On the death of a horse in our culture of myth.

As we all know by now, Barbaro, the subject of a previous post—for which I took some heat, both on and off the blog—had to be put down yesterday. I was sitting at the computer as the news came through, and instantly I had mixed emotions. Mixed emotions? you might wonder. What kind of cold-hearted SOB could have mixed emotions about this? I am not a cold-hearted SOB. As a man who has always loved animals and rooted for the underdog (or underhorse, in this case), I did indeed shed a tear for this horse and what he'd been through, only to die anyway. But I also knew what this meant: that those who loved Barbaro, along with their willing allies in media, would subject us to another round of the mind-killing mythology that has surrounded this magnificent beast since it came up lame in the Preakness last May. And I knew that no one in this culture of ours would take a stand for common sense. We'd just nod solemnly, say our amens, and smile our bittersweet smiles as around us, otherwise intelligent, highly functioning people praised this animal's "gallant battle" for life, expounded on the heroic lessons that this valiant equine taught us about courage and poise, and even told us "what Barbaro and Christopher Reeve had in common."* (I stared unblinking at that last headline for a full 30 seconds before moving on to the next news item.)

Sigh.

Here we have a horse that was universally held up as an icon of invincibility—an example of how, if you just fight hard enough, you can beat the odds. In the end, Barbaro did not beat the odds, and there are several conclusions to be drawn. Perhaps horses do not have courage after all (and really, I'm including the perhaps to be nice about it. We have no evidence that horses feel such emotions as courage). In any case, whatever courage Barbaro did or didn't have was insufficient to overcome a lethal injury. For that is the way of life and death. If you are shot in the head with a shotgun, point-blank, you are almost surely going to die, no matter how courageous or valiant a person you normally are. Courage does not conquer all. No more than "the will to win" causes us to win in the absence of talent and/or the right (favorable) circumstances.

Still, we cannot discuss anything anymore without romanticizing it: whether it's sports, politics, business or, as here, the life and death of a horse that got fatally injured during a race (and make no mistake, that injury was fatal the moment Barbaro suffered it. How do we know? Because he died.) Nothing just happens. Nothing is the simple byproduct of purely physical causes and effects that whir and click altogether apart from human knowledge and control. Everything happens for some larger, mystical reason that's connected up in some way to human motivation or even—my favorite—"karma," that drugged-out 60s term that's making a comeback (no doubt because there are so many formerly drugged-out Boomers in positions of authority and influence). In reality, people, much like horses, win and lose, succeed and fail, live and die, often for reasons that are not, and can never be, understood. Why do we need a "story line"? Why must we surround the visible details of life with trappings and emotional mythologies that simply aren't there?

I know I'm in the minority. Even my wife asked me yesterday, "Look, if it gives people comfort to see things that way at a time like this, what's the harm?" The harm is that it perpetuates an unsubstantiated view of life and its workings that is tearing our society apart at its roots. Little by little with each passing day we are taking our collective eye off the things that really matter—things like hands-on training, provable competence, hard work, logic and related aspects of cogent thought, etc.—in order to put our faith instead in abstractions that can't be measured or even, in most cases, adequately defined—things like "the will to win," "a can-do spirit," and that all-purpose standby, a "positive mental attitude." Of course, the hucksters of happy-talk are eager to keep feeding this crap back to us at whatever price we'll pay.

Yesterday was a very sad day, because a beautiful animal died...an animal that we came to care about, and pull for.

Can't that ever be enough?

* It turns out that if you read the actual story, it does have a point to make about the costs of care in these cases. Still, the piece starts out by drawing a parallel between the "valiance" of Reeve and the racehorse.

Gee, where DO we get those negative messages?

I hate to keep harping on this body-image thing, but late last night I think I saw a slightly different version of that obnoxious NutriSystem ad we've discussed before—a version that zeroes in with even greater cunning on a woman's self-confidence and overall sense of being at-peace with her body. After giving us the usual blather about how she's down to a size 2 and feels "so sexy," the spokesmodel gushes, "This is the first time I could put on a swimsuit and not feel self-conscious!"

So let me get this straight, then: She felt self-conscious at a size 6? A 4?? Are we supposed to picture her trying on swimsuits in the mirror at those "bloated" sizes and grimacing in disgust each time? (None of that action specifically appears in the ad, of course, but that's the subtle message being sold here.... And what other inference is there?) These sentiments are bound to register with the audience: millions of American women getting ready for bed, putting on nightgowns or what-have-you, preparing to walk into their bedrooms and be visually surveyed by their significant others. Maybe I'm taking this stuff too seriously, but I find it almost unspeakable.

And speaking of unspeakable... As I'm sitting down with the morning paper after writing the above, I hear the opening for a GMA segment about body image and "changing the negative messages women send themselves." Diane Sawyer's expert guest is the editor of Self magazine, who wonders, along with Diane, "Where do we women get these awful messages about our bodies?" And as she's saying this—as she's saying this—GMA runs a shot of the cover of Self, which shows a skinny, smiling woman in a bathing suit. Much as I'd like to think that this was done with a note of irony, I'm sure it was just intended to reinforce the editor's credibility and stature by showing the audience the magazine she runs.

So, Ms. Big New York City Magazine Editor, I think we have at least a partial answer to your question, Where do women get these messages? They get them from you and your stupid magazine. (The photo at left, taken from Self's web site, is original and unretouched.) They get them from the advertisers who pay your bills, running ads similar in tone to the NutriSystem ad described above. Want to help the average woman have a better body image? Put a 45-year-old, 160-pound model on your cover now and then. Yes, in a swimsuit. Let's see you put your magazine where your mouth is....

The pathology of dopes.

Much as it pains to me have to face the fact that I didn't write it, there's a nice piece in the current Harper's, "Pathologies of Hope," that notes the degree to which the Culture of Belief increasingly infects even the practice of medicine, as yours truly foresaw in SHAM chapter 11. The actual writer is Barbara Ehrenreich, best-selling author, social critic, cancer survivor and Harper's contributing editor. Ehrenreich segues from her medical insights to observations on today's widespread proclivity for scrapping proven methods and well-considered planning in favor of something like wishful thinking. And, she writes powerfully on the tyranny of the PMA crowd (see under The Secret in particular), who'll savage anyone who dares question the promises they make for positive thinking, no matter how outlandish those promises get.... Cosmic Connie, are you listening from Montana, or wherever on America's vast highway system you may be?

Femme fat-ale?

"Promoters of weight-loss schemes would have you believe that a special substance or combination of foods will automatically result in weight reduction," says Quackwatch founder Dr. Stephen Barrett. "That's simply not true. To lose weight you must eat less, or exercise more, or do both." Barrett points out that there are about 3500 calories in a pound of body weight. "To lose one pound a week," he says, "you must consume about 500 fewer calories per day than you metabolize, period."

That's a rather depressing truth. But increasing evidence suggests an even sadder truth for women: that Mother Nature simply doesn't want Her girls to be too slim. And She'll fight them tooth and nail when they attempt to challenge Her on that prerogative by burning off unusual amounts of calories.

As part of the ambitious, multidisciplinary Heritage Family Study (HFS), researchers at Texas A&M put over 500 men and women on a 20-week endurance-training program. The clinicians expected the nature and intensity of the exercises to yield permanent biophysical changes. It didn't quite pan out that way. Though improvements in exercise tolerance were clear, the results in weight loss were underwhelming for the men, and downright shattering for the women, who lost, on average—this is not a typo—.1 kg.

That’s 3.5 ounces, people.

A fluke? Other data suggest that the HFS women should count themselves lucky. The Midwest Exercise Trial, whose results were reported in August 2003, put a random mix of men and women on a demanding 16-month fitness regimen. They exercised regularly at up to 75 percent of their maximum heart rate, thereby burning an additional 2000 calories per week, on average. Men lost about 11 pounds. The typical woman gained a bit over a pound. And it wasn't that they replaced fat with heavier, bulkier muscle tissue, either. The women's collective body-mass index remained almost constant throughout.

So let's do the math about the bargain these latter women struck: Each of them burned about 138,000 extra calories. During 16 sweat-filled months of exercise. In order to gain a pound. (It seemed worthy of italicizing a second time, in this case). Glenn Gaesser, associate professor of exercise physiology at the University of Virginia, put it all in perspective when he observed that in caloric terms, the women in the study "did the equivalent of walking from New York City to Seattle, and then down to San Diego." And ended up weighing more.

Not exactly what you see in those Bally's ads, is it? For that matter, it wasn't even what you saw in the official summary of the study, whose authors apparently were so dismayed by the results that they felt compelled to spin them. "Moderate-intensity exercise sustained for 16 months is effective for weight management," reads the blandly upbeat conclusion, in part.

There is, however, a possible way around this: Become a movie star like, say, Linda Hamilton, training for her role in Terminator 2. Hire a personal fitness consultant, be prepared to commit several grueling hours each day (including weekends) to working out, micromanage your entire schedule and all of your menu choices around the single-minded goal of getting buff. If that's a realistic option for you and your lifestyle, go for it.

Short of that, for most women, lasting weight management may be a tough road in which they're fighting biology, anthropology, and heredity every step of the way.

(And as for the title of this post... Look, we all have good days and bad days. Put this down as a bad one.)

READ PREVIOUS SHAMblog POSTS ON DIETING AND WEIGHT LOSS:
Those lumps, those bumps...those chumps.
DietLand: A brief history of federal oversight(s).
Only the data are slim. Part 2.
Only the data are slim. Part 1.
Hoodia wanna believe?
Waste size.

(the) Nerve of Steele?

I'm always amused when a self-help guru shifts into serious pot-calling-the-kettle-black mode. A fine specimen comes to us today via this press release about life coach Devlyn Steele. "There are plenty of self-help gurus selling books, tapes, seminars, and programs that the millions who pay for them hope will change their lives, but certified life coach Devlyn Steele says reading a book or spending a few hours at a seminar are [sic] not enough," poses Streele, who is not only the resident guru here but also the official "press contact" listed at the bottom of the release. "People continue to flock to programs that claim to provide ways to improve their life in one way or another, and billions* are being spent. The reality is that there is no real evidence that these programs succeed... You cannot read a book or attend a seminar over a weekend, and wake up Monday morning with a new behavior. Learning and being able to change behavior and apply what you learned are very different."

Pretty damning stuff. Few minced words. And if he'd left it right there, I'd have no quarrel with the man who has "often been referred to"—albeit usually by himself—"as America's leading life coach." Of course, Steele doesn't leave it there. He's dissing the rest of the SHAMscape purely in preamble to his own buzz-building effort for something called Tools To Life. More on this in a sec.

Dissing things that aren't him is actually a favored tactic of Steele's. Among his targets, on another of his sites and linked pages (there are about 159** of them), is formal psychotherapy. Oh, sure, he's careful to emphasize that coaching is not therapy—CYA and such. But then—after invoking Freud—he subtly but efficiently explains why coaching is better: "Therapists are not there to give you magic answers. In therapy you look for your right answers, but this can fall short. In therapy it can take years to achieve goals. The ideas in coaching are to help you learn to take control of your life today. Regardless of the past, you can still make decisions every day to live a happier, healthier and better life. Coaches believe you can be in charge, be responsible and achieve results right now!" Condensed version: Coaching provides the magic answers.

Notwithstanding his marketing-savvy attempts to differentiate himself from the crowd, most of Steele's patter sounds like standard-issue Empowerment, flavored with those all-pervading latter-day motivational condiments native to The Secret. As Steele says on one of his pages, "We become what we think," and, "If you think success, success will happen." (Sound familiar?) He claims that success has definitely happened for his own Tools To Life participants, TTL being what he calls a "social networking" site that "provides the tools that self-help books and seminars fail to provide." He describes it as "the first web site to provide an actual 'toolbox' with a fully interactive, multi-media guided self-development program to enable you to grow and expand your life. You choose whether you work alone, with your friends, or with new friends through our support network. They provide the encouragement, feedback, and support missing from other self-improvement programs."

I'll give the guy this much: The site and its tools, per se, are free. I could find no particular hidden costs in any of the materials on TTL. And on the surface, at least, those materials are considerable. It's just, there's a certain overall non-specificity to the presentation that might easily leave a person (a) wondering if it's just an extended ad or "teaser" for something more, and/or (b) wanting for Steele's actual coaching services, which are not free: $250 for a 45-minute session. But we'll try not to be too cynical about this.

And to be fair, Steele does include a testimonials page on his primary site. "What Clients Say" showcases effusive feedback from "real" people with such crediblity-inspiring IDs as "Hope, actress," "George, a Captain of Industry," and the irrepressible "Julie," who is "so excited" because she got her "acceptance letter to the University of XXXX." I mean, what further proof could you need?

* No argument there. Currently $10 billion, projected to top $12 billion by next year, as per Marketdata Enterprises.
** I'm using this number as a "figure of speech." So if you're a fan of coaching, or Devlyn, please don't go counting up the sites and impugn me on that basis.

Those lumps, those bumps...those chumps.

If the weight-loss industry were to award lifetime-achievement honors in the category of Perverse Genius in Combined Health Gimmickry and Deceptive Use of Language for the Purpose of Hoodwinking Gullible Consumers, the "war on cellulite" would win hands-down. What better exemplifies the diet movement's stranglehold on the American consciousness than a woman's willingness to spend real money on fake cures for a problem that does not, technically, exist? Stripped to its essence, one might say, this is a multi-billion-dollar industry dedicated to making women feel awful about the way they look in a bathing suit.

According to Prevention, the worldwide market for anti-cellulite products has grown by 113 percent since 2000, and it shows no signs of slowing down despite recent, (relatively) aggressive enforcement action by the FDA and FTC. And that's fascinating, because cellulite is a made-up, non-medical term—a marketing coinage dating to 1960s European health spas that sought a more sophisticated, serious-sounding way of describing the unwelcome dimples of fat on the thighs and buttocks of their well-heeled clientele.

Groups of fat cells, you see, normally live out their lives encased in fibrous compartments. When the cells swell, they distend that fibrous tissue and puff out over it; think of muffins rising in a tin. It's a disagreeable phenomenon that afflicts most adult women—90 percent being the oft-reported figure. But fat is fat is fat. This fundamental truism has been confirmed in controlled studies using advanced scientific and medical diagnostics. Further, while the amount of body fat can be adjusted through dieting and exercise, increasing evidences suggests that the distribution of fat is basically locked in by heredity. Which means the only reliable way to reduce the size of a particular area of the body is to achieve a generalized reduction in weight—and even then, the proportions will remain much as they were. A cellulite-laden pear will not magically morph into a svelte hourglass.

Nonetheless, the cellulite myth emigrated to the U.S. in a big way with the 1973 publication of Cellulite: Those Lumps, Bumps and Bulges You Couldn't Lose Before*, by (French-born) Manhattan salon owner Nicole Ronsard. Since then, purported anti-cellulite products sold through various channels have included abrasive sponges and mitts (even though cellulite isn't a surface phenomenon and can't be "scraped away"), creams and gels to dissolve cellulite (even though there's no reason to suppose that any topically applied ointment can shrink fat or restore tone to the stretched-out fibrous material), supplements containing vitamins, minerals and/or exotic herbs (even though no evidence exists that you can beat cellulite by ingesting anything—and many of the herbs are untested for safety), bath liquids, rubberized pants, body wraps, pressurized heating pads, motorized exercise machines, vibrating hip-high massage boots, and finally, "hormone" or "enzyme" injections, some types of which were ruled dangerous by the FDA after causing strokes, liver failure and several deaths. A series of any one of these questionable regimens can cost thousands of dollars.

Of late consumers have been turning to anti-cellulite compounds that are essentially diuretics. As noted previously, not only are diuretics ineffective for selective weight reduction, but they can be dangerous when used without close medical supervision. Moreover, the weight returns as soon as users replenish the liquid in their bodies—which they must, and fairly soon, if they hope to avoid dehydration and its own roster of grave health risks. This in turn sets many users on a dangerous "yo-yo" course of self-dosing wherein they begin gobbling larger amounts of diuretics in order to deal with the sudden return of (water) weight they thought they'd "lost." Bottom line, this is no more a legitimate approach to weight loss than slitting one's wrists would be a legitimate approach to fighting high blood pressure.

One of the real tragedies here is that over the years, the sheer profitability of the disreputable approaches has forced generally more reputable companies, like Revlon, to try to elbow their way into the ever-burgeoning anti-cellulite market.

A final caveat: This is an investigational area, and in today's world of daily high-tech advances, you'll hear all sorts of claims for products that "have shown promise in small studies." One such approach is laser therapy (which seems to be emerging as an overall latter-day panacea, given its proven utility in dental work and vision correction). Bear in mind that all of these areas remain under study, and no such methodology has yet been shown conclusively to "work." If you can't stand your thighs, the best option for now, according to a segment aired on 20/20, may simply be to make the cellulite less conspicuous by using tanning cream. As the TV newsmagazine concluded, if it's "good enough for Pamela Anderson [shown, above], then it's got to be good enough for the rest of us."

* And still can’t, though Ronsard elected to leave that out of her title.

READ PREVIOUS SHAMblog POSTS ON DIETING AND WEIGHT LOSS:
DietLand: A brief history of federal oversight(s).
Only the data are slim. Part 2.
Only the data are slim. Part 1.
Hoodia wanna believe?
Waste size.

Barack like me? *

Dear National Media (and/or anyone else who's interested),

Let me say first that I've never been big on racial or ethnic identity. I think it's silly (why is a simple accident of genetics so meaningful, especially when there's increasing evidence that very, very few of us have "pure" bloodlines?), arbitrary (I have uncles from "the old country" who are darker than Halle Berry), divisive (do I really need to expand on that one?), and generally stupid. Nor do I understand racial/ethnic pride, or why role models have to be of a certain color or religious persuasion. As a so-called white guy, I'm inspired watching Tiger's majestic swing or listening to Maya Angelou deliver verse in that soothing, hypnotic voice of hers; I would think that a so-called black child should be able to draw similar inspiration from Roger Clemens' mound presence or a sermon on wealth building from Warren Buffet—all the more so if he's been brought up to think of himself not as a black child, but just an everyday kid with brownish skin.

Having said all that—if we're going to play this silly game—then, as Ricky Ricardo might've put it, would someone please 'splain to me why, if you're half-white and half-black...you're black? I don't know where I've been, but yesterday I became, evidently, the last person in America to learn that Barack Obama's mother is white. (To make things even more interesting, his black father abandoned the family when he was very small, leaving his mother and her all-white parents to raise him.) So why is he the "first legitimate black candidate" for president? Why is he not, to an equivalent degree, just another in a long series of white candidates? Or colorless or "unspecified" ones. Similarly: Berry's mother is white. (Her dad, too, left when she was small.) Why then, a few years ago, was so much made of her being the first "actress of color" to take home a best-actress Oscar? I just don't get any of this... And come to think of it, isn't Tiger's mother Asian? So what does that make him? "Blasian"? How insane this gets...

Why can't we just stop it? ALL of it. Why can't Barack Obama just be some guy running for president? For that matter, why can't Nancy Pelosi just be the new Speaker of the House (i.e. without the prefix "first female," which you folks in media use almost as if it's part of her actual title)? Why can't people just be individual people, judged as such? Funny, I think I heard something like that once, from a guy named Martin....

Sincerely,
Steve (just take me as I am) Salerno

* apologies to John Howard Griffin.

DietLand: a brief history of federal oversight(s).

Consumer demand for the next weight-loss godsend is such that "revolutionary products" that lack any scientific foundation (and may be unsafe) typically generate millions in ill-gotten revenues before the government steps in.

Mostly, though, the government opts out. (As is often true of regulatory impotence, the reasons can be traced to a cozy, strange-bedfellows relationship between politicians and heavy hitters in the drug, weight-loss and food industries.) Even when it becomes impossible for Washington to ignore what's going on, the results of its enforcement actions amount to less than meets the eye. A dozen years ago, the Food and Drug Administration (FDA), unnerved by the proliferation of useless and dangerous weight-control products, spearheaded passage of the Dietary Supplement Health and Education Act of 1994 (DSHEA). In theory, the law more precisely defined dietary supplements and their ingredients; amplified FDA policies on nutritional labeling; tightened up then-sloppy guidelines for point-of-purchase materials promoting supplements; added new requirements covering the use of testimonial claims and supportive matter; and granted the FDA the authority to establish so-called "good manufacturing practice" regulations to ensure product potency and uniformity.

Trouble is, many of DSHEA's regulations turned out to be unenforceable if not downright counterproductive. It probably isn't coincidence that since DSHEA, the number of major FDA actions against the diet and fitness industry has actually shrunk. Though there may be political factors in play here—such as a more laissez-faire Republican administration calling the shots—critics also allege that by putting the government's policies and tactics down in black and white, DSHEA gave scammers a blueprint for exploiting its gray areas and finding loopholes in its language.

The post-DSHEA years witnessed an avalanche of carefully worded ads and other publicity for products in all personal-care industries. (Notably, this explains why the phrase "reduces the appearance of fine lines" [emphasis added] has become staple text for all anti-aging potions. It's the kind of phrase that gets in under the consumer's radar. In reality, the manufacturer is conceding that its product, far from removing or even "treating" wrinkles in any therapeutic way, merely covers them up. A consumer who buys pricey anti-aging products is, therefore, buying more of what she already owns aplenty: make-up.) This trend is clear in the results of an ambitious 2002 multi-disciplinary study of weight-loss advertising involving shared staff from the Federal Trade Commission, Bureau of Consumer Protection and other watchdog groups. Researchers compared ads in eight leading national magazines in 1991 to those in the same magazines a decade later. The principal author of the study's executive summary, Harvard's Dr. George Blackburn, concluded that misleading advertising not only remained "rampant and potentially dangerous," but that the nature and magnitude of the deception had actually gotten "dramatically" worse since 1991.

A further case in point: Some months before ephedra was pulled from shelves, supplement makers who'd been reading the tea leaves (green ones, no doubt) scrambled to develop replacements and today are having a field day selling new addictive stimulants that are too obscure to set off any alarm bells at the FDA. Most of these substitute compounds work as diuretics, promoting water loss, similar to the popular (and later discredited) diet pills of the 1970s. And—also like those earlier pills—they may cause electrolyte imbalances, altered endocrine function and other potentially serious health problems.

Consider, too, electronic muscle stimulators, promoted as aids in fat loss and overall "body shaping." Hooked up to the user much like an electrocardiogram, an EMS device supplies tiny jolts of electricity that cause muscles to expand and contract passively—without any exertion on the user's part. Most often such products are touted as "abs builders" (even though studies show that "exercising" abdominal muscles in this manner is in no way analogous to a gym workout). After a flood of TV spots for EMS-type products that promised to help buyers "get six-pack abs without doing a single crunch!", the FDA in 1995 clarified its longstanding skepticism of the devices, denouncing as plainly "fraudulent" the marketing of EMS units for any type of body shaping. Nonetheless, a 2005 survey of dozens of (anonymous) health-club owners revealed that a decade later, the FDA stricture continued to be widely flouted by neighborhood gyms, who don't advertise the service, but simply offer it to regular customers as an adjunct to their workouts.

Complicating matters it that sub-agencies within the government are actively working at cross-purposes with the rest of the anti-fraud initiative. Chief among them is the National Center for Complementary and Alternative Medicine. (If you own a copy of SHAM, see pp. 219-222 for a "nice" overview of NCCAM and its ills.) NCCAM lends legitimacy to far-out health regimens that range from improbable to asinine, at the cost of billions of dollars in public funds wasted since the agency debuted as the Office of Alternative Medicine in 1992. NCCAM has been a particular champion of "natural" regimens that claim to promote weight loss and offer other general health benefits. Current NCCAM budget: $123 million.

The real shame of it all is that, while the government has been ineffectual at combating the industry's excesses, weight-loss marketers have been adept at turning the government's own procedures to their advantage. One favored tactic is to patent or trademark weight-loss products—as if patents or trademarks = credibility. It's important to realize that in issuing a patent, the U.S. Patent Office is saying only that a product differs in some material way from other registered products. Neither a patent nor a trademark constitutes an endorsement of a product's utility or safety…no more than the copyright on a product's labeling or advertising materials constitutes an endorsement of the accuracy or honesty of those materials.

In observance of DSHEA's 10th anniversary, the FDA announced a major push to improve the "transparency, predictability, and consistency of its scientific evaluations and regulatory actions to protect consumers against unsafe dietary supplements making unauthorized, false, or misleading claims." Among the agency's partners in this ongoing endeavor are such federal bureaucracies as the NIH Office of Dietary Supplements, the National Toxicology Program in the Department of Health and Human Services and, regrettably, NCCAM. So we'll see.

I for one am not optimistic. (But you already knew that.)

READ PREVIOUS SHAMblog POSTS ON DIETING AND WEIGHT LOSS:
Only the data are slim. Part 2.
Only the data are slim. Part 1.
Hoodia wanna believe?*
Waste size.

* Careful readers will note that this post is now back, "by popular demand." Actually, by special arrangement with two editors.

It's deja vu all over again.

Amazon finally posted my review for The Best Life Diet this morning, January 17, as a day-old review from January 16, which of course means that it never got to be anywhere on the book's first page, where new reviews properly belong—and where they're far more likely to be read by site visitors. As noted in last night's p.s. to yesterday's post, this is the same basic fate that befell my last review for a book written by a major member of the Oprah camp (Phil McGraw's Love Smart). Draw your own conclusions.

P.S. Just in afterthought to all this: I promise this will be my final comment on this book and this whole matter, before getting back to the business at hand (and I left a similar comment in response to what is now the first review of Best Life Diet on its Amazon page)... But isn't there something slightly absurd about posting a glowing review for a brand-new diet book as soon as you finish reading it? Don't you have to wait a while to see whether the diet even works, first?

And, quickly, on the diet front....

Attempted to post a review early this morning for Bob Greene's new book, The Best Life Diet, currently running the table nationwide: No. 1 on Amazon and in Barnes & Noble, No. 2 on the New York Times' best-seller list for advice books. I gave Best Life a fairly rigorous scan yesterday during my weekly foray to B&N, and came away underwhelmed. So far, Amazon has not seen fit to post my review; I awarded 2 stars, but more to the point, I made some pretty cynical comments about Greene and his high-octane sponsor, Oprah Winfrey, which may be holding things up. Other reviews for the book have gone up with today's date, though I have no way of knowing whether they were submitted before mine. My intuition tells me that I'm on a "watch list" these days, such that my reviews are themselves individually reviewed for content before posting. If that sounds a bit paranoid or, worse, narcissistic, remember that my Amazon identifier does in fact reference my own book and this blog—which gives me a vested interest—and Amazon does have a history of spiking some of my more caustic reviews. Plus, there was that whole "Marilyn Barry" episode last year, wherein I'm sure I did not endear myself to the powers-that-be. So we'll see what develops.

POSTSCRIPT, 11:15 p.m. Well, my review still hasn't made its way onto the book's page, so I think it's safe to assume that it's been embargoed by Amazon. Conspiracy theorists may be interested to note that my review for Dr. Phil's book, Love Smart, suffered a similar fate: Amazon condensed it dramatically, then buried it anyway at the end of the list of reviews for the book, as if it had been written days earlier (thus forcing site visitors to scroll through dozens of other reviews in order to find it). You're telling me this is all coincidence?

I'm attempting to re-post it as we speak. I'll keep you...posted.

On my newfound love for Kelly Ripa.

Some of you will be inclined to file this under "more proof that Steve is really gay," alongside my confessed addiction to Lifetime Movie Network and certain other viewing preferences I've disclosed from time to time. But I must also admit to a fondness for watching Live With Regis & Kelly each morning. And it's odd, because it's not that I like either of them all that much. Regis can be snide and abrasive in that way that reminds me of why I left New York, and Kelly can be barf-inducingly perky in that way that reminds me of why I left San Diego. But somewhere in the synergistic middle ground, I manage to find a quiet peace each morning. Also, it helps keep me up to date on my cultural references. I figure that between LWR&K and The View, I'll never be too far behind the curve on Trump v. O'Donnell, and I'll even know what Jennifer Hudson wore to the Golden Globes....

Anyway, on this particular morning, the keynote guest was Diana Ross, who's releasing her first album in seven years. At one point Ms. Ross is sitting there, beneath the immense mushroom cloud of her hair, parrotting that achingly familiar line about how her success in music demonstrates that "you can do anything you want if somebody just believes in you!"... And Kelly chimes in with, "Yes, but it helps if you have a voice like yours. Regis likes to tell me I can sing, too—but for some of us, it just isn't gonna happen."

Bravo, Kelly! Thank you for introducing a much-needed note of sanity to morning television, and the "empowered" American media as a whole.

Only the data are slim. Part 2.

As we saw last time, internal consistency isn't something that diet authors lose sleep over.

Item: Though Sugar Busters rails against saturated fats, the book's list of "acceptable" foods variously includes butter, cream, cheese, eggs, milk, lamb and pork.

Item: In the appendix of his Ultimate Weight Solution, Phil McGraw asserts that a health bar should contain no more than 140 calories. The bars he himself endorsed under the Shape Up! brand contained 210. (As I note in SHAM, writer Gregg Easterbook has convincingly pointed out* that, regardless of what you called it, McGraw's peanut-butter nutrition bar was, in fact, a candy bar.)

Item: Other diet books include recommendations for foods that either don't exist or would be awfully hard to find/quantify in the real world...such as the "lean bacon" that The Carbohydrate Addict's Diet urges its followers to buy.

Even the major health magazines, which generally cover their terrain with greater integrity and attention to detail, devote way too much copy to pandering to their audiences instead of dutifully informing them. This is true throughout mainstream publishing. "Every women's magazine runs cover lines telling readers they can lose weight by just walking," says a former editorial colleague of mine. "Granted, every bit of exercise is a plus. But walking takes so little effort that it's not going to change your body's metabolism in any significant way.** But editors know from surveys that that's what readers want to hear. So every month, at least one of the magazines runs a major feature that combines 'walking' and 'weight loss' in some direct—and thoroughly misleading—way." When the choice is between telling the truth—the whole truth—and losing readers, magazines go the pragmatic route.

One encounters this same mindset ("tell 'em what they wanna hear") at all levels of the weight-loss movement, from its big-picture issues right down to the tight-focus claims of individual players.

Big-picture: The industry persists in hyping the notion of targeted weight loss—"lose those ugly saddlebags by July!"—even though selective slenderizing of body parts has never been demonstrated clinically and is out of conformity with everything we do know about biophysics and nutrition. To be sure, says Quackwatch's Dr. Stephen Barrett, "There is nothing you can ingest, no pill or potion, that will spot-reduce a specific part of the body."

Tight focus: In Enter The Zone, Barry Sears writes, "I believe the hormonal benefits gained from a Zone-favorable diet will be considered the primary treatment for all chronic disease states, with drugs being used as secondary backup." He can believe it all he wants, but it's groundless fantasy, certainly at this juncture in medical science. Meanwhile, The South Beach Diet promises that you won't ever be hungry, despite menus averaging between 1200 and 1500 calories a day (erring towards the lesser number). Did Agatston ask any men?*** This would also be a good time to reiterate what's really going on with diet books as a class: If readers lose weight at all, it's because they're eating a lot less food. And do you really need a diet guru to lay that out for you? (Tellingly, when a Prevention reader of unspecified gender asked Agatston if his/her calorie intake was too low at between 950 and 1200 calories per day, the doctor effused, "It sounds like you are doing great." Though I concede that I lack the clinical research to back me up here, I strongly suspect that a man of normal activity levels could drop a fair amount of weight by consuming 950 calories a day in malt liquor, if that's all he ingested.)

What's more, I can't stress often enough that, while there's scant evidence that these products promote weight loss, they are not benign in their overall health impact. This became clear in the late 1990s when Redux and Fen-Phen, the once widely used appetite suppressants whose chemical formulas made them dieting's answer to "speed," were banned after causing dozens of deaths due to soaring blood pressure and heart-valve abnormalities.****

Today, we have other "weight-loss aids" with precarious backgrounds:

Conjugated linoleic acid, an element of Dr. Phil's (since repudiated) line of nutraceuticals, does little for dieters but has been linked to liver damage and compromised insulin resistance. Leptin, the protein we mentioned last time around, which is now being positioned as a silver bullet for obesity, may also upset the body’s fragile insulin/sugar balance. Dried fucus vesiculosus extract, a seaweed derivative found in today's hottest anti-cellulite pills, won't help your cellulite, but contains up to twice the U.S. RDA of iodine per pill, posing a danger to people with compromised thyroid function. It also may affect the length, timing and overall predictability of women's menstrual cycles. The plethora of herbal teas that vow to catalyze quick weight loss contain potent laxatives and diuretics that often cause cramping, nausea, diarrhea, light-headedness, and uncomfortable sensations in the arms and legs; and, they play havoc with homeostasis (the body's attempt to maintain a steady state of biological function). As with other products that cause a dramatic water loss, the culprit is acute depletion of potassium reserves and other electrolytes. This can lead—has led—to heart-rhythm disturbances even in young, otherwise healthy people.

And so it ever goes. Untroubled by its shaky scientific foundations and marketing excesses, the soon-to-be-$60 billion weight-loss industry marches on, doing its business with impunity, beset by no apparent qualms about its fanciful claims, and seemingly beyond guilt or shame.

More soon....

* writing in The New Republic, October 2003.
** I should clarify here that the author of the linked article was not my source for this quote.
*** And what about dieters who are simultaneously exercising? A 1200-calorie menu is totally insufficient to supply the needs of a body (male or female) that's also engaged in vigorous physical activity.
**** and still without yielding the weight-loss results one might expect! One major review of data involving Redux users showed an average weight loss of just 3 percent. On a 200-pound man, that would be a rather underwhelming loss of just six pounds.

Another, gone too soon.

I feel the need to mention* that the jazz world—my first and ever-enduring love—lost one of its most prolific and influential figures the other day when tenor-man Michael Brecker lost his long battle with leukemia at age 57. Brecker actually got his jazz legacy off to a dicey start by devoting some of his early years to electro-funk fusion music, and in more recent decades became so ubiquitous on other leaders' albums that people with only a casual knowledge of jazz might've figured him as "just some studio guy." Such labels could not possibly be more wrong. History will remember Michael Brecker as one of the handful of truly inventive tenor-men to pick up a horn in the post-Coltrane era—along with, say, Joe Henderson, Joe Farrell and one or two others. He was a stylist in his own right as well as an absolute tenor virtuoso who could fly through even the most challenging set of changes at breakneck speed. Not only that, but along the way, he'd invent spontaneous riffs that would literally stop you cold; you'd have to immediately rewind the tape or CD just to listen again and savor what he'd done. Brecker was also a gifted composer.

In my own first life as a jazz musician I played mostly local venues in New York's outer boroughs as well as the occasional more prestigious gig in "The Village." (This was back in the days when, at a famous/infamous club like Slugs in the Far East, you could enjoy an evening of great jazz, several large drinks with actual booze in them, and perhaps a stabbing, all for just ten bucks...) Though I never met Michael Brecker, I was lucky enough to cross paths with his brother and fellow modern-day jazz icon, trumpeter Randy, when he came to Brooklyn College for one charmed evening to solo with the BC Jazz Ensemble; I was a student there and the group's featured clarinetist. The ensemble was then led by bassist Chuck Israels, who'd paid his dues with jazz icons whom you need identify, among jazz lovers, by first names only: Billie, Benny, Herbie, etc.

The photo is from one of Michael Brecker's mid-90s albums, Tales from the Hudson (featuring an almost frighteningly good, and yet typical, uptempo solo by Brecker on its first track). Though this blog can't do the photo justice, it is one of my favorite album covers: haunting and sensitive, like the sounds that emerged from Brecker's horn when he was in a more contemplative mood.

I'm always amazed that in a world where we elevate people who can't do anything* to the most dizzying heights of celebrity, enormous talents like Michael Brecker will simply pass through, unknown in both life and death to all but a relative few hard-core fans. Rest in peace, Michael. You enriched my life, and the lives of millions who understand the difference between fame and talent.

* This post may be a bit esoteric for some, so just let me vent and then we'll get on with it.
** Which, I suppose, is another way of saying that they're "shams."

Only the data are slim. Part 1.

A minor disclaimer: I cannot promise that all of the embedded links will work, because a number of them are from subscription sources. Give it a shot.

NOTWITHSTANDING THE CEASELESS ADVERTISING and the knowing tone of the diet movement's celebrity leadership, the underlying data are shockingly scant. "It's amazing how few good studies have looked at weight loss," observes the Harvard School of Public Health's Dr. Walter Willett, one of the most influential figures in modern epidemiology. "The long-term evidence in particular is meager. We need much bigger and longer randomized trials."

Some of today's best-known diets reached cultural eminence, transforming American eating habits along the way, without being meaningfully validated for efficacy or even safety. (The cover story in the January 2004 Nutrition Action Newsletter featured a sidebar under the sly heading, "The Atkins Low-Evidence Revolution.") Today, Atkins' "low-carb" mantra is a ubiquitous social phenomenon; many restaurants now devote a boxed-off portion of their menus to "Atkins-friendly" dishes. Nutritionally speaking, the diet was also the progenitor of the biggest blockbuster of the new millennium to date, The South Beach Diet. Nonetheless, the very few scientifically rigorous studies of the diet cast doubt on its usefulness for genuine weight maintenance. Dr. James Hill of the Center for Human Nutrition, whom we met last year at around this time, says his studies of the people in his national weight-control registry show that Atkins dieters fare no better than others when it comes to long-term success—and may expose themselves to significant health risks in the bargain.

Or let's look at another popular (albeit unlikely) diet guru from recent years. In 2003's Ultimate Weight Solution: The 7 Keys to Weight Loss Freedom, Dr. Phil McGraw, who lacks any background in nutrition*, evinced an all-embracing familiarity with the subject and its implications for weight management. He began by separating overweight readers into "pears" and "apples"—in itself, an unoriginal step. But McGraw went on to use his book as a sales pitch for a branded "Weight Management Supplement & Complete Multivitamin" system that, he claimed, was specifically targeted to each body type. The system included a dizzying array of supplements, anchored by the now-infamous Shape Up! line of health bars and shakes; these featured McGraw's ruddy face on the packaging, and were made by CSA Nutraceuticals, coincidentally owned by McGraw's former Texas business partner. McGraw insisted that the CSA regimen, which set hopeful consumers back about $120 a month, had "solid clinical evidence behind it." Among those who disagreed was Yale's Dr. Kelly Brownell, one of America's most visible and respected experts on diet and nutrition; "a recipe for making money" was how Brownell described the McGraw plan to the New York Times. Another top clinical researcher in nutrition, Jules Hirsch, dismissed the whole thing as "gibberish." Under threat of federal indictment, CSA in 2004 promised to stop distributing the products, and the whole mess eventually was resolved not in a lab—where it should've been assayed in the first place—but in a Los Angeles courtroom, where McGraw agreed late last year to fork over $10.5 million to consumers who felt defrauded. Even so, the paperback version of Ultimate Weight Solution remains a solid performer on Amazon. (It goes back to what I've said a thousand times: We don't want to hear what we don't want to hear.)

All popular diets play fast and loose with the few established facts we do have about weight management, promising benefits rooted in the flimsiest of data and/or extrapolated from studies with doubtful real-world relevance. Of the rush to anoint the natural protein leptin as the next weight-loss godsend, health blogger Phil Kaplan writes, "When scientists found that injecting leptin into an obese, genetically altered mouse with a [flaw in a specific gene] caused it to lose ½ of its bodyweight in 4½ weeks, needless to say they were thrilled. If you are a genetically altered mouse with [that genetic flaw], then yes, leptin injections may help…"

Also by their nature, diet books and mainstream plans reduce complex formulas and inscrutable biophysical processes to jacket copy. Taking the time to explain the real mechanisms of action—to the extent such mechanisms are even known—would require far too much qualification and thus soften the "punch" of the promise. For a good illustration, one need look no farther than the current holy grail of pop-culture weight loss, the glycemic index (GI). The GI is the core concept of the mega-best-selling South Beach Diet by Dr. Arthur Agatston, as well as any number of other faddish diet programs. Basically, the GI organizes foods into "slow carbs" and "fast carbs," the theory being that you want to build your menu primarily around foods that provoke a slow rise in blood sugar (low-GI) rather than a rapid one (high-GI).

But there's a problem right off: The GI isn't a constant. The same prepared foods and even raw food components test out with different GIs according to how they were grown, stored, cooked, etc. [See cover story from Nutritional Action Newsletter, linked above.] Take something as straightforward as plain old rice. White rice can be low-GI or high-GI, depending on whether it's Uncle Ben's converted (low) or instant (high). Ditto pastas: No universal GI consistency exists, even among specific types of linguine: Thin linguine yields a higher GI than thick linguine. Is the average dieter sophisticated enough—and sufficiently committed to doing his/her homework—to sift through all this? More to the point, should he/she be expected to have to sift through it all, after paying $50 or more for a book and its associated menu planners, or hundreds of dollars for membership in an online diet plan? The overarching irony is that GI-mania may be a house of cards anyway. No less a figure than Thomas Wolever, the University of Toronto researcher who helped develop the GI food scale (and later contributed to the more scholarly weight-loss book, The New Glucose Revolution), concedes that his branchild is no dieting panacea. "I've yet to see evidence that a low-GI diet aids weight loss," he says in that same Nutrition Action Newsletter cover story.

The crippling flaws in mainstream diet books are endemic to the process that brings them to market. For one thing, there's a strong impetus in publishing circles to have these books authored by celebrity doctors**. This may seem sensible enough—who better to write a diet book than some doctor who "discovered" a fantastic new weight-loss method? In practice, the celebrity doctor seldom arrives at his insights after long-term affiliation with a large research hospital specializing in the medical aspects of nutrition. In fact, celebrity docs seldom are actively involved in clinical research. Often they're just selling a plan that they thought up based on anecdotal observations of their own patients—if that. Today's doctors-cum-authors may have little more to offer than a theory of how a certain weight-loss regimen might work, which they brainstormed with some hotshot literary agent, who then changed things around a bit strictly for marketing purposes. No joke, and not even much of an exaggeration. You'd be shocked at how many "breakthrough!" diets were conceived not in a lab, but by some agent and editor at a pricey New York bistro like Elaine's.

A former fitness editor I know puts it like so: "A lot of the agents and even the editors don't really care all that much if the information is true. The rule of thumb is that you find a study, any study, to back up whatever you wanted to say in the first place.*** Then you filter out anything that might contradict it. That way you haven't really lied to your readers. You've just told them something that's convenient for you to say." Convenient. And profitable. And false.

Such imperatives often put authors with nominal consciences in the position of having to use the interior pages of their books to distance themselves from the very promises made on the cover. In the most extreme cases, an author may have to distance himself from the whole point of his book. To wit, the following statement, which appears inside the hot-selling book Good Carbs, Bad Carbs: "In spite of the title…there are no bad carbs."

More to come....

* and who, cynics have observed, could stand to shed a few pounds himself.
** and preferably telegenic male doctors, who will play well on the morning shows.
*** Sadly, this is all too true of today's journalism as a whole.

Memo from the department of "it's nice to know somebody's reading along."

In response to the handful of you who've asked me off-blog, I took down the "hoodia" post for editorial reasons. The skinny, as it were, is that I'm (suddenly) working on a couple of pieces about the peculiar American folly of "weight-loss season." Inasmuch as the publications involved prefer to buy first rights—which basically means they want to know that the material isn't already in print—I feel duty-bound to save my best stuff for them. I'll be re-posting the material here after it publishes there. That doesn't imply that in the meantime, I'll be dumping my worst stuff on SHAMblog. It simply means that I'll have to find alternate approaches to the subject.

Hope you'll hang around to see what we come up with.

Hoodia wanna believe?

"The search for an optimal diet plan is almost a national pastime," Dr. George L. Blackburn, associate director of the Harvard Medical School's Division of Nutrition, once observed. I'd argue only that Blackburn understated his case: I'd omit the almost and change pastime to obsession.

As noted, America spent at least $46 billion to try to shed its extra tonnage in 2004, and is projected to spend $61 billion by 2008. One-third of all adults were on a diet at some point last year, including up to 95 percent of women under 30; in today's busy world, you can even "go to" Weight Watchers meetings online (and is it me, or is there something slightly ludicrous about being able to attend such events without ever getting up off your fat behind?) Last year a record 140,000 Americans became sufficiently fatalistic about other paths to fitness that they underwent weight-loss, or "bariatric," surgery (even though the Mayo Clinic and most other responsible institutions reserve such surgery for the morbidly obese and/or those afflicted with serious weight-related health problems). Cha-ching. Another $3.5 billion.

Feeding this insatiable appetite for weight loss requires a steady stream of supposedly fresh material (the adverb is important, and we'll explore its meaning in due course). This naturally leads to ever-more-extravagant promises and a feverish upping of the ante as competing magazines, plans, books, chains, pills and freelance gurus try to market-differentiate from, and outdo, each other. Amid all this, the impossible becomes possible, the outrageous becomes the norm. Or as Blackburn put it, "Dieters are easily seduced by meaningless anecdotal accounts of quick weight loss and totally unrealistic promises of easy success." Hope springs eternal.

Ahhh yes, Hope. I think I once mentioned that my original title for SHAM was "Hyping Hope." That's an even better title for today's weight-loss movement, a realm in which common sense, let alone any reverence for the scientific method, is not just unfashionable, but seen as cynical and "disempowering."

But let's hear it from the irrepressible Richard Simmons: "Don't let anyone tell you what you can and can't do, or what's 'realistic' for you to achieve!" he lisps during a raucous GMA segment in which he leads floor exercises for several dozen overweight women. "You're always going to run into people who want to throw cold water on your goals. Well, don't let them! There's nothing stopping you from losing the weight you want to lose!"

In fairness to Simmons, who always struck me as well-meaning, I don't think he intends this as a blanket alibi for the unscrupulous promoters of worthless diet aids. He refers instead to the sad truth that there are people who live to rain on your parade.* Trouble is, that same argument has been used to wave off legitimate criticism of the weight-loss movement—and is used daily in self-defense by con artists selling products that (at best) won't do you much good and (at worst) may do you substantial harm. Nor do you have to descend into the movement's deepest, darkest crevasses to encounter such risks. Haphazardly tampering with the body's normal system of intake and outgo is asking for trouble, even when you're not eating trees or gulping herbs native to rain forests and other regions better known for giving the world AIDS and Ebola. Serious health questions have even been raised about diets (like Atkins) that are now cultural institutions and, as such, have transformed American eating habits. With fad diets, you get all the risk, regardless of whether you ever get the benefit in lost weight.

Nonetheless, American dieters—to their downfall—operate under the assumption that the kookier the regimen, the more "visionary" it must be. Any plan that sounds too commonsensical lacks the pizzazz to gain popular traction and thus become, from a marketing standpoint, the Newest New Thing. As Harvard's Blackburn suggests, this has the effect of imbuing even the most outlandish weight-loss scams with a certain topsy-turvy credibility. Or as Quackwatch's Dr. Stephen Barrett puts it, "It's hard to get anybody's attention peddling an old standby like Vitamin C. But if you tell people they can lose weight by consuming ground-up Brazilian tree bark…?" (Admit it, you half-thought I was kidding about the trees, didn't you. Perhaps we have a glimpse of our species' future in the photo, above right.)

Beyond the general American vulnerability to self-improvement scams that I describe in my book, this diet-specific vulnerability can be further explained in two ways. One, a lot of folks will tell you they've "already tried," and failed at, the commonsensical approaches to weight loss. So they hunt out new wrinkles. But there's a reason for their chronic failure...which brings us to Two: Genuine weight control requires dedication over time. It requires self-sacrifice, and patience. In most cases, it requires meaningful changes in lifestyle. That's a level of personal investment that the average American dieter either can't or won't abide.

Accordingly, dieters shy away from things they don't want to be true—and for which actual evidence exists—instead putting their faith in things they want to be true—but for which there's zero evidence! A perfect example is the CW that "fasting makes you fat." It's simply false. (Not to sound insensitive, but if it were true, shouldn't those hordes in Darfur be grossly obese?) Sybaritic culture that we are, we recoil from the very idea of fasting. It's uncomfortable. It entails willpower and self-denial. And we should recoil, because fasting eventually causes the body to metabolize proteins from its own heart and other muscles/organs. In effect, you eat yourself. The problem, therefore, isn't that fasting makes you fat. It's that fasting makes you dead. But strictly as a weight-loss tool, fasting does work. We refuse to accept that, because fasting is a radical conceptual cousin to the idea of EATING LESS, and that's just not how we Americans like to conceive our weight loss. We don't want to make the hard choices.

No. We want the pill or plan that screams EAT ALL YOUR FAVORITE FOODS AND LOSE 39 POUNDS BY NEXT TUESDAY!

To be continued...

P.S. Look it up.

* I've been accused of this myself, of course. For a textbook example, see the comments following my recent Amazon review of The Secret, which for some reason won't link properly.

It's my party and I'll die if I want to...

Today's item more properly belongs near the end of our just-begun thread on America and its weight problems, but when I saw this story out of the U.K. I couldn't resist. So instead, consider this a postscript to "last year's" discussion of body-image.

The U.K. news story describes the proliferation of web sites for those with eating disorders—and not exactly the kinds of sites you'd expect. Though they do offer tools and resources that might help an anorexic or bulimic kick the habit, these so-called "pro-ana" sites are primarily designed to make you feel more comfortable with your condition, such that you see it as less of a psychological impairment than a "lifestyle choice." As the article puts it, "The Eating Disorders Association warns there are over 500 pro-anorexia sites [that] have such slogans as 'hunger hurts but starving works...' Some even offer tips for becoming thinner alongside glamorous photos of stick-thin celebrities, including where to buy slimming pills over the internet and vomiting techniques."

If you read SHAM, you know that one of my basic premises was that there's nothing really wrong with most of us, so we don't need the brand of help that self-help offers. That is in fact the very reason why SHAMsters spend so much time making us think there's something wrong with us—so that they can turn around and sell us the alleged cure. The pro-ana movement, however, shows us the opposite end of the spectrum, where we confront a situation that, while far less common, is far more serious: People who do have a genuine mental-health problem aren't going to find the answer in self-help.* As the story tells us, "Such websites often lure youngsters into thinking they can cope without seeking professional help—which could lead to serious medical problems and even death... About one in five people who don't get appropriate treatment die prematurely, so they are literally killing people."** The story quotes U.S. studies that suggest that anorexics who frequent pro-ana sites are less likely to seek formal treatment. The sites may even lead visitors to chat rooms where girls (this being chiefly a female phenomenon) can discuss techniques for improved starvation.

The immediate peril here is obvious, but there's a more subtle takeaway that we can also blame on self-help and its contributions to latter-day mores. This is what happens when a society becomes obsessed with "empowering" people by destigmatizing even their worst tendencies, which it redefines simply as "lifestyle choices." (Hey, it's all about you!) As the late Randy Shilts noted in his brilliant book on the early days of the AIDS crisis, And the Band Played On, one of the most vexing initial problems for public-health watchdogs was overcoming the resistance of gay activists themselves, who insisted that society view gay promiscuity as "a legitimate lifestyle choice." Trouble is, sometimes a lifestyle choice becomes a deathstyle choice.

P.S. For those of you who were born after 1965 and are no doubt wondering, the title of this post is a riff on a famous song lyric.

* which, in fairness to myself, I touch on at the end of my chapter on life coaching.
** I am sometimes dubious about grim statistics like these, when put forth by organizations with an obvious interest in making the problem sound as dire as possible. Clearly, though, the picture here is grim. See links in my previous post on body image, which is itself linked in the first paragraph, above.

Get your video watched by billions!

I'm growing increasingly impatient with AOL. Or at least, the folks that AOL has in charge of content. Seems that, of late, if they're not (stupidly and illogically) trying to implant doubt in your mind about some aspect of your life that you shouldn't be worrying about, they're (stupidly and illogically) trying to reassure you about something you shouldn't be reassured about. Earlier this week AOL went back to headlining its feature on "signs you're heading for divorce," whose flaws and fallacies we covered in a previous blog. (I guess they figured, hey, what better way to start the new year than by making perfectly happy subscribers second-guess their marriages.) Today now, a top feature is "You Don't Need School to Succeed," which, when you click through, provides a half-dozen examples of celebrities who "made it" without going to college. Gee, another brilliant idea from AOL: Why not try to talk one of their core demographics (kids in their late teens and early 20s, who are notoriously balky anyway when it comes to "doing what they're supposed to do") out of comitting 100 percent to their education!

In study after study, the vast majority of people who (a) didn't finish college and (b) aren't named Gates earn dramatically less than those who went farther in school. To take someone like Sir Richard Branson, featured in today's AOL story, and use him as an illustration of why you don't really need schooling is almost as ridiculous* as using Saddam Hussein as an example of "how to get your video the top spot on YouTube!" Sure, it "worked." But it's not really the approach you want to take.

* not quite, but almost.

Welcome to 2007. And a slightly new spin.

In keeping with a project I'm working on—which I'm not yet at liberty to discuss—I'll be broadening the focus of SHAMblog in 2007. We'll still spend our fair share of time on the likes of Tony Robbins, Dr. Phil, The Secret and related cultural silliness. But we'll also be talking about self-help in a more general sense, as well as about other idiosyncratic and/or fraudulent aspects of American consumer society. Especially those aspects driven by narcissism and uber-self-interest.

I hope you'll all stay with me and encourage others to pitch in. I think it's going to be a fun journey.