Oprah and the Power to Persuade

Two weeks ago, Newsweek took on Oprah with a cover story calling out her promotion of some of her guests' health claims, which are sometimes not always based upon scientifically-sound principles or research. It's hard to take on a powerhouse media deity like Oprah, because of her positive influence in so many people's lives. It's harder to stand fast with your criticism, and yet Newsweek appears to be doing just that.

From actress Suzanne Somers' use of "bioidentical" hormones to combat aging to Jenny McCarthy, the Playboy model and actress who promotes the completely discredited theory that childhood vaccines may cause autism, Oprah's been there making sure these poor stars get a spotlight on their causes. Would Oprah give the same airtime to a random doctor promoting the use of cognitive-behavioral therapy to help prevent teen suicides (as a recent study just found)? I seriously doubt it. Cognitive-behavioral therapy is neither sexy nor provocative. Hollywood stars who claim they are being silenced by large pharmaceutical companies are far more in vogue and bound to get more ratings.

What about the need for science to enter into this discussion? Sorry, Oprah's not there to give you a balanced discussion about the science. Oprah is, after all, an entertainment talk show, not a documentary on PBS. Oprah says, "I believe my viewers understand the medical information presented on the show is just that -- information -- not an endorsement or prescription. Rather, my intention is for our viewers to take the information and engage in a dialogue with their medical practitioners about what may be right for them."

Yet that sort of statement isn't very intellectually honest. If Jenny McCarthy sits on stage next to Oprah, all the while having the real medical experts, scientists and doctors in the audience, waiting to be called upon (like students in class), you can see the power differentiation carefully orchestrated by Oprah and her producers. This isn't some sort of production mistake -- this is Oprah completely understanding how her influence works, and using that power to persuade in a very specific and targeted manner, implying "I'm sitting next to the real expert who has the 'untold story.' This is who you should pay attention to." The researchers? Their opinion is of the same value as any random audience member.

Oprah has an incredible power to persuade through her influence. She can make or break a book author by recommending his or her book on the show. And now, by examining sometimes ludicrous medical claims and giving them the illusion of legitimacy, she clouds the picture for millions of people seeking an answer to a health concern. Not because we have any new scientific data, but because she has used the power of the media and her personality to simply change the conversation from one dealing with the scientific method and scientific data, to one dealing with unsubstantiated "cover-ups" and Hollywood personalities. Look at these poor (yet very rich!) Hollywood stars who can't get their story heard!

Perhaps it never occurred to Oprah that the reason nobody is paying much attention to the likes of Somers or McCarthy is because their story is a bunch of malarkey based upon anecdotes and stories. And while such stories can be very powerful to tell a personal experience that may help change someone else's life through the telling, it's when she or one of her guests move from simply relating a personal story to making specific medical and health recommendations that is causing some concern:

[Oprah] didn't make it clear on the show what form of the disease she had, or what her doctors believed brought it on. She shared with her audience that she took thyroid medication and spent a month relaxing in Hawaii, where she ate fresh foods and drank soy milk. Northrup advises that in addition to conventional thyroid medication, women should consider taking iodine supplements.

That is just what they shouldn't do, says Dr. David Cooper, a professor of endocrinology at Johns Hopkins medical school who specializes in thyroid disease. "She is mixing truth with fantasy here," he says. First, "thyroid disease has nothing to do with women being downtrodden. She makes it sound like these women brought it on themselves."

Cooper agrees that thyroid patients should seek thyroid hormone treatment to bring the symptoms under control. But, he says, Oprah should have stayed clear of soy milk. "If you're hypothyroid and you're taking thyroid medication, you do not want to be taking soy. It will block your body's ability to absorb the medication."

Iodine, he says, can be even riskier. "[Northrop] says iodine deficiency is more common in women, when in reality it's not very common in women at all. This is a myth." The thyroid gland, he says, is extremely sensitive to iodine. "If you have mild hypothyroidism, taking iodine will make it worse."

Of course, nobody watching the show had this important information and may have started doing something seemingly innocuous -- such as drinking soy milk -- that may have completely wreaked havoc on their condition.

But don't take my word for it. Check out the views from around the Internet about the story, summarized in the blog entry from Newsweek ("Hey, Did You Hear We Took on Oprah? The Blog-o-sphere Reacts"). Sadly, Newsweek chose not to link to those that were critical of Newsweek's coverage of this story. Here, for example is Suzanne Somers' response. Somers rightfully points out that she just acts as a mouthpiece to the many doctors she has spoken with and interviewed on the topic of bioidentical hormones.

Lee Schneider has also weighed in on the controversy by suggesting that Oprah has it right. He recently wrote on HuffPo:

Newsweek is going backward, contributing to the backlash against new medicine. Oprah is going forward by supporting medical pioneers. While looking into the sun, drinking crud or shooting up in the vagina may not seem so brilliant, breakthroughs come from acts of courage or folly and sometimes both.

But all of the examples Schneider notes are of scientists who went against the conventional wisdom of their day. So the obvious question becomes, if the science is real and legitimate, why isn't Oprah talking to the researchers themselves instead of someone like Somers or McCarthy? Are we really that shallow a society that we dare not interview scientists, for fear they couldn't keep an audience entertained for a whole 40 minutes of television?

Peter A. Lipson, M.D. (PalMD) drives this point home at "White Coat Underground" that "HuffPo gets it wrong about Oprah." He rightfully notes the distinction between actual scientists who've been pioneers in their fields, and folks like Suzanne Somers, who act merely as spokespeople for this emerging "science." Medical treatments either have good supporting evidence, or they have little. There's no squishy middle ground of feel-good stories nor a Journal of Things That Have Helped Famous People.

This is a key point, because in science, there are varying degrees of standards and quality, and a process called "peer-review" that ostensibly seeks to weed out junk or poor science from the high quality, objective science. Now I admit, this process isn't fool-proof and doesn't always gets things right. But it's the best thing we have right now, and it's the usual process researchers use to communicate with one another about these kinds of controversies. Short circuiting the process through celebrities like Oprah, McCarthy and Somers ensures that only one side gets heard.

This remains a very interesting controversy. It would be even more interesting to see Oprah address this controversy directly on a future show, inviting the Newsweek authors and some of the science bloggers on to discuss how this sort of media promotion can ultimately be a great disservice to her loyal viewers.

Comments

[luv2run]

Oprah has done several shows and several magazine articles about thyroid disease, but she and her "expert" guests have never used the words "Hashimoto's" or "autoimmune". Hashimoto's autoimmune thyroiditis is a common disease in older women, but very few people have ever heard of it. It is unbelievable that a thyroid patient like Oprah is not willing to present information about Hashimoto's to her viewers and readers.

Ladies, please educate yourselves about Hashimoto's disease! Do a web search on "Hashimoto's symptoms" and see if you are at risk, or go to http://thyroid.about.com . Knowledge is power.

[ThyroidAdvocate]

Oprah's show is, understandably, always about what interests Oprah. Why else would she have disregarded thyroid issues for years -- doing shows on menopause, weight, fatigue, infertility, low libido -- and NEVER mentioning thyroid as a key trigger in these issues -- until she herself developed thyroid problems?

Bypassing any medical view entirely, we had Dr. Christiane Northrup saying that thyroid disease develops because women "swallow their words." Oprah claimed she cured her thyroid problems with Hawaiian vacations and soy milk (when soy is BAD for the thyroid). Then Oprah stopped her prescribed thyroid medication entirely, and went on Suzanne Somers' regimen. In the end, she has disowned her own thyroid problem.

I agree with Oprah's defenders who say that the convention­al/conserv­ative medical establishment is bashing Oprah to discredit ALL alternativ­e/holistic medicine. And Oprah's mere mentioning of thyroid disease has given it a higher profile -- which is good. But as a thyroid patient advocate and proponent of holistic approaches, I am also concerned because Oprah's thyroid coverage has totally bypassed anything medical. Holistic views of thyroid disease are part of the story, but on Oprah, they ARE the ONLY story.

Ultimately, viewers need to realize that Oprah's show is entertainment, and is not meant to be balanced health advice. But Oprah, recognizing her power and influence, has a moral and ethical obligation to be more responsible to her viewers.

Mary Shomon
Thyroid Patient Advocate
Author: The Menopause Thyroid Solution
http://www.menopausethyroid.com / http://thyroid.about.com

[docuguy]

Sometimes medicine, advice, entertainment and television don't mix very well, but getting people thinking about complementary or integrative medicine that might just work is important for people who are seeking ways to heal themselves. The value of Oprah (and the "poor" stars she supports) is in starting up a debate like this one. - Lee Schneider

[VirHop]

Just because something medical isn't part of the mainstream doesn't mean it's bad medicine. The peer review process in the U.S. is terribly broken -- here's a quote from a former editor of the New England Journal of Medicine -- published in the January 2009 New York Review of Books titled, Drug Companies & Doctors: A Story of Corruption by Marcia Angell:

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of TheNew England Journal of Medicine.”

There is plenty of good research behind bioidentical hormones, including large studies from Europe showing its safety and efficacy. Between Big Pharma misinformation campaigns and misguided people like Suzanne Somers who promote extreme protocols, there is a lot of confusion out there, made worse by journalists who don't do their homework.

As someone who has been researching and writing about bioidentical hormones for over a decade, and the co-author of a best-selling book, What Your Dr. May Not Tell You about Menopause with the late Dr. John Lee, I wrote an Open Letter to Oprah detailing why the Suzanne Somers approach is misguided. You can find it, along with a lot of solid research, at http://www.virginiahopkinstestkits.com/bioidenticalhormonebreastcancer.html

Virginia Hopkins

[grooveygrover]

If the people in the medical profession were doing their jobs people would be healthier, instead people are just getting sicker and sicker and sicker. The food we eat has no nutritional value. The drugs we take don't cure anything they only mask symptoms at best, create other issues at worst.

The actions belie the words: in this case the action being the fact that more people are sick than ever before, the words being the healthcare industry is making us healthier. Believe what you want

There is something wrong when you call healthcare an industry.

[Theda]

The trouble with Oprah, Suzanne, Jenny and all the others is......th­ey're self-aggrandizing narcisscists!

Suzanne Somers, especially, is so "into herself" that she's morphed into the expert on.......j­ust about everything.

Vitamins, hormones, food, drugs, sex, marriage, youthfulness, chemotherapy, parenting, etc.......­.......hey­, look no further because Suzanne is the expert!

[Theda]

Before vaccinations, countless babies and children died from polio. Remember THOSE days, anyone?
Oprah is a hypocrite. She trashed James Frey's reputation on-camera and berated him because he included fictional elements in what was basically a fictional autobiogra­phy---simi­lar to nearly all celeb autobiographies!. I read the book and knew instantly by the second chapter that it was largely fiction.
Then.....O­prah fawned over Jessica Seinfeld and her cookbook and the two of them were smarmy and all kissy and huggy on-camera. But when Jessica was accused of plaguerism and a lawsuit was filed against her for stealing recipes from another woman's book, Oprah didn't belittle or "scold" Jessica on-camera!
Oprah lost her journalistic integrity years ago. When Sharon Stone was a guest, Oprah did her smarmy "girlfriend" routine and she and Sharon were practically French-kissing each other on-camera.
Hey, even Obama is avoiding Oprah these days.....s­mart move on his part!

[Just Margaret]

um...last I checked, Oprah has never claimed to be a journalist.

[Theda]

She started out as a TV reporter..­..a journalist. She's crossed the vague line between journalism and entertainment, and she does promote so-called "experts" on serious subjects.

[grooveygrover]

you sound jealous/envious of both Suzanne and Oprah

[Theda]

I'm not "jealous" of Oprah and I think Suzanne is too way out there to be taken seriously! As an American, I am free to criticize Oprah if I choose....­even though so many worship and adore her! She's not MY "goddess." This is the first time Oprah has been publically criticized to such a large degree for her often wacky guests, and her fans don't like it.

[toocoldout]

If it weren't for Oprah, Obama would not be president. Check out this study:

http://freakonomics.blogs.nytimes.com/2008/08/06/so-much-for-one-person-one-vote/

I wonder if that's why Oprah's being attacked for health advice, especially at a time when he wants to reform health care. And the first lady just shared the cover of O magazine with Oprah.

[treboi]

"this is Oprah completely understanding how her influence works, and using that power to persuade in a very specific and targeted manner, implying "I'm sitting next to the real expert who has the 'untold story.' This is who you should pay attention to."

Ok, first, anyone who watches Oprah and does this without any outside consultation deserves whatever happens to them...the world is overpopulated as it is, lets get rid of the dumb ones early.

I'm not here to support or deny what happened on Oprah's show, but I hate how doctors like you want to just try and sing the praises of the medical industry..­.yes medicine and science have brought society a lot of great things, but the medical industry, like Oprah's entertainment industry, are about money.

The medical industry tries to get us addicted to as many substances as possible in an effort to make money. And doctors like yourself are paid to push them on us even when we don't need it. My grandmother passed a couple of years ago from organ failure...­at the time the doctors had her on different combinations of 10 different medicines. No one suggested the medications had anything to do with the death, but my grandmother was never the same after she started the medications.

All this being said, you need to help clean up your own house before you talk about someone elses, Doctor...

[Dr. John Grohol - Huffpost Blogger]

Yes, I can totally see how you could take away how I am single-mindedly singing the praises of the "medical industry" through phrases like this one,

"Now I admit, this process isn't fool-proof and doesn't always gets things right."

Medicine isn't foolproof, and neither is science. Nor did I ever make either claim in this article. What claim I did make is that celebrities aren't the best conduit to have reasoned discussions (or even presentations) about these kinds of issues. Instead of them being objective and based in facts, they inevitably become personal and based in personal experiences.

And there's absolutely value in such personal experience (again, as I noted in the article). But it's not on the same level as the empirical, scientific method.

A controlled study of 1,000 randomized people has far more generalizability to the population than 10 personal celebrity stories. But the "Oprah effect" completely turns such a fact on its head.

[quindy]

Thank you, well said.

[hankm]

There's plenty of quack science currently in the mainstream, too. Just look at psychiatry and psychology.

Go Oprah!

[ephoenix5]

"Jenny McCarthy, the Playboy model and actress who promotes the completely discredited theory that childhood vaccines may cause autism,"

I don't believe this has been really discredited. In fact, that movement seems to be gaining momentum and concern for a proper research into this is growing even at governmental levels. I will disclose that I don't really know what the truth of that is -- I just don't know. But if the alleged link has not be disproven beyond a shadow of a doubt, I think we should all be concerned for our children.

[MNmommy]

"The movement" is not gaining momentum, but for the celebrities that are pushing it.

The "alleged link" has been disproven many times over.

[grooveygrover]

yes, disproven by the very companies that produce the vaccines, how convenient.

anyway it isn't the vaccines themselves but the use of mercury as a preservative that she is advocating against.

When I read that my son would be more likely to contract meningitas (sp?) from the vaccine than he would just by living his life (I read this is the information package the doctor has to give you about any vaccines they prescribe) I voted no for that one and a few of the others that he is eligible for now that he is a teenager.

[jhNY]

As the medical model dictated by the insurance industry consists of a maximum 15-minute conversation with a patient followed by a few jottings on a prescription pad, the drug prescribed often being but the latest touted by pharmaceutical reps, for which if precribed in sufficient quantity, said reps will provide the doctor with a bonus, often in cash, perhaps the physicians need to remember 2 old maxims: 1) First, do no harm. 2) Physician, heal thyself.

But yeah, that pop health stuff that Oprah touts is also aggravating, and probably equally harmful or useless.

[Seldon]

sometimes harmful, all useless