A diet of Dr. Phil

Everyone’s heard it by now: Americans are fat and getting fatter. Their ballooning waistlines have come despite years of calorie counting, magic pills and fad diets. They’ve come despite reams of scientific research about the dangerous health risks of obesity. They’ve come despite stern public admonitions from the nation’s leading governmental and medical organizations about eating less and exercising more.

If anyone has a chance to reach the nation’s couch potatoes, it just may be a 53-year-old former college linebacker from Texas whose mix of folksy charm, tough talk and motivational skills has brought him a television audience of 65 million viewers. Phil McGraw, almost universally known as “Dr. Phil,” has taken on low self-esteem and troubled relationships, and now he’s tackling America’s epidemic of flabbiness.

Fueled by an autumn marketing blitz, Dr. Phil’s new book, “The Ultimate Weight Solution: The 7 Keys to Weight Loss Freedom,” has rocketed to the top of the New York Times and other bestseller lists. With 2.5 million copies in print, it’s already in its ninth printing in eight weeks.

The popular psychologist launched his book and his weight-loss campaign two months ago on his nationally syndicated daytime television show, second only in ratings to that of his show business mentor Oprah Winfrey. The show and his Web site (www.drphil.com) are tracking the progress of 13 volunteers whose starting weights ranged from 195 to 464 pounds as they struggle to slim down.

He’s made recent appearances promoting his book with talk show hosts Larry King, Jay Leno and David Letterman. The Los Angeles resident was recently the subject of a Katie Couric special about his weight loss plan and was later featured discussing his seven keys in a weeklong series on “Today.”

Now Dr. Phil’s face is even popping up on a new line of health and nutritional products called “Shape Up!,” available at such major retailers as Wal-Mart, Target and Sav-on. The multivitamins, snack and meal-replacement bars and shakes all carry Dr. Phil’s picture.

Dr. Phil, who declined to be interviewed for this story, essentially summarizes what other nutritionists, doctors and health professionals have been saying for years. But some health officials say he might just be what the nation needs.

“Maybe Dr. Phil, because of his popularity, is going to be able to do what the American Medical Assn. and the American Dietetic Assn. haven’t been able to do -- get the message out,” said Doug Kalman, a nutritionist and spokesman for the American College of Sports Medicine.

Dr. Phil’s simple message, particularly the emphasis on the psychology of eating, seems to be resonating. Obesity is a “disease of choice,” he says, that can’t be cured, only managed.

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Avoid emotional eating

In his book and appearances, he recommends accepting your body type and setting realistic goals that don’t include looking like a Hollywood movie star. But do take personal responsibility for your weight, especially by avoiding emotional eating. “You never see a fat coyote,” he has said on at least one TV show. “They eat what they need to live and move on.”

When it comes to food and nutrition, don’t diet or deny yourself food, he cautions. But watch your portion sizes. Load up on foods that are high in nutrients and fiber, lower in salts and fats, and take some work to actually consume.

He urges choices like broccoli, shelled peanuts and fish. Conversely, he recommends eschewing foods like Big Macs or burritos stuffed with sour cream -- basically, any food that’s turns the eater into a “wood chipper.” And finally, exercise vigorously for 20 minutes at least three times a week.

“There [are] brilliant people doing all kinds of fabulous research, but if you can’t communicate it to the people who need the information, it doesn’t work,” said Susan Kleiner, a Seattle author of several books about fitness and nutrition. “Dr. Phil has a wonderful style, and hopefully people will get motivated because we’re in big trouble here.”

Dr. Phil’s appeal is built upon his “Get Real” philosophy, which stresses action over analysis and getting “over it” so you can get “it” done. His average-Joe looks, unpretentiousness and sometimes crass wit, which includes such lines as “Pat yourself on the butt and kiss it goodbye,” contribute to his high ratings, which spiked more than 25% at the debut of his second season. His overall message of individualism and can-do spirit resonates deeply with many Americans. “This notion of reinvention and the ability to remake ourselves is very much a part of the national character,” said Robert Thompson, director of the Center for the Study of Popular Television at Syracuse University. “American history is really a makeover show.”

Perhaps endearing him to viewers even more is his own battle of the bulge; at 6 feet 4 and 240 pounds, even by his own book’s weight charts, he’s at the outer fringe of what’s acceptable. Just as a reformed addict carries more credibility with a junkie, so, too, Dr. Phil may do so with those grappling with their extra pounds.

Obesity has deeply affected his family as well. He blames it in the deaths of his father and his mother in-law. Inspired by these wounds and years of treating overweight patients as a clinical psychologist, Dr. Phil took it on himself to lead the charge against obesity. And he means to win.

“I think people see him as a big, bald daddy,” said Allison Conner, a New York City clinical psychologist who has used Dr. Phil’s behavior therapies in her practice. “And so many people in this country need that kind of father figure to steer them in the right direction.”

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A questioning of motives

There probably would be no Dr. Phil today if it weren’t for a lawsuit brought by a group of Texas cattlemen against Oprah Winfrey for comments she made about mad cow disease on her show nearly a decade ago. In 1996, Dr. Phil was hired as a jury consultant and helped the talk-show host prepare for, and ultimately win, her case. The pair hit it off; Dr. Phil months later began appearing as a regular guest on her show and quickly became popular for his “tough love” approach.

But Dr. Phil’s in-your-face style, and most recently his decision to step over into the world of celebrity health endorsements -- something Oprah has never done -- has earned him his critics. They contend that linking his name and likeness to nutritional products is driven more by greed than altruism.

The financial details of Dr. Phil’s licensing agreement with CSA Nutraceuticals have not been disclosed. But in interviews Dr. Phil has said that the start-up company, based in Irving, Texas, will donate an undisclosed portion of the annual sales -- which should be around $1 million the first year -- to the Dr. Phil Foundation. The nonprofit Dallas charity, founded this year, is dedicated to fighting childhood obesity and related diseases.

“Dr. Phil obviously has some smart businesspeople around him who decided to leverage the brand that is Dr. Phil and make it an even greater franchise,” said Anthony L. Almada, founder of Imaginutrition. The Laguna Niguel consulting firm advises supplement companies on product testing.

The decision to enter the health-related products business has surprised Dr. Robert H. Eckel, a professor of medicine at the University of Colorado Health Sciences Center and chairman of the American Heart Assn.’s Council on Nutrition, Physical Activity, and Metabolism. He’s quoted in the front of Dr. Phil’s new book praising the television host for cutting “through the confusion of fad diets.”

When he offered the positive review to Dr. Phil, Eckel says, he and the AHA were unaware of the supplement business.

Had he known, he might have withheld his support, Eckel said. While standing behind Dr. Phil’s weight management program, as outlined in his book, as scientifically sound, Eckel is nevertheless uncomfortable with the new product line. “It smells faddish,” said Eckel. “And that’s something we try to avoid.”

Dr. Phil’s foray into health-related products has frustrated some nutritionists as well. Joanne Ikeda, a nutritionist at UC Berkeley who has tracked the diet business for more than two decades, said she used to watch Dr. Phil’s show regularly. But not now. She believes Dr. Phil is cashing in on his celebrity for a product he doesn’t truly understand.

“I was really surprised by the snack bars,” she said. “I really admired Oprah Winfrey for never taking advantage of her popularity like that. She drew a line and said I’m not stepping over this one. But not Dr. Phil. I think it’s a real problem.”

Ikeda also objects to much of Dr. Phil’s weight management advice. It’s simplistic and misleading, she said. Advising obese people to evaluate their emotional reasons for eating is one thing; getting them to change -- a far more difficult task -- is quite another. Further, it doesn’t make sense to tell people there are seven simple keys to losing weight and keeping it off, when studies show that 95% of those who lose weight put it back on within five years, she said.

“He’s really just advocating a ‘no diet-diet,’ ” she added. “He’s written a namby-pamby, eat-better-and-exercise-more-and-you’ll-magically-lose-weight book.”

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Controversial advice

Other critics say that some of the nutritional advice -- while probably not harmful -- seems to be based on a misinterpretation of data. For instance, among the book’s advice to the “weight loss resistant” is a recommendation of 10 micrograms of vanadium a day. Taking supplements of the mineral was once touted as a potential way to help balance blood sugar levels, but that theory was never proved, and its effect on weight loss is unclear.

Furthermore, the vanadium study cited in the book’s appendix examined subjects who took the nutrient in amounts 750 times greater than what Dr. Phil suggests. “Ten [micrograms] is a laughable amount,” said Almada.

Dr. David Heber, director of the UCLA Center for Human Nutrition, criticized Dr. Phil’s nutritional supplement information as well. Dividing people into “apple” and “pear” body types, as Dr. Phil has done in his book and with his supplements, is essentially meaningless, he said. “There’s no difference in the supplemental needs between an ‘apple’ and a ‘pear,’ ” he said. “There’s not a lot of science to support what he’s saying on that point.”

As for Dr. Phil’s nutrition bars?

“You can get the same thing at Trader Joe’s,” added Heber. “A bar is a bar is a bar.”

The challenges, however, are unlikely to derail Dr. Phil, who has consistently touted the scientific accuracy of his book. As for the nutritional products, “I think it’s a good product and I’m doing it for a really good reason and purpose,” he told the New York Times in a recent interview. “Although if I was doing it for a commercial -- as a brand extension of my own -- I wouldn’t apologize for that either.”

But even if he is capitalizing on his fame, as some observers contend, in the end, his contribution to battling America’s considerable weight problem may be more important.

“Overall his message is pretty healthy,” Thompson said. “Someone needs to be saying it.”