Nutrition & Health News This Week

Oprah Embraces Wegovy... and More

Oprah, Freedom Fighter?

By now, you’ve probably heard that Oprah Winfrey hosted a primetime “Oprah Special” on ABC News (now on Hulu) to tell the world she’s on an obesity drug, part of what she calls a “weight-loss revolution.” Oprah portrays herself as the victim of fat-shaming, which is no doubt painful and true. For decades, we’ve watched her go up and down the weight roller-coaster, including the Oprah show’s “wagon of shame” episode in 1988, its most-viewed ever, when she wheeled out 67 pounds of animal fat in a wagon, representing the weight she’d lost after consuming nothing but Optifast shakes for weeks. Now Oprah’s slim again and back in the spotlight. 

The ABC special is part of Oprah’s “personal narrative of freedom and triumph,” wrote a columnist for the New York Times. Still, we wonder: Is Oprah delivering her overweight fans from the burden of fat-shaming or has she simply moved over to thin-person camp, suggesting others can do the same? The show felt like an infomercial and featured experts funded by Novo Nordisk and Eli Lilly.

Oprah’s latest is part of the normalization of a life-long commitment to the new drugs known as GLP-1 receptor agonists — Ozempic, Wegovy, Mounjaro. In a discussion of the Oprah special on The View, Whoopi Goldberg revealed that she was taking Monjaro, which means injecting the drug once a week. Co-host Sunny Hostin admitted she was, too. 

These drugs can jump-start weight loss, but whether they’re sustainable and safe for long-term weight maintenance remains to be seen. The weight loss from GLP-1-based drugs can come at a “terrible price”, says Benjamin Bikman, a professor of cell biology and physiology at Brigham Young University (who wasn’t talking about the financial costs, which can run over $10,000/year). One primary mechanism of action is a slowing of the intestines, which in some cases can lead to stomach paralysis with serious consequences. 

“Additionally, with such a change in diet, up to 40% of the weight a person loses is due to lean mass loss,” says Bikman. “Unfortunately, when a person stops taking the drug and weight rebounds (which it does, and quickly), fat mass returns rapidly, while lean mass is likely gone for good.”

We wish the best for Oprah, Whoopi and everyone else on these drugs, and we recognize the benefits of being freed from the burdens of obesity. The long-term consequences of taking such powerful drugs is concerning, however, especially among younger people. Meanwhile, the truly unshackled victors from this week’s events are the drug companies, who now have major media moguls as their champions.

The AHA Takes a (Cheap) Shot at Intermittent Fasting

At Unsettled Science, we often comment on a troubling association: the worse the science, the more the media coverage. There are caveats, of course: it helps if the science is commenting on the human condition (health, eating, sex, happiness), and it hits the jackpot if it’s challenging ideas that are considered “quackery.” Toss in a revered organization like the American Heart Association (AHA) as the source, no matter how scientifically bankrupt the study, and the jackpot triples. By these criteria,  neither peer review nor even publication is necessary. The insatiable demand for this kind of news will launch it into the stratosphere.

So the media was on fire this week with the news that intermittent fasting – restricting your eating during the day to a short window of, say, 8 to 10 hours – had been linked to a higher risk of cardiovascular death. It might be easier for us to list the media outlets that didn’t cover the story than to list those that did. (Even The Hill, as in “Capital Hill,” which covers politics, policy, and international relations, found an excuse to write it up in their health care section. )

So where do we start? The study, indeed, has yet to be published, hence no paper was available for review. It was presented as a “poster” at the AHA annual meeting. The primary authors were from China, although two of the co-authors were at the Harvard School of Public Health (which does not surprise us). The poster hit the news because the AHA put out a press release, acknowledging in the small print that this was “preliminary research,” but with a headline guaranteed to nonetheless get attention: “8-hour time-restricted eating linked to a 91% higher risk of cardiovascular death.”