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.
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.