Introduction to Obesity
Broadcasting superstar Oprah Winfrey, who struggled with obesity for much of her life, and Dr. Ania Jastreboff from Yale School of Medicine have teamed up to study the biology of obesity and offer a new path forward. Her new book is “Enough: Your Health, Your Weight, and What It’s Like to Be Free” (to be published January 13 by Avid Reader Press).
The Struggle with Obesity
My patient Alice began blaming herself in her childhood. Her well-meaning mother put her on a diet when she was a teenager. Even before that, she had begun to develop what she eventually called the “voice of self-hatred.” She still remembers being ten and sitting in the front yard with her legs bent, seeing the curve on the inside of her leg and wishing she could make it smaller. "That’s the line where your muscle is, and there’s a curve on the inside. That’s the fat and the extra skin. I thought, ‘Oh, if I could just cut that off, my leg would be perfect.’ I had a pen and drew the line of where I thought my legs should be and where the fat should be cut off. I just knew I was bigger than I wanted to be.
The Impact of Diets on Alice
A few years later, her mother put herself and Alice on a no-carb diet. “Atkins was quite tall,” says Alice. Her father and two younger brothers were exempt; it was only for the girls of the family. Which basically meant that Alice and her mother still ate everything from the garden except no beets because beets had “too many carbs.” After three days, Alice became outraged. She grabbed some crackers from the cupboard: “Mom, I just ate a whole sleeve of Saltines!” When her mother heard this, she was not angry with her. Alice shared: "She was also desperate for carbs and ate three saltines herself. And then dutifully went back to her no-carb diet."
The Relentless Voice of Self-Hatred
At sixteen, Alice began monitoring her weight for exercise. The voice of self-hatred in her head became very specific and clear. "That cupcake you just ate – how many calories does it have? How many carbs does it have?" She described it as not letting up, not even for a tiny bite. It was relentless. Fast forward more than thirty years, and by the time Alice was almost fifty, she had tried every diet and exercise program in the world: forty-seven, to be exact. Atkins, keto, South Beach, The Zone, low carb, no carb, ultra low fat, liquid only, Jillian Michaels, Jane Fonda, Suzanne Somers, total body HIIT workouts, gym memberships, a YMCA strength trainer, DietBet, StepBet, a Mediterranean diet, a vegetarian diet, the raw food diet, intermittent fasting. She had even tried hypnosis.
The Problem of Obesity
She had three teenagers, a fulfilling job in communications, and a loving boyfriend. She struggled with obesity despite spending much of her adult life monitoring every bite of food, eating mostly healthy meals and exercising every day. She had successfully lost weight countless times. That wasn’t the problem. The problem was that she kept getting it back. She always blamed herself for obesity. She didn’t know anything about the biology of obesity. From Enough: Your Health, Your Weight, and What It’s Like to Be Free by Ania M. Jastreboff, MD, Ph.D., and Oprah Winfrey. Copyright 2025. Reprinted with permission from Simon & Schuster, Inc. All rights reserved.
