Victimizing Obese Teens: Today's Oprah

I rarely watch Oprah, but I took a chance on it today. The topic was teenage obesity. I hoped the show would offer something other than the same old tired anti-obesity tripe that we hear day in and day out: eat fewer calories, exercise, and control emotional eating. And if that doesn't work, maybe surgery is the way to go.

Everyone with any interest in obesity should understand the following facts:

• Obesity is not a mental illness. Therapy and "learning to love yourself" can't hurt, but they are no more curative for obesity than they are for any other physical disorder.
  
  
• Appetite and cravings are hormone driven. Simply repressing them eventually throws the body into crisis mode. The hormones will win, if you can't get them under control.
  
  
• Stress can increase appetite and cravings. That's why most people eat when they are emotional.
  
  
• All calories are not equal. If you saw the show, you know the nutritionist said a glazed doughnut is a better choice than a bagel with low-fat cream cheese because it has fewer calories. Nonsense. Eat the doughnut and you'll be hungry again very soon. The bagel with cream cheese will have a less dramatic impact on your blood sugar, give you a little protein, and leave you satisfied longer. But the truth is, neither of these is a good choice.
  
  
• Gastric bypass surgery has dangerous long-term consequences. It's the typical simple-minded pseudo-science of conventional medicine that says if you lose weight with gastric bypass, you'll have a greater life expectancy. Where's the longitudinal data? What about the hormonal changes, the dangerous vitamin deficiencies, and the gastrointestinal disorders that result from bypass? How do they impact life expectancy?
  

As usual, the obese teens on today's Oprah faced a hearty dose of shaming. That's guaranteed to drive up the stress hormones and make matters worse. Dr. Oz presented some good nutritional information but, on the whole, the nutritional advice was very confusing.

Shame, confusion, and a sense of desperation turn eating into a source of anxiety--and the stress hormones rise even more. It's a damn dirty shame that we turn a biological necessity into a source of such torment. And that torment is heaped on top of all the other difficulties the truly obese must live with every day.

Exercise is the one positive in this infernal debate; it's the one thing the so-called experts seem to be getting right. Exercise can help tame and balance the hormones that drive appetite. Unfortunately, exercise alone is usually not sufficient.

When are we going to cut the crap and get to some serious answers? When it comes to obesity, traditional medicine is still way off the mark, often doing far more damage than good.