Type 2 Nutrition #1000: Oprah Winfrey or Me?

 In 2010, when I started to write about nutrition – specifically, nutrition for type 2 diabetics – I had no idea that I would write 1,000 columns. After all, my message was really quite simple: 1) take charge of your own type 2 diabetes health, 2) eat very low carb and 3) lose weight without hunger…and your type 2 diabetes will take care of itself. Your diabetes will quickly go into remission, and you will become healthier and happier with all your outcomes. The scale and your lab tests will testify to your success.

And that all proved to be true.

But it was also true that this Very Low Carb thing was a new paradigm. As such, at the time, it was not sanctioned by the medical establishment. In fact, it went against the Standard of Care. Clinicians were taught to treat a somewhat higher than normal blood sugar as a precursor to a metabolic disease condition which they named Pre-diabetes, to get a billing code. Then they established a new standard for defining full-blown type 2 diabetes (a different billing code), and just to be sure they were covered, they established that “obesity” was classified as a disease so it too could get its own billing code.

To treat these conditions, observable on any office scale and by simple laboratory tests, they could prescribe existing and newly developing pharmaceuticals to “treat” these symptoms of disease. And as the conditions worsened (because they had designated type 2 diabetes as a “progressive” disease), they prescribed higher doses and, with the passage of time, new classes of meds to treat the disease.

Of course, these physicians also advised patients to “diet and exercise” (“eat less and move more”), but when that didn’t work and the disease “progressed”, they blamed the patient for not sticking to the prescribed diet. On the patient’s chart it said “patient non-compliant.” It never occurred to the physician that it was the “prescription,” the diet recommended by USDA/HHS, Big Pharma, and the AMA, AHA, ADA, etc. that was the underlying problem…in point of fact, the cause of these chronic diseases.

So, in 2010, my storm-tossed message was lost in this sea of conflicting messages. I had to repeat it over and over, as it turned out, 1,000 times. But I did get some encouragement. Among the first, the 2015 Dietary Guidelines for Americans (DGA) stopped recommending that we eat no more than 300 grams of cholesterol a day. “Dietary cholesterol” was, “no longer considered a nutrient of concern.”

Another, the 2020 DGA declared that dietary fat be no longer limited to 30% of daily input. That was a tacit admission that eating fat didn’t make you fat. And, with protein at 10-15%, and carbs already at 55-60% (and by implication the leading cause of obesity and Insulin Resistance, this delimiting of fat allowed for fewer carbs. Unfortunately, they then doubled down by pushing for more “factory-made” fat (vegetable and seed oils), aka PUFA’s, instead of Saturated Fat naturally present is animal protein

Finally, the ADA, after years of opposing low carbohydrate diets as dangerous fads and hard to stick to, with “not enough long-term randomized controlled trials,” etc., the ADA relented and admitted that low carb diets were now an acceptable eating pattern for blood sugar regulation and weight loss.

But, in this storm-tossed sea, Big Pharma is fighting back. Recently, Oprah Winfrey had a primetime television network special touting the latest craze in weight loss drugs: a new class of injectable drug called a GLP-1. Two brands, Ozempic and Mounjaro, are among a passel in a crowded field that is very expensive ($1,000/mo.) and not covered by medical insurance (yet), and that’s why Oprah is schilling for them. She said, “don’t blame yourself” for being fat. She pointedly added, obesity is a “disease.” The 1-hour show was an infomercial for Big Pharma designed to get the taxpayer to “pay the piper.”

So, the way I see it is this: you have a choice: MY WAY: 1) take charge of your own health now, eat very low carb and lose lots of weight without hunger or 2) OPRAH’S WAY: wait for the lobbyists and politicians to make a deal, and then inject yourself in the belly with chemicals for the rest of your life.