nothing but an earth diet! Dr Eades lets start a new diet revolution here and stop the insanity!

    I think low carbers need more tv coverage and media exposure. For whats it is worth I will do my part when I finally lose the weight> I am still on with that celebration on Coney Island beach. I will jump naked in winter time on polar bear day into Atlantic Ocean with a message on my back “‘ Oprah please give Dr Eades a chance, I was once fat on a skinny diet and now I am skinny on a fat one! I believe that a movement starts with one idea, one person, one message!

  69. Underactive thyroid problem is usually related with metabolic syndrome but why is it? Hammond’s research on SHBG has shown that excess sugar will lowers liver sex hormone binding globuline production. Could same thing happen with thyroid binding globuline TBG which carries about 99 % of inactive thyroid hormones?

    My understanding, based on the research I’ve read, is just the opposite. Insulin resistance and hyperinsulinemia increase the liver’s output of SBHG. If the same occurs with thyroid – I don’t know if it does, I’m just speculating – that could be a reason overweight people seem to have reduced thyroid function.

  70. Dr Mike I have noticed that you are a late person going to bed. Unless I am wrong you are still responding to blogs around 1 am. i swear since starting low carb living I have so much energy at nights after work that I cant possibly sleep until 3 am. It is 4 30 am now in NYC and I cant even think about sleeping. I have so much energy now I cant even contamplate sleeping. What could possibly be an expanation for that? And are you a believer that the cortisol goes up after certain time after it gets dark and that is very unhealthy to stay up late at night? Whats your theory on sleep?

    My theory on sleep is a little more complex than what I want to write in the response to a comment. In short, sleep is a good thing. Get some.

  71. If Oprah continues to eat soy products she will damage her thyroid gland beyond repair. Unfermented soy should be banned for human consumption.

  72. “I have no idea how hard it is to lose weight? I have only counseled with thousands of overweight middle-aged women in my career. I think I know how difficult it is. And I know all about how to understand thyroid tests correctly plus how to check for low iodine, which few doctors do. I always -always – put my patients on Armour thyroid, even if I had to take them off of Synthroid to do it.”

    Hi Dr Mike, did not mean to bash YOU, if I didn’t think you were right I wouldn’t be reading your blog 🙂 🙂
    I was just venting on how hard it is for some women to lose weight even when doing LC.
    And endos are great for diabetics but they don’t seem to get how to treat thyroid. My GP, who is a dear and works with me on my thyroid meds,(and most importantly is not afraid to actually LISTEN to his patients) told me there are only about 55 endos in the Philly area and most med students aren’t choosing that as a career because in the current state of healthcare there are not a lot of procedures you can bill for.Yikes.

    Anyways, just wanted to post this and wish you a Happy Holiday and to thank you for all you and MD do.

    Thanks. Happy Holidays to you and yours, too.

  73. “Strange as this may sound, why don’t you try some decaf herbal tea with a little sugar or honey in it at bedtime.”

    I too have the same problem as ‘sleepless’ which I think is why I struggle with LC. My situation does seem to get better very gradually over time which hopefully sleepless’s will too. I’ve been low-carbing a little over 1 year. I am not sure if it is the time span or the fact that I seem to spend about 1 week out of every month eating all the carbs I want that is helping… not eating the carbs intentionally though and it’s still way less than I used to consume. I am still losing very gradually, about a lb a month. My blood pressure has come down, still maintains and all other stats are good.

    I am curious… if our carbs are practically nil throughout the day, will a teaspoon of sugar still throw us out of ketosis? Is it the total carb consumption per day that’s important or at one given time? Can we eat 20-30 grams of a different carb (not sure what’s in a t of sugar) at night, accomplish the same thing and still obtain benefits of the diet?

    I read in Schwarzbien’s book a while back that insulin resistance or any sort of damaged metabolism will take a year, sometimes longer to correct itself with proper diet (she is also proponent of low carb just not to same extent). If I remember correctly she indicated that too low a carb count for these people isn’t a good idea in this transition phase. Sorry to reference someone elses book but it may shed light and give hope to those feeling their body rebelling a bit and trying to make it through this adjustment phase.

    Yes, a teaspoon or two of sugar usually will throw one out of ketosis, at least long enough to get to sleep. Remember, all the blood sugar circulating in the body of one with a normal blood sugar adds up to a little less than a teaspoonful. If you consume a teaspoon or two of sugar, you will effectively double or triple the amount of sugar in the blood, which will turn off the production of ketones for a while.

  74. Dr. Eades

    I am very curious as to the doses of cortisol these patients who developed Cushings were on? Most people who take HC take a physiological dose (i.e. the amount that is needed to make up the deficit between what they produce and what a fully functioning adrenal gland produces) as opposed to a pharmacological dose which far exceeds the amount healthy adrenals produces. Pharmalogical doses tend to bring about severe side effects such as obesity. This does not tend to happen with physiological doses.

    What dose were these patients who developed Cushings on? Have you read Jeffries Safe Uses of Cortisol? It is actually a medical textbook.

    I have attended conferences and spoken a number of times for an outfit that recommends cortisol replacement in physiological doses. Most of the people at these conferences that I’ve seen are disaster cases. What happens is that the dosage starts with a physiological dose and when no improvement in symptoms is experienced, the prescriber ups the dose a little. With time the dose goes too high and terrible problems develop. I’m not saying that this isn’t appropriate treatment – physiological doses of HC- for a few people, but not for everyone who walks through the door. I view adrenal fatigue syndrome as I do candidiasis. Some docs think every problem anyone might have is caused by an overgrowth of candida, and they treat for that with anti-fungals. I believe that a few, with emphasis on the word few, people have candidiasis, but not the majority of patients. Clearly you have benefited from being treated with HC, and I’m glad. Had you come to my office, you probably wouldn’t have been treated with HC. Actually, you absolutely wouldn’t have been treated with HC because I’ve never treated anyone with HC. Had I thought you had an endocrine problem, I would have referred you to an endocrinologist.

    No, I haven’t read Jeffrie’ book. And at $200 per copy, I’m not likely to.

  75. Great post!

    Dr. Oz is an excellent surgeon who has performed surgery on two of my friends. That being said, I wouldn’t take nutritional advice from him nor Bob Green. The bottom line is they have it wrong. Hence, I’m here at your blog. 🙂

  76. After reading Gary Taubes’ book “Good Calories, Bad Calories”, I’m back to trying PP. My doctor had recommended it in 1998 and it worked well. Then, my doctor’s husband who lost weight on PP became diabetic and my doctor’s advice changed. Add in I’m sensitive to Arachidonic Acid and then menopausal symptoms started. I didn’t balloon up too much, because I still minimized my sugars, but have gained weight. Additionally, I’m lactose intolerant and a low-carb diet becomes a challenge. I’ve also found Kathleen Desmaison’s advice on diet and brain chemistry helpful for controlling mood swings.

    I just could never develop a diet combination that adequately included the concept of a balanced diet. With Gary Taubes’s information, I’m ready to try again. His book has been a source of freedom for me. Now, I know why my body has reacted the way it has. I know from my own body and the death of my mother from diabetes what he writes about is true. I’m here, because there are issues with low-carb diets and it helps to communicate with others who are on them. PP seems to have the most flexibility, so it meets my needs the best.

    I feel for Oprah, because I don’t think we still know enough about what is the absolute best diet for each individual. My frustration with the quote unquote diet experts is they seem to assume we are all the same and we aren’t. When I realized how much of conventional diet wisdom is based on out and out lies about diets, it was quite the revelation.

  77. Doesn’t it just drive you crazy to watch as people spin their wheels doing everything but what would actually help? People spend so much of their lives and money chasing after everything but the right thing. I’ve felt nothing but contempt for Dr. Oz ever since I saw that travesty of journalism when Gary Taubes was on Larry King Live, and Oz, helped out generously by Joy Behar and Jillian Michaels, dominated the program, drowning out Gary every chance he could with his own pontification on a subject he knows nothing about. And we should all weep for the decline of Western civilization to contemplate how someone such as Oprah can have so much influence over people, not to mention her pet politician Obama. Just look at how many comments come in here when the subject is Oprah!

    I’d like to pursue a little more the discussion about hormone regulation. If my questions will be answered by your forthcoming book, don’t bother now, but just tell me to be patient and wait. I’m one of the middle-aged women behaving myself on low carb but in a stall and even experiencing some slow creep upwards in the last year. I envision going to my doctor and telling her I’m trying to lose weight but not succeeding. I’m pretty sure if I say I’m following a low carb diet, the rejoinder will be that I need to watch my calories and fat intake, exercise more and make sure I’m getting those healthy whole grains. And if I say I want my hormone levels tested based on the recommendation of a doctor whose blog I read on the Internet, I predict that won’t go over too well. But let’s say I insist on pursuing HRT, here’s what I’m wondering: are bio-identical hormones easy to ask for, are they priced comparably with synthetic, are they typically covered by insurance, is the garden-variety MD knowledgeable about them, once you are on them, what happens when you go off or do you always have to take them? Was the big scare a few years ago that caused the rethinking of the benefits of HRT just for the synthetic kind or was it for any HRT? If I thought a year of so of them would be safe and would take off the rest of the excess weight, I would pursue this route, but if I’m going to be dealing with a resistant doctor, or a big, long-term expense for what the establishment perceives as an alternative therapy, then this door may not be one I can go through. Sorry, but I’m totally clueless about this. I reiterate my recommendation to write a post on this–I’d really like to read about how diminishing female hormones affect weight and how HRT helps.

    In most cases, bio-identical hormones are less expensive than synthetic hormones. As long as these hormones are prescribed by a physician, insurance will pay for them. MD’s insurance pays for hers. The big scare a few years ago was with the synthetic hormones. You need to find a compounding pharmacy and ask you doctor to call the pharmacist and have him/her (the pharmacist) to compound the hormones to replace what the doc would normally prescribe. I’ll push MD to do her post.

  78. I see that Tom Daschle, former senator from Big Grain, has been nominated as secretary of HHS. Look out, food pyramid! Next will come the requirement for a day’s dose of Lipitor as an additive to corn flakes.

    Maybe not. They raise a lot of cattle up there, too.

  79. It’s good to know then that the physiological doses are okay. Do you know of any contraindication between physiological doses of HC and insulin resistance? I’m also curious what do you do when you have a patient that cannot tolerate even the smallest dose of armour such as 1/2 grain? A patient whose labs clearly indicate hypothyroidism. This is why I was prescribed HC so that my body could process armour.

    And a little known secret, if you or anyone else ever wants to buy Safe Uses of Cortisol you can get it directly from the publishers for $43.95

    I’ve never had a patient who couldn’t tolerate a small dose of Armour thyroid.

    If I can get the book from the publisher for $43.95, I’ll buy it. Do you have a link to the publisher?

  80. In reading through the posts on this blog I find it interesting how many people have come to the realization that the ‘experts’ (usually MDs) are not giving good advice. As a result they have taken matters into their own hands (i.e. they have a ‘survival instinct’). It is probable that some of these people fit society’s stereotyped image of normal (i.e. overweight, tired etc.). Yet they figured out what their doctor didn’t or couldn’t – that they have underlying health issues that need to be addressed.

    If some can figure this out I find myself wondering why so many who are regarded as intelligent are so ignorant and neglectful when it comes their own health when there are signs everywhere of a catastrophic decline in the health of the general population. It seems inconceivable that so many otherwise intelligent people could be so dumb. Maybe the answer is that they aren’t concerned about their health because they think they don’t need to be concerned.

    A least part of the answer may lie in a state of complacency due to a longevity bubble that has emerged from the illusion of large increase in life expectancy. The life expectancy of a male today is around 80 years. But retirement planners typically base projected retirement income needs on a minimum life expectancy of 90 years. The rational behind the 90 year minimum life expectancy is that theses planners claim that medical advances have resulted in a huge increase in life expectancy over the last 20 years. Based on this they theorize that due to even greater medical advances (statin hype comes to mind here) a person investing for retirement today will live to be at least 90 years and probably a lot longer.

    This of course means that the retirement planner will benefit financially from those who sock away more money. But the reality is that the idea that we can live our lives with reckless abandon and still live to be at least 90 years of age is probably pretty compelling to a lot of people fostering a “Carb, schmarb, who cares if I am a little pudgy, I’d rather enjoy life and not worry about what I eat” attitude.

  81. Thanks for the fetal “damaged pancreas” info…likely explains why I’m losing so slowly which I find so frustrating! Apnea (diagnosed Apr07), NID type 2 diabetes (diagnosed Aug08), systolic hypertension (Apr07), obese (long time), female (last time I cked *G*), just turned 60 (how did that happen, I’m still late 20s-early 30s if I think about it). On Maxzide (37.5-25 mgs, 1/2 tabl), 50 mgs Cozaar, 1500 mgs Metformin ER, Januvia 100 mgs, D (very low levels), Nasonex for my now chronic congestion thanks to the drug side effects (nasal mask is no picnic with congestion). Take 600-800 mgs magnesum citrate, 1K IU Vit D, Coromega fish oil packette, 265 units DHA, 500-500 mg Proline-Lysine combo, 500 mgs L-gluatmine at bedtime, 200 mgs tocotrienols, 1K-2K mgs bio-ascorbate C, 50 mg CoQ10. BP 125-130/65-70. 7-day BG average 131. Sleeping 8 hrs/day. Carbs about 10-15 pgms per meal, about 5-8 snack & always with lots of protein. Water about 80-110 ozs/day. Eat a ton of low-carb veggies (good thing I like all of ’em *G*). Can’t retain potassium so I drink 6-10 ozs low-sodium V8 daily and some fresh/cooked tomatoes daily. Another 10 #s and I’m gonna either drop the diuretic or half the Cozaar and see if I get edema (lungs seem to be the target so I know immediately if it’s too soon to drop the drugs). I don’t like the drug side effects but I gotta survive until I lose enough to not need them. What a bummer! I’m low carbing but my wt loss is maybe 2 #s/wk (couldn’t it be more? *sigh* my first round of zoning in ’97 saw 4-5 #s/wk loss with 85% compliance). My thyroid panel shows all normal levels at this pt. About to buy a BP cuff and add quercetin as it encourages loss of fat & also drops BP. Also gonna start using my topical progesterone again and see if that helps. The news that my mom’s diet during pregnancy may be the cause of what seems to be such slow loss (to me) is encouraging & I need all the help I can get to believe I can get healthy again…tho I must say that from BGs in the 300s at diagnosis to seeing them in the 120-130s is exciting. Doc wants to tinker by adding another drug (is he nuts?) but I’m gonna start exercising MORE and see if that drops my fasting BGs (130s-140s, sometimes 120s). Ahh, one day I’ll actually be able to eat a serving of fruit…now, it’s 4-5 raspberries or blackberries or my BG spikes. All my docs say because these conditions are of recent onset, I might not need any RXs WHEN I lose the weight. I keep reminding myself that I didn’t get fat in a single yr so it’s gonna take some time to lose it all. Thanks for the info…I’ll quit obsessing over what I’m doding wring or what I can change to lose faster (I know ‘slow and steady’ means my eating and exercising will be firmy established habits by the time I lose…but still. Oh, diabetes runs in the maternal side of family (skipped mom tho) so if there really are genes associate with it then i’ve likely got ’em tho I was way too skinny until I was in a car accident at 28 but the trauma might have triggered all of this cascade of biochemical ‘stuff” *G*! Anyway, thanks again for the info…

    Thank you for the interesting history.

  82. Dr. Mike:
    I am a 58 year old woman, 225 lbs, who has extreme difficulty losing weight. However I follow a high fat, medium protein, low carb, no processed anything, diet and got my Lipid battery figures today from my doctor:
    Cholesterol 4.67 (182)
    Trig 1.17 (104)
    HDL 1.68 (65)
    LDL 2.46 (95)
    Ratio: 2.8
    I celebrated by going to Humpty’s and ordering a 4 egg, bacon, cheddar and mushroom omelet with a side of caesar salad make with real bacon and no croutons.

    Apparently, according to my doctor, I am perfectly healthy. The weight just doesn’t come off very easily. I suppose I’d have to reduce my calories.

    But then do we really believe in the lipid hypothesis? LMAO

    Nice labs!

  83. Whoa, Iodoral is a *much* higher dose supplement than my little kelp pills (at least according to the label…my concern there as I said is lack of standardization since it’s just powdered and pressed sea vegetable). It seems like sources that don’t lead back to Dr. Abraham claim that amounts in excess of 500mcg may be too much. I assume that if you recommend it you use it with your own patients; do you have good external information on safety at this dose?

    Yep. It’s in a form that absorbs well and one a few times per week shouldn’t cause a problem.

  84. Your comments on fetal programming are interesting… maybe worthy of a longer post? Of course, now I’m a bit worried, as I am 20 weeks pregnant and while I usually follow a low carb lifestyle, I fell off the wagon during the first trimester due to my morning sickness. The only things that sounded good some days were saltines and macaroni and cheese. Then again, I haven’t eaten sugar in almost a year, and I didn’t succumb to any sweets in my early pregnancy, so perhaps my baby will make it out okay. I wish I’d heard about this earlier… I certainly would have been more careful!

  85. I said years and years ago, in the local health club lecture that kicked off my whole career, that Oprah talked about “being addicted to food,” and that she attributed it to emotional stuff, a “hungry heart,” all that New Age stuff — but that rather than food addiction, what most people have, and Oprah appeared to have, was carbohydrate addiction. I really hoped that she’d try a low carb diet and give it the bully pulpit it deserved.

    I was SO FURIOUS when the Hellers came on her show, wearing their white coats and calling themselves “doctors” (when, of course, they are PhDs, not MDs) — and insisting that CAD wasn’t a low carb diet! Oh, no! Low carb diets were BAD! Carbs were ESSENTIAL! (I immediately tune out anyone who comes out with “carbs are essential,” because it’s clear they don’t know what they’re talking about.) Such an opportunity squandered.

    I’m not surprised Oprah’s still fighting her “food” addiction. It’s damned shame.

  86. I once watched on Oprah, Mehmut Oz expound on antioxidants and phytochemicals and the like. I got very frustrated … alas, they get the macro nutrition (carbs/proteins/ fats) all wrong… but were fussing with getting the micro nutrition right?

    Maybe, Oprah with her feeling re: spiritual awakening/ consciousness, does not feel good about eating meat anymore? Re: South Beach — it is appealing to people who are convinced about low carb but don’t eat much meat. I did SB for 3 months and tracked everything I ate — I was averaging about 80 g of carbs. As a type 2 diabetic, glycemic control was better, but not good enough to be normal. I needed to get down to 40g and stay there to get my sugar under control. Basically need to seriously the lentils, milk, yogurt and stuff from SB.

    It is quite a challenge — but, I was able put together a 40-50g diet that a near veg. can live on and not feel hungry or deprived and still get the 80 – 100g of protein. Eggs, cheese, cream, whey protien, dreamfield pasta, almond flour and all the spices and ethic foods crafted with substitutes… I found a way to do this and lead a tasteful and healthy life without rice and high carbs.

    Of course, if you want to be vegan and have insulin resistance or diabetes, I don’t know what they could do.

    I see Diabetes and obesity are perhaps a even more serious problem in the developing world … look at the populations around the world ..poor/ vegetarians/ getting affluent/ protien deprived and doctors adopting the USDA pyramid because it is ‘proven’ and recommneded. God help us.

  87. On the subject of sleeplessness: I have tried honey in my tea before bed and all it does is makes my heart pound. It doesn’t knock me out but sometimes keeps me tossing and turning for an hour or so. This actually started after menopause. Before, if I had something relatively carby at bedtime it would reliably knock me out.

    I recently read in one of Jonny Bowden’s books about inositol. I tried half a teaspoon in about half a cup of water last night (it is flavorless) and in about 15 minutes I felt very warm and relaxed. I had a very restful sleep that lasted longer than usual. Bowden says it’s great for insomnia, but it can also be part of a regimen to treat depression.

    Dr. Eades, if you have a minute can you tell me if you’re familiar with inositol and what you think of it? Thanks 🙂 Anne

    First I’ve heard of it as a soporific. I really don’t have a lot of experience with it.

  88. Oprah had a BIG tiff with the beef industry about 10 years ago, based on some comments on a 1996 show she had about beef and mad-cow disease. Some beef industry people sued her, but the case was thrown out, IIRC. I seem to recall her saying she’d never eat beef again, or something like that.

    I don’t follow Oprah at all, unless she’s in REAL news (Or acting in a movie). Is her feud with the beef industry still on-going? That might be a BIG obstacle for her to overcome.

    It ended up in a lawsuit that she won. As far as I know, the feud is over, although I’m sure she doesn’t have a lot of love for the beef industry, as I probably wouldn’t had I gone through what she did. It was a silly lawsuit, and she should have won.

  89. I tried placing an order through your portal to Amazon.com. I have an account at their Canadian branch, Amazon.ca.

    Amazon.com recognized my account and accepted my order right away for one of your books. Good start. But when I added Iodoral it was like the supplement police came down on me. For some reason they will not or can not ship Iodoral to Canada. As I said in another post it is probably easier to get high grade cocaine or heroine on the street (if I were into this sort of thing) than it is to get dangerous goods like Iodoral or (God help us) magnesium chloride hexahydrate. I finally found a reliable source for the latter. I would considering setting up as a street dealer if the demand was there. But it is not that great so far.

    On another note our Health protectorate branch has introduced a regulation that prohibits any product being labeled as ‘low carb’. Can book burning be far behind? I hope your Protein Power books are fireproof Dr. Eades.

    It’s pretty much impossible to ship supplements to Canada unless they are made in Canada or have gone through the lengthy acceptance process that the Canadian government requires. Just another way our leaders keep us safe.

  90. I read a nice quote in my office today that said ” Opportunity – You ”ll always miss 100 % of the Shots you dont take. I ate a lot of drek last night, few slices of cakes and few slices of pizza! And than today I felt like a chewed up gum, flavorless and lifeless. I was bloated, irritable and cranky. And I did crave carby crap all day long

    I did manage to work it out and stay in control! But fun it wasnt. I was still full of undigested fecal matter from yesterday. So as I am sitting in my office looking at that opportunity statement I am thinking about tomorrow. Tomorrow and Monday and New Year are my best friends. I can always rely on them to take another shot at my attempt to get back on that porvebial locomotive! So I rephrased the statement and put it right on top of my computer ”

    Opprotunities of Tomorrow is a chance of correcting lots of undigestable fecal matter of yesterday!

    Dr Eades is there any way to ease symptoms of withdrawal from overindulgence when going back into ketosis from a day of too much undigested carbs?

    Not that I know of. The old saying ‘Stupidity should hurt’ comes to mind. Don’t think I’m singling you out; I do the same things some times and pay the same price. And when I do, I always think of that saying. If stupidity didn’t hurt, I would probably do it more often.

  91. I placed an order for two of your cookbooks after going through your portal. There was no option that I could find to re-direct the order through Amazon’s Canadian branch.

    I didn’t bother to check. But the books are probably less expensive even with the dollar difference. But I ended up having to pay about $15 for shipping because only orders within the US qualify for super saver (no charge) shipping.

    The next time I place an order I will compare the shipping cost on a number of books or items vs. one book. It is usually more cost effective in terms of shipping costs to order a number of items.

    Iodoral is a lot cheaper in the US than it is in Canada even with the brutal shipping costs.

    Thanks for the orders. If you have a friend in the US, you could have said friend order the Iodoral then mail it to you, which should get around the regs.

  92. Thanks Dr. Eades… I really wasn’t trying to get a medical diagnosis online lol…but just wanted to know your thoughts based on the symptoms presented and the labs presented. I just wanted someone else to say he should have done a thyroid panel and possibly tested cortisol levels…which you did!

    Someone suggested that if some of us can figure out that what we were doing wasn’t working then why can’t Oprah, and figure out that possibly we have metabolic disorders. I, like others, think that she just relies on those close to her and believes in them. I understand because I have been there. I have been there and done what my doctors told me to do and after years of suffering decided that it wasn’t working and there had to be something that they were missing… Unfortunately, however, low carb worked for me in the past but when I put on 55 pounds last year due to antidepressants and my breasts started leaking due to other meds I said okay enough is enough.

    I’ve found since then that losing weight is not so simple now, at midlife there are other factors that are obviously preventing the weight loss but I continue low carb because I feel better and I prefer whole foods now. I ballooned up to 235 pounds on a 5’3 frame. Since March have lost 20 pounds… I have a long way to go but realize I may need my hormones balanced out to achieve this. Unfortunately, finding doctors in my area that thoroughly understand the thyroid and female hormones as it relates to bioidenticals is difficult!

    I read that Oprah had changed doctors in an attempt to find out what was going on with her thyroid and many women find themselves doing that because most doctors treat labs versus symptoms. Why is that? I don’t understand why one can’t look at a lab range, especially if the patient’s labs are at the lowest end of the normal range and say well perhaps this is something that we need to look at further…

    It’s disheartening and I’m thankful for doctors like you who are actively trying to enlighten people as to what is really going on with their health…as opposed to putting a bandaid on things!

    Oprah reads a lot and I don’t understand why she hasn’t picked up other books like yours. In terms of sleeping, lately I have started adding a complex carb to my dinner and that seems to help me sleep better…just a small amount but it makes a huge difference for me…especially since I am so low on serotonin!

    Thanks again for your insight!

    I think, or at least I hope, that more and more doctors are going the bioidentical hormone route because the meetings that I go to about such things are getting larger and larger. And more and more people are requesting bioidenticals and leaving practices when the don’t get them. Medicine is a profit-driven business like any other, and when docs lose patients (i.e., customers), they ultimately start to pay attention.

  93. Dr Eades, I don’t think the situation I have is atypical, the only thing atypical about is the fact I actually practice what I preach, I.E. I have lost ALL of my excess weight and have NOT regained it.

    The reason most women don’t have my problems, is because most women stay leptin-depleted for about 0.5 seconds until they start regaining their weight back. It takes a mentally interesting person to not eat when hungry, for years and years.

    But, look at the evidence Dr… studies show that significant weight loss = leptin deficiency = everything one might expect in leptin deficiency (RE: hunger, cravings, metabolic changes).

    Do you not see the irony in your perspective that obese people choose to stop doing LC and replenish lost weight, as if it were exclusively a moral or discipline problem rather than a physiological drive to regain fat? Isn’t this an ironic point of view for a man who prides himself on being smart enough to see through the common perception that over eating causes weight gain (rather than weight gain driving over eating, via insulin abberrations)?

    Won’t you at least entertain that it is possible that abnormal leptin levels might play some role in controlling post-weight-loss feeding behavior?

    Do you have many patients who have lost significant weight and keep it off?
    Do they report any change in hunger or a need to constantly restrict calories even on LC?

    I can tell you this is more often the case than not, based on my own experiences and interacting with many other successful weight maintainers.

    It’s usually the people who have not changed their body weight much on LC who report eating all they want and not feeling hungry.

    Insulin is the key to losing or gaining fat, but lots of things control insulin. Leptin levels after weight loss hugely influence insulin via subjective hunger/feeding as well as major metabolic changes that occur.

    I don’t even think ‘LEPTIN CONTROLS EVERYTHING”, I am using it more of an example then anything else. I am trying to illustrate the point that we really do not KNOW that oprah would be successful if she were to eat low carb, because the bottom line is weight suppression is hard no matter how it is done.

    It’s a hell of a lot more than the hedonistic (i.e. indolent choice) to eat carbohydrate that determines weight status. Desire to eat carb is often hormonally controlled, and depleted fat tissue can affect that greatly.

    Hmmm. It seems you think we’re engaged in an argument here when I agree with you in principal 100 percent. I do think leptin plays a role in weight maintenance, but until it’s widely available, what difference does it make? If people follow low-carb diet in weight maintenance, they keep their triglyceride levels low, allowing the leptin they do have to cross the blood-brain barrier and exert its effect. If people on maintenance try to follow low-calorie, high-carb diets, they do just the opposite. Here is a post I wrote on this issue over a year ago.) The triglyceride raising effects of carbs are beyond dispute now as is the notion that triglycerides prevent leptin crossing the BB barrier. All I’m saying is that in the absence of readily available leptin, the only real tool people have to maintain weight loss is a low-carb diet.

  94. Do you have any experience with low-dose naltrexone? I know it is normally used as an opiate blocker at higher doses of 50mg but have been reading that at low doses of 4mg is very effective for treating carbohydrate addiction, insatiable hunger and insomnia when taken at night.

    Can’t help but respond to the comment about synthetic hormones because I am interested in this topic:

    It is my understanding that bio-identical hormones do come from natural plant sources but are refined and processed the same exact way a synthetic is. The end result is pretty much the same.

    The synthetic hormone scare you refer to, I believe was a previous study which showed increased heart disease and breast cancer from hrt. However, the study consisted of women who started hormone treatment well over the age of 60. Whose to say they weren’t on their way to develop these diseases anyway? Another factor is that the doses used back then were much higher than used now. HRT was originally used because it was thought to ward off heart disease and aging.

    The largest study to date, results in earlier this year, was done with much younger women. Results could not really conclude that hrt caused all the diseases previously thought. I think there was a very slight increase of heart disease and slightly lower than average incidence of breast cancer. Even though, I believe most doctors will not prescribe hrt if risk factors are high for heart disease and breast cancer. It is now recommended only to deal with negative symptoms of menopause and is best started within 1 year of onset of menopause.

    If you are at risk of heart disease and take bio-identical hormones it does not spare you. Isn’t that like saying natural aspirin won’t thin your blood like synthetic aspirin? Also, there is no way your doctor could know what replacement level is normal. Levels vary all over the place from person to person and even within a single person’s life span. Also, bio-identical hormones are mixed to order each time by a person… tremendous room for error. I’ve had some interaction with a compounding pharmacy (client/vendor relationship) and that is a scary thought. How about being totally natural and age the way nature intended? I understand the symptoms go away once your body transitions.

    Synthetic hrt has come a long way; there are now patches and sprays that use the same form of estrogen (I know the patch does) as the bio-identical variety. The spray can be used to relieve hot flashes just at night if desired. The patch is a low dose and can be cut in half. The idea is to use just what you need to feel better. There is no other reason to use hrt. It will not ward off disease, aging or promote weight loss.

    In conclusion, I don’t think anyone can say hrt makes you healthier; It just makes you feel better. And I don’t think anyone can say bio-identical is safer. I don’t know why bio-identcal hormones are thought to be better. I suspect it is marketing… again, thanks in part to Suzanne Somers. MD may change my mind when she does her post; she may want to use this entry to rip apart.

    Yes I’ve been brave playing devil’s advocate here and I feel like I’ve just thrown myself to the wolves (wink)… I say that affectionately.

    First, I’ve never used naltrexone for carbohydrate ‘addiction’ for myself or for patients, but I am familiar with it. It has been used pretty successfully for alcohol addiction. It works by blunting the ‘hedonistic’ response to whatever the addictive agent it. But it can blunt all kinds of hedonistic responses that people may not necessarily want blunted. If your life is being ruined by alcohol, it’s worth it, but for other less life-ruining addictions, I’m not so sure it’s warranted.

    You’re making a mistake in your characterization of bioidentical hormones as being essentially the same as synthetic hormones – they are not. Synthetic ascorbic acid (vitamin C) is the identical molecule as natural ascorbic acid. Not so with hormones. Natural hormones can’t be patented. The only way the pharmaceutical companies can patent a drug – which is what these synthetic hormones are, basically – is to create them with a chemical structure that is unique and can therefore be patented. Premarin, the leading ‘synthetic’ hormone is derived from pregnant mares’ urine, thus the name. The urine is collected from pregnant mares, the horse estrogens are extracted (which are different in proportion than in humans), and are then subjected to a process called conjugation, which changes the structure so they can be patented. So, they are very different from bio identical hormones, which are identical to human hormones.

    I’ll leave the rest of your comment for MD to deal with when she does her post.

  95. I’m amazed you never had any patients get hyper-like symptoms on armour ever. That is fantastic. I know so many people who needed to take minute doses of HC so that they could process armour. Then after a few months they weaned off and stayed off HC and all was well with their thyroid doses.

    I hope to be a success story like one of your patients soon!

  96. Debbie wrote, “I was deficient in selenium, B-12, Magnesium and Carnitine. My thyroid function improved with the selenium supplementation. I was making reverse T-3. After genetic testing showed Vitamin D receptor variants they also insistied that I be tested for iodine deficiency. After adding Iodoral to the regime my throid panels are now normal and the weight has stayed off.”

    So where the heck do you find a doctor to do all this? I’ve tried several doctors over the past couple years, and can’t find one who will test for these types of things and yet isn’t flaky.

    Witness Women to Women. Yes, they prescribe bio-identical hormones, which is good, but they also believe carbs are absolutely necessary for life. The following is from an email I received just this morning from them:

    “Your body needs carbohydrates

    “It may be tempting for women who feel they have a problem with sugar to simply cut out all carbohydrates. But an all-or-nothing approach just isn’t healthy — it takes all four food groups to regulate insulin and quell sugar cravings. Here is an explanation for why.

    “Whenever we eat foods that contain complex carbohydrates, our bodies convert them into a simple sugar known as glucose. Glucose is the main source of fuel for our cells. The brain in particular cannot use any other source of energy (like fat or protein) aside from glucose, so it is absolutely essential to eat carbohydrates.”

    This means that although they are great when it comes to HRT, their stance on diet means we’ll never see eye-to-eye and my appointments will all be filled with arguing. Under their care, I gained 20 pounds on the Schwarzbein diet because they said I needed a minimum of 90 carbs a day. I said I would gain weight, they said no I wouldn’t. Well, I gained 20 pounds in about 3 months.

    They also said I had adrenal fatigue. When first tested for salivary cortisol, my early morning result was 12 (the normal range is 13 – 24, so my reading was “depressed”). After a couple months on all their supplements to increase my cortisol reading (over $100 each and every month in supplements, including bio-identical HRT), I was re-tested. Now the reading was >110 (apparently off the charts).

    So, I said I was going back to low-carb eating because the 90 carbs a day was too much, and I was dropping the supplements because being 1 point outside of “normal” was a whole lot better than being 80 points outside of “normal.”

    They insisted that neither the diet nor the supplements caused the weight gain.

    So, I dropped them. Sure, they’ll do any test I ask for, and then some. But I don’t agree with their philosophy.

    Now I can’t find a doctor who will do the tests. I go to more traditional MDs, and they’re so “by the book,” that they won’t test for anything, and if I get them to do so, they won’t treat.

    My latest TSH was 4.89, yet I can’t get anyone to treat me because the other numbers (T3 uptake, T4 total, Free Thyroxine, Thyroglobulin Antibody, and Throid Peroxidase Antibody) are all “normal.” Women to Women looked at these numbers and asked why I’m not on thyroid meds (yes, they do recommend Armour, but wanted me to do the iodine test of peeing into a keg all day long). Others look at the numbers and say I don’t need meds.

    So what’s a menopausal woman to do?

    By the way, I ran out of my HRT stuff the week before Thanksgiving and W2W failed to call in a refill for a week, despite daily calls. So, I was off the meds for a week. People approached me at their own risk. I had a terrible migraine for the full week, and it lasted yet another week but weakened slightly. No way I’m going off the HRT for a good long time.

    Sorry this got so long.

    I, too, am looking forward to your new book (already ordered through this site), MD’s post on HRT, and your upcoming article on iodine deficiency.

    Until that time, I’m going to order some Iodoral (through this site, of course) and take 2 per week to see if it makes a difference. Think that’s enough?

    THANKS again!!!

    Sorry you’ve had so much doctor trouble. I know it’s a real pain.

    MD takes Iodoral daily. It takes a while to build up decent levels.

  97. My theory as to the question of why mayo has 0g protein is that most mayo recipes don’t use egg whites at all. Hellman’s mayo lists in the ingedients list “whole eggs and egg whites,”. Note that both whole eggs and egg whites are between 2 commas thereby making them a single ingredient. I entered into fitday my favorite recipe for homemade mayo and added in one whole egg in addition to 4 egg yolks. The result for protein per serving was under .4 grams therefore would be listed as 0.

  98. I have a friend who says he’s tried Atkins twice and both times when he was 3 or 4 days into it he experienced massive headaches and therefore quit. Would you mind speculating was to what might have caused this and what he might do to avoid this result if he was to try Protein Power?

    It could be that he just didn’t want to do the diet and so told you that it gave him ‘massive’ headaches. That’s always a possibility. He could also be one of those people who get headaches when in heavy ketosis. If so, then the Protein Power diet may work better for him because he shouldn’t get into a heavy ketosis with PP (he may not even get into ketosis much at all), and shouldn’t suffer the headaches.

  99. This comment is about the lady who wrote the following….

    ” celebrated by going to Humpty’s and ordering a 4 egg, bacon, cheddar and mushroom omelet with a side of caesar salad make with real bacon and no croutons

    I am a 58 year old woman, 225 lbs, who has extreme difficulty losing weight. However I follow a high fat, medium protein, low carb, no processed anything, diet”

    The above breakfast she had is “processed food”. The cheese is most likely made from imitation pasteurized process cheese food. The “real” bacon is loaded with preservatives and other man made chemicals. Try and stay away from restaurant chains such as Denny’s, etc as they use the cheapest “processed” foods they can get away with.

  100. Its the woo, I know that leptin might trigger hunger attack in people who lost lots of weight even more than people who are currently loosing. But for the life of me I dont understand what carb cravings have to do with leptin or hunger connection. As I remember from my nutrition class as well as physiology one, once you gain weight you gain new fat cells with it. But once that weight is lost, those extra fat cells stay with you forever, what basically happens they shrink in size. Am I correct Dr Eades? So it would only be logical from evolutionary and physiological point of view that those shrunk fat cells are starving for their soldiers aka fatty acids. By starving they initiate a whole cascade of reactions, including leptin and possibly activating hypothalamus of the brain. there are few theories out there about hypothalamus and weight set point and what happens when you lose weight. But where does leptin and carb connection come into play?
    And how do you then expalain eating a big meal and stiill craving for sweets? There is no leptin there!
    Dr Eades i asked you a question earlier but I meant to ask you something else, i just didnt phrased it wrong. English is my fifth language.

    I meant to ask you how do you prevent impulsive overeating of carbs or overeating period? I know you might be an expert on binge eating or behaviorial psychology but dealing with obese patients over the years have you found any particular tools that would help one like me to effectively deal with emotional binging?

    Too many questions, Vadim. Each of your questions in this one comment is worth an entire blog post, not just a simple answer in the comments section.

  101. For a less intrusive way to supplement iodine, you can paint regular iodine in a 1″x1″ (or so) patch on your skin. If it disappears within 24 hours, you are deficient. To treat, just reapply every 24 hours until you see a faint stain remaining after the 24 hour period. Treatment continues as above to test and treat…. (Read this in a teaser ad for a medical advice newsletter.)

    Hope this is clear!

    Hmmm. I would be a little suspect of this method of iodine deficiency testing.

  102. I know I should probably simply wait until you do your post on iodine deficiency, but here goes. If you would rather wait until your post to respond, I’ll understand.

    QUESTION: Is the only way to test for iodine deficiency the “collect your urine in a huge keg and keep it in the refrigerator all day”?

    I don’t put much store in the “paint a square of iodine on your skin and watch it” either. Just like the “test” for candida where you spit into a clear glass of water and if there are are “spider legs” hanging down, you have candida. (Or maybe that one really is true; who knows.)

    I’ve read that too much iodine can be as bad as too little iodine, so I feel like I would want to be tested before taking Iodoral every day.

    QUESTION: Is it really ok to take Iodoral every day, or should I be tested?

    Thanks again!

    PS to Ellen: Thanks for the link!

    Yes, the best way is to collect a 24 hour urine. Both MD and I have done it, and it’s not that big a deal.

    It’s always better to test first, but iodine deficiencies are so common that it probably won’t hurt in the short run to take an Iodoral at least a couple of times per week. If you test and are deficient, then once a day is fine.

  103. Several years ago Patti LaBelle was on Oprah’s show. She had been diagnosed with diabetes and went on a low carb diet. She looked great. Of course, Oprah asked her what she was eating and Patti said that she didn’t eat anything that was white: sugar, rice, potatoes, etc. Of course she never said those two little words we all love — low carb.

  104. I appreciate your distinction between bioidentical and synthetic hormones. I so appreciate that you and MD are addressing this issue and I look forward to her post.

    Here is where the confusion lies: estradiol and prometrium, can be obtained from pharmaceutical companies, estradiol as a patch and prometrium as a pill. It is my understanding that both these hormones are bio-identical hormones. If so, then they wouldn’t come under the distinction you describe being that they are manufactured by a pharmaceutical company. What am I missing here? I understand that a compounding pharmacy can provide custom variances and offer other human identical hormones such as other forms of estrogen and testosterone, but again, unless we are tested as young women, whose to know what is normal for us. And is it wise to be getting the amount of hormones as a mature woman that were originally meant to be conducive for making babies. I’m pretty sure most women would like these points in particular addressed. Thanks to MD in advance.

    You are correct in that Estrace (estradiol) and prometrium (progesterine) are bioidentical hormones made by pharmaceutical companies. Most bioidentical hormones used in compounding pharmacies are made by pharmaceutical companies. The versions you mentioned come as fixed doses, and, in the case of prometrium, a capsule to be taken orally. Anything taken orally makes a pass through the liver before it gets to the blood, and, depending upon how the liver is working at a given point, can have a lesser or greater effect from dose to dose. Estrace is simply estradiol, only one of the three estrogenic hormones produced by the ovaries. And Estrace is a fixed dose – it comes only as it comes in the patch, which isn’t optimal for fine tuning. Estradiol is the primary estrogen that prevents hot flashes, but it doesn’t do anything much for vaginal dryness or some of the other symptoms of menopause. Estriol is the hormone for that, but estriol is also fattening, so you have to be careful with it. Compounding pharmacies can compound products that are extremely precise and are in a cream that has much greater consistency of blood levels than oral formulations. I hope you can see the difference here. And I’m just scratching the surface of all the diddling that can be done with bioidentical hormone replacement.

  105. Off topic, but a good read in today’s edition of the New York Times online.

    Drug Maker Said to Pay Ghostwriters for Journal Articles
    “The documents show company executives came up with ideas for medical journal articles, titled them, drafted outlines, paid writers to draft the manuscripts, recruited academic authors and identified publications to run the articles — all without disclosing the companies’ roles to journal editors or readers”.


    On a related vein, I am seeing evidence of coordinated campaigns of misinformation being waged on low carb sites, in particular low carb diabetes sites. The content of and number of posts with similar information raises suspicion. For example:

    “I think low carb is really great. But when I try to get under 120 grams a day I am so tired I just want to sleep all the time.” Or, “I am a competitive athlete. Low carb makes sense to me. But after switching to low carb I have no endurance. I just don’t see how anyone can be on low carb and still be an athlete.”

    I read the article, too. This ghostwriting of scientific articles for the pharmaceutical companies is getting a lot of attention in the medical literature. Everyone finds it abhorrent.

    Could be a misinformation campaign or could be people who are looking for an excuse not to do low-carb. But then why post on a low-carb board?

  106. The Met broadcast today, Queen of Spades, has bass Paul Plishka in the cast. His “testimony” forms an important part of Dr. Dean Ornish’s Eat More Weigh Less book. I googled to see whether Plishka had kept with the Ornish plan. A big plump NO. He says that he got too tired of feeling deprived all of the time.

    Interesting. Thanks for the report.

  107. I was fascinated with your comments in this Oprah blog re: hormones, and having “a hormonal workup and bioidentical hormones.”

    As a post-menopausal who is religiously following Prot Power and not losing yet, I’m sure that’s an issue with me; however, my great concern is for my 33 year old daughter-in-law. From month to month, she suffers greatly for up to a week with symptoms ranging from what might be mild-to-severe PMS. This includes mild cramping and moodiness, (AKA “grouchy”), some months, or becomes very severe, with cramping, depression, and withdrawal from family friends, and activities in other months. She’s a wonderful lady, but she and her family suffer during these weeks. It was via your post that I forwarded to her that she realized PMS could be her problem!

    My question, then, is, “How in the world do you find a doctor willing to be that THOROUGH with hormone (and thyroid) tests?” In my 40+ years of experience, my GYN doctors have gone only by the symptoms I’ve relayed, without any hormone testing. They then either gave me hormones or told me I could get through it as is. It seemed to be mostly “hit and miss”

    My D-I-L is now going to see an OB-GYN. Do you have any ideas on what she do to insure that her new physician does these more specific tests and follows through??

    I would wish that you and MD practiced here in Montana; however, we are currently experiencing a blizzard with a HIGH of MINUS 12 expected for tonight! Not exactly golf weather! My guess is that you’d much rather be in beautiful Santa Barbara. LOL


    I’m glad MD and I don’t practice in Montana. It’s a great place to visit, but I wouldn’t want to practice there. 🙂

    It’s tough to find a doc who will go the extra mile to figure out all the hormone issues. In my experience, it’s especially hard to find an OB-Gyn who will. She might have better success asking around and seeking the services of an alternative-type primary care physician. I’ve found that increasing omega-3 intake helps prevent some of the symptoms of PMS. Maybe she should give krill oil a try. I don’t think anyone is going to fool with her hormones at this stage since she is premenopausal.

  108. On the subject of sleeplessness:
    I’ve had big sleeping problems untill I switched from all kinds of sweets at my tea time (8 to 10 pm) to bitter-sweet chocolate. Then low carb diet came along and helped even more. Now, the only two things can wake me up – hot flush and alarm o’clock (I hate both) 🙂

  109. What you said above is true of Premarin, but not products like Vivelle Dot or Climara or Estrace. They use the same bioengineered yam- or soy-based estrogen used by the compounding pharmacies in their creams and troches.

    True. See my response to Kris.

  110. Dr. Mike, what do you think of DHEA and/or pregnenolone supplementation? I’ve been taking a modest dose of DHEA for… gosh, almost fifteen years. It’s one of those things that made me feel vastly better almost immediately. I’ve been under the impression that the body then converts it to the various hormones it needs. I feel fine, but would be willing to go the bioidentical hormone route if you feel it’s superior. Pretty sure my doctor would be willing to refer me to a local doctor who prescribes bioidentical hormones; she’s amazingly cool about my tendency to direct my own health care. (And about the only doctor in town who prescribes Armour Thyroid. Thank God.)

    I can’t make that call or you. DHEA is kind of the basic hormone that the body then converts to the other hormones it needs. On of the components of the metabolic syndrome is a fall in DHEA levels. I’ve recommended it to many patients, but I always checked their levels first.

  111. In response to Angie regarding my celebrating with an 4 egg omelet, I suppose she forgot to check my lab results.

    She was right in one area. I don’t eat in restaurants often because they don’t use much fat and they if they do they use the wrong kind. I make my own 4 egg omelets floating in butter with tons of bacon on the side, sometimes ham or both. Then I wash it all down with pickle juice. All that sodium. I’m going to die soon.

  112. In response to woman finding physicans who understand bio identicals..and for that matter good with thyroid as well…I found my Dr. through calling my local compounding pharmacy and asked THEM for a refferral to a Dr. that they work with.

    I explained my frustration and they teamed me up beautifully with my current Dr. I just didn’t have it in me to ‘explain’ and ‘educate’ a closed minded HMO Dr. I have to pay for my services (for the most part) as he isn’t “primary” on my insurance…but the QUALITY of care I get now beats ANY care I got in the HMO cattle call. I wouldn’t trade him or anything now!

    I figured I’d make searching for a list of physicans who knows their stuff SHORT by going to the source of whom would know. The Compounding folks WORK with the Dr’s/patient in ‘tri’ care…which is their point. To make specific medications for MY specific needs…instead of dosing for the ‘average’.

    Compounding pharmacy is the place to START..and save yourself some frustration.

    My Dr. is of the “Wellness” type. Willing to prescribe meds if necessary…as it’s not ‘evil’ and can have definite benefit…but also willing to suggest alternative suppliments where that is a good choice too. Best of both worlds!

    A good idea. Just find a compounding pharmacy and ask the pharmacist for a physician recommendation. The pharmacist will know who knows what he/she is doing.

  113. Cindy, 11. December 2008, 0:19
    Oprah, like myself, is an all or nothing kind of gal. Low carb works for me. No way could I eat carbs in moderation.

    Low carb would work for Oprah if she did the right diet oh & Cindy I’m not having a go at you but i loath that ‘eat whatever in moderation’ line. Just who’s “moderation” are we talking about???? no one ever tells you what moderation looks like how much it weighs or how much of it you can eat before it becomes not moderate?? a bit like the “normal” patients so many medical researchers talk about, Just who’s version of “normal” are we taking about?? what is normal or moderate for that matter differs from one person to the other a bit like finger prints. so unless you have had something measured from the time you were born who the hell can say what is normal for you anyway? Just because something may be the average total taken from a random sample of persons does not make it even a very good “average” let alone an indication of what is normal.

  114. I saw the Hellers on the Oprah show and found the CAD diet to be the answer to my prayers. I followed the rules strictly which said you had to balance the carbs you ate at the reward meal with low carb vegetables and protein. I went even so far as taking a can of green beans to a local restaurant that I knew didn’t serve much in the way of vegetables. I would take a serving of the “goodies” in the teacher’s lounge home for my reward meal and thus never felt deprived. I lost 25 pounds in 5 months and have kept it off for over 6 years. I did eventually go to a more Atkins style low carb and no longer do the reward meal idea. I do think it really helped me and am not sure if I could have been successful initially on another version. Since the reward meal had to be carefully balanced excess amounts of pasta etc. were not really a problem, but the idea that nothing was off limits was very comforting at the time. And by restricting the carb intake to one hour a take coupled with the balance of protein and fiber (salad) I had no carb craving later.
    Like everything what works for some doesn’t work for others. Also if you follow the Heller’s plan as they intended it (read the book) it can be a great plan for some.

    Thanks for the report. I’m sure that the plan works for some.

  115. Thanks for your reply. At the end you said, ” I don’t think anyone is going to fool with her hormones at this stage since she is premenopausal.”

    Guess I’m not clear on what you meant by this statement??? (Must by my menopausal brain. LOL)

    What I meant was that no physician was going to give reproductive hormones – other than birth control pills – to a female of reproductive age who is making plenty of hormones on her own.

  116. By jove, I think I’ve got it! I answered my own question when I re-read all of the posts. You are saying that PMS is generally NOT solved by messing with hormones. Every magazine I pick up says something else, and I guess I was thinking that HRT could help PMS, too!

    I’ll pass on the info re: krill oil and hope that her M.D. will come up with ideas, too. I assume there are no “sure cures” for PMS. That’s terrible.

    I found out that, due to severe pain from a herniated disk that doctors agree should be left untouched for now, she has been on Tramadol for several years. They also had her on an antidepressant for a time, but it really affected her adversely – with no change in the PMS symptoms. She has been off of that for over a year. Poor thing is really an outgoing and loving lady much of the time. Those other times are hell for her.

    (Am I wrong, or are many doctors passing out antidepressants like candy nowadays?)

    Many have often passed out anti depressants and anti anxiety drugs like candy.

  117. The problem with her thyroid issue is she is not getting any meds. I was recently diagnosed with an underactive thyroid and I can’t lose to save my life, even though I eat way less than a person my age and weight should be able to eat. I started meds, but so far the weight still won’t move. I’ve gotten a crash coarse in thyroid stuff since I was diagnosed on August. I’ve read eveyrthing I can and printed out stuff in medical-ese for my doctor to read. I want to make sure I get the best treatment possible even though my doc is a GP and not an expert in thyroid.

    Oprah needs meds, needs to exercise again, and needs to stop binging.

  118. Dude, you live on her street.

    Walk down, say you’re a neighbor and you need to talk to her about something.

    (Okay, she has security, and it isn’t necessarily that easy… but it isn’t that hard, is it?)

    By the way, I don’t mean this as criticism. I respect what you did writing this blog post. I learned from it personally. A lot.

    I bookmarked with an “important” tag because of what I learned on fetal pancreatic programming… which makes SO much sense in my case. Thank you.

    I hope Oprah sees your post and, if not, others do.

    You would have to see her house to understand why just popping by wouldn’t do the trick. Large gates, much security, huge estate grounds.

  119. “What I meant was that no physician was going to give reproductive hormones – other than birth control pills – to a female of reproductive age who is making plenty of hormones on her own.”

    You’re right.

  120. To Marveen: go to Dr John Lee’s website and hunt for the research on treating PMS with topical progesterone (bioidentical to what a woman;s body produces naturally). I hope that research is still posted. My container of topical progesterone even lists how to use it IF you are still menstruating. Wish I’d known about this waaaay back when…I’d have tested my saliva for hormones, tried the cream for a few months to see if they made any difference, then tested again to see if the hormone levels changed one way or the other. ‘Course it means educating yourself about hormones, no easy or simple task given Big Pharma’s dis-information. But, there’s no good reason for her to suffer the shortsighted approach to PMS I hear so many complain about. I personally took the BC route and now wish I hadn’t but that was then and this is now. Good luck!

  121. Victoria, with all due respect, you don’t get the point of this post at all.

    Possibly you’re right and Doctor Eades is wrong. Possibly.

    But you still show no evidence of understanding what he said.

  122. Even with a crash course, it is still difficult to find a doctor knowledgeable enough to diagnose and treat thyroid disorders correctly. I, too, am having thyroid issues. My mother, sister, grandmother, all have thyroid problems. I hair is thinner than paper and the signs are all there. However, the doctors have been refusing to do the proper testing. Testing only TSH and T4 which is not sufficient, telling me instead that my labs are normal!

    I’ve been on plan since March with 20 pounds weight loss from 235…. At 5’3 I am morbidly obese and am beyond frustrated! I agree she needs meds, exercise, and to stop the binge eating. But with frustration comes binge eating…even if I go off plan once a month I still beat myself up but I get back on right away…and still no weight loss…even with exercise!

    Unfortunately, it is very complicated!

    It can certainly be complicated. And it can involve an iodine deficiency as well as simply a thyroid that isn’t working properly. More often than not an iodine deficiency – which is common – causes the thyroid to work less than optimally.

  123. If you would offer to help Oprah for free and without publicity, would you, Dr Mike? I am a dietitian who struggled with my weight for 9 years, since I was 18 years old. Against much that I was being taught, and against much of the ‘common’ belief of my colleagues, I tried the low-carb diet, and it worked so well for me. The best part is, because I am trained in the area of nutrition and food, I have the knowledge to implement the low-carb diet in my own life easily.

    Oprah is like my spiritual mother, and I feel sad when I read about how she felt, and think about the ‘health experts’ she is surrounded with. Dr Oz once went on the show advising everyone that one of the best thing they could do to improve their heart health is to have an aspirin a day. I think that is nonsense, not sure if you agree with me, Dr Mike.

    I would not offer to treat her for free but I would certainly treat her without publicity. I have treated a number of people without publicity. In fact, I got reverse publicity for it. The tabloids all reported these people to have been on the Atkins diet.

    I would treat her only if I were the only one treating her. I wouldn’t want to be second guessed by Oz or Greene or any of the other coterie of pets with whom she surrounds herself.

  124. Don’t forget that Oprah also successfully sued te Beef industry so pride is probably preventing her from going to the diet that proves the Cattlemen were correct.

    Actually, the beef industry sued Oprah and lost. I’m sure she doesn’t have a lot of warm fuzzies for the beef people.

  125. Christoph,

    I didn’t say or insinuate that Dr. Eades is wrong. My point is that Oprah’s problem isn’t either/or. Most likely her obesity has several contributors. Fetal programming, binging, eating soy with an untreated thyroid problem., etc. She needs help and could get it if she really looked, but she’s not interested. I feel bad for her. I mentioned the thyroid issue with her because that’s something I can personally relate to. I’m sure it’s not the only reason she gained her weight back, and I hope my post didn’t come across that way.

  126. Read the Carbohydrate Addict’s Lifespan Program. Oprah didn’t follow the diet at all if she thought she could eat everything she wanted one time a day. It is very measured and works if you follow it. Many of us have thyroid problems. Not all of us have put on 40 plus pounds. She shouldn’t blame all of her woes on willy-nilly problems lots of us have. Weight control is self-control, pure and simple.

    As I wrote, I didn’t see the program, but people whom I trust did and told me that the Hellers themselves told Oprah to eat whatever she wanted – including macaroni and cheese – during her reward meal. Maybe others have a different recollection. If so, I would like to hear it.

  127. Get your agent or publicist to find you a pseudo-Oprah! A female 50-something, no longer in the limelight, marginal celebrity who could use the publicity. She loses the weight on the right low-carb plan and the press will love you both.

    Any suggestions?

  128. Camryn Manheim, Cherry Jones, Pam Grier……There have to be hundreds more

    Interesting…I don’t know a single one of these women. Not that I don’t know them personally, I wouldn’t know who they were if they walked up and kissed me.

  129. That’s why they’re “marginal” celebrities. And Google is your friend.

    Manheim is known for her role on the tv show “The Practice.” She currently has a role on the tv show “The Ghost Whisperer.”

    Cherry Jones can be seen as the first female U.S. President on “24” this season.

    Pam Grier is currently a regular on “The L Word” on Showtime. She was in several “Blaxploitation” films in the 70’s. Quentin Tarantino cast her as the title character in “Jackie Brown” in the late 90’s.

    Thanks for the update. I’ve never watched any of these shows, so I wouldn’t know.

  130. You’re welcome and thanks for responding. The three I named are talented actresses, mainly seen on TV these days.

    Thanks for this blog, I really enjoy it.

  131. I’m late to this post and this blog, although I read Mary Dan and Mike’s first book when they were still practicing in Little Rock. And now that I have moved here, I sure wish there was a good physician here who practiced from a similar perspective.

    But my point in terms of this post is that Victoria is correct. Oprah is not dealing with her thyroid issues. There are a number of people who have tried to contact her about this without success. She has followed that Dr. Christine whoever’s approach on this and the woman is just wrong. If Oprah is hypothyroid, it doesn’t matter if she followed the low carb diet perfectly. She would still not be able to lose weight. And she would feel fatigued and likely have other symptoms as well, regardless of her diet. Further, Synthroid may not be the answer either, though most doctors, especially endocrinologists, will insist this is the only treatment. I know I would not take anything other than Armour.

    And for anyone who is curious, I have practiced a low carb diet off and on for over 40 years, and steadily for the last 4 years. I have a pretty good understanding of both issues.

  132. Hi Dr. Mike!

    I was wondering about Iodine (since Dr. Davis blogged recently about it) and I had NEVER known or thought about iodine, ever. So, I came to my tried, true and trusted site “Protein Power” 😉 and found in one of these 144 comments your reply:

    “Go to Amazon (through this site, of course ) and get some Iodoral. It’s a good iodine supplement. I plan a post on iodine deficiency and iodine supplementation soon.”

    I will be ordering this; thank you. Waiting on that post about Iodine! Now I’m all interested and want to hear your say!

    Iodine is important and many, if not most, people are deficient. I’m working up to the post on it, I promise.

  133. Low carb is the only diet that works for me. It was common sense in the 1960s. The caveman diet was recommended to me for systemic Candidiasis in the 1980s and worked fabulously. After hypoglycemia then Diabetes 2, I followed Dr. Richard K. Bernstein’s Diabetic Doctor Diet of 30 g carbs. However with menopause and depression and being hypothyroid with severe incapacitating chills and normal TSH, I’ve been on and off the carb wagon. Antidepressants work only temporarily or not at all. In Canada, on Vancouver Island, it’s becoming impossible to have desiccated prescribed. Does iodine or Lugols or iodorol substitute for desiccated? I hadn’t realized all these symptoms/diseases were related or that they could(would) be treated. ALL hormones give me migraines — any way around them? Any advice on where to seek treatment?

    You might try Dr. Jay Wortman. He’s in your area.

    • Dr Jay Wortman does not see patients. Have you heard of anyone else in the area treating bioidentical including thyroid (and best of all would be someone who understands and even agrees with low carb so you don’t have to argue and fend off statins etc.) Thanks.

  134. I’m coming way late to this party, but I think I have some info to add. (Sorry it’s long.)

    Kathy from Maine wrote: Now I can’t find a doctor who will do the tests.
    Monet wrote: …the doctors have been refusing to do the proper testing.

    This is not an ad for them because I’m a member, but not otherwise affiliated: but the Life Extension Foundation (www.lef.org) will sell you the paperwork to get whatever blood (and other?) tests you need. I’ve done D3, all the thyroid tests, all the various blood lipid etc. tests, c-reactive, testosterone, and other tests. Their prices are great, and they refer you to a couple of local blood labs to have the blood drawn. (They mail the results to you, and to your doctor if you ID one.) (On their site: Click on Products, then Blood tests for the complete list of tests and pricing.)

    Here’s my tale about LEF.org: I’m on Armour (have been for a couple years). My refills ran out (with *really bad* planning on my part: It was a Monday, I had pills enough till Thursday!!), so I called my doc’s office to get them to call the prescription in again. They refused, since I had not had a blood test in a year. (EEK!) Should I try to get the LEF lab order mailed to me and then get the blood drawn (at one of several local labs they refer me to) and then wait for the results (and thus run out of pills)? Or just have my doc write the lab order? I decided not to risk the timing, and picked up the lab order at his office on my way to the lab. Three tests: TSH, T3 and T4 –- OUCH! it came to $395!!! (I have no insurance…) Put it on AMEX {sigh}, got home, looked up the pricing on LEF.org –- $83 –- TOTAL for ALL THREE tests!!

    I did not go back and try to hassle my doc to lower his pricing; I don’t want to get him annoyed, since he’s quite willing to prescribe as I ask (Such as Armour, and hydrocortisone for my adrenals: I’ll comment on them on another thread, Dr. Mike) , and it was my own fault for not checking ahead on my prescription refill. So, I consider paying off those ungodly fees to be my punishment for carelessness!

    Dr. Mike wrote: MD takes Iodoral daily. It takes a while to build up decent levels.
    Judy B wrote. :For a less intrusive way to supplement iodine, you can paint regular iodine in a 1”x1″ (or so) patch on your skin.

    I’ve been taking Iodoral for even longer than Armour. (The Iodoral lifted a brain fog I did not even know I was under!) A couple years ago, just before xmas, I ran out and, fearing my order might get lost in the seasonal package-overload at the Post Office, I decided to wait till the new year to re-order. (Oh and, I learned much later, LEF sells it for slightly below retail!) Within a couple days of running out, I started having hot flashes. (I was around 51 at the time.) The pills came and the very day I started taking them again, the hot flashes quit completely. My doc said, when I reported it, “Well, you know, LOTS of body tissues use iodine and iodide…” (Yeah, I knew that, but I didn’t KNOW that! )

    As for painting it on your skin — while a possibly dubious way to test (the actual testing experiments I’ve read have been equivocal) — it is an okay way to get some iodine into your body! Just be really careful NOT to let it touch anything you don’t want stained until it is well-and-truly dried!

    Thanks, Dr. Mike for being such an amazing support to all of us sufferers out here!

    Glad to be of help.

  135. I actually did the carb addicts diet , lost 150 pounds 15 years ago and kept it off……what happened for me was that although you think you can eat mac & cheese and apple pie…..there is really something that happens in the brain and you cannot eat a morsel after 20 minutes..I do a radio show, my radio partner lost 50 pounds on it after watching me and has kept it off and does his”hour” every day..the only thing he misses is that he just cannot “feel” hungry the way he used to during that hour…..so my own experience has been a stellar one on “the carbohydrate addicts diet”..I love your site…..

  136. I was reading your old posts and came across something that prompted me to ask a question. I was diagnosed with under-active thyroid 15 years ado. I am 50 y.o. now, had been on Synthroid till October 01,2010, now it is the Armour(by my request) . My doctor says it is better to avoid iodine because my thyroid gland is partially destroyed by anybodies (it is confirmed by tests) and iodine may unnecessary stimulate already stressed gland. I didn’t start loosing weight immediately after switching medications, just feel more alive, get cold less, don’t need to sleep too many hours.It is all good. I live in Florida, may be I will sing a different song on summer.

    Just because I have the opportunity to communicate with you, I wont to report on my low-carb variation of your program. I noticed, that in order to loose very slowly, I have to avoid all snacks. Right now it is just breakfast (2 eggs+butter, green tea without sugar substitute), lunch(hand size grilled lamb+sourcraut, or other cabbage salad, coffee+cream+sugar substitute+! oz of walnuts ), salad or vegetable soup for diner.

    Do you mind to say what is your advice about iodine for people in my situation?

    • I can’t possibly give you medical advice over the internet. I would have to know a lot more information before I could advise you on your iodine intake, especially since your own doctor – who knows you much better than I do – has advised against taking iodine.

  137. Trust me I been there and done that…research ACIDITY and once I started to ALKALIZE my body and cut out all the acid foods I was able to lose the weight and get my life back… YOU are acidic and the fat is holdiing on because of inflammation. CuT out all the processed stuff and fake sugars and it will come off. I eat real food like farmers and now no weight problem…just organic foods that won’t make me ill!!!

  138. Poor Oprah. She gets such terrible advice on health, fitness and weight loss matters and she blames herself (lack of willpower) for her repeated failings.

    I did a 5 or 6yr vegan cleanse with lost of soy (similar to Oprah’s) and now require 2 kinds of thyroid medications (synthetic T3 & T4) to feel right.

    I wish somebody would’ve told me about that before I read John Robbins’ nonsense that got me sold on the vegan way of life.

  139. I pay no attention to my diet composition whatsoever, beyond ‘tastes good’. I don’t gain any weight because I rigorously exercise several times a week. Burn more calories than you intake and you will lose weight. It’s physically impossible not to.

  140. Hi Dr. Eades:

    I’m still waiting to see your post on iodine. It seems to me that it is the one nutrient that may be missing from a low carb diet, unless you’re eating sea weed.

  141. Opera Istarted a book on my life,my accident with a train at thirteen/1987. All the problem’s/challanges, you call it. I wanted contact your show around 1994 but was shy and stiil would rather write a book, then wine on TV.. My mother said it was not wineing, I did get a bad deal,25,000 for pain and suffering, for three limb’s. Ambulance chaser’s,I was in an office with paper’s at 13,on morphine, bassically it was not that bad. Yet today I am pist off, liveing off the goverment. I am going to ask war amp’s and the goverment to help pay. I am sad.

  142. I believe what you posted made a bunch of sense. However, think about this, suppose you added a little
    information? I mean, I don’t wish to tell you how to run your blog, however suppose you added a title that grabbed people’s attention?

    I mean Oprah’s plight The Blog of Michael R. Eades, M.D. is kinda boring. You could look at Yahoo’s
    home page and watch how they create article
    headlines to get viewers to click. You might try adding a video or a related picture or two to get readers excited about everything’ve written. Just my opinion, it would make your posts a little bit more interesting.

  143. This is silly. I was on the CA Lifespan program for years and am returning again after 5 years off. You don’t pig out at the reward meal – you should check your sources. Read the book!

    The eating program leaves you with lots of energy (and you’re never hungry), and also saves you from the yo yo dieting that is so hard on your heart. It also cuts the cravings completely out of your day — when you’re doing the program right, you don’t even care for the sugar and carb heavy foods that you used to eat at every meal. You don’t miss it!

    Any nutrition program takes some amount of discipline and understanding.

    I think the author of this post should at least have read the book, or a summary of the reward meal, before broadcasting. It’s just silly the way it’s explained here.

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