Oprah and the Power to Persuade

Perhaps it never occurred to Oprah that nobody is paying much attention to the likes of Somers or McCarthy because their story is a bunch of malarkey based upon anecdotes and stories.
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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.

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