Because I've fallen somewhat behind on my reading, I was only able last night to catch up to this excellent Newsweek expose of the public health menace that is Oprah Winfrey. No matter how bad you feared it was, Oprah's even worse than you could have imagined, letting her "experts" push ideas such as "diet will prevent you from catching HPV, so don't worry about the vaccine" and otherwise encouraging her viewers to take health measure that will actually degrade their health and work against their interests. It also functions a neat examination of the sort of motivations that keep health woo alive, despite all evidence and common sense against it. I somewhat disagree with the authors, who seem to think that the emphasis on woo on Oprah's show is all about her massive ego. It actually seems to me that it's ratings-grabbing pandering, and Oprah just has, for whatever reason, a real ear for those things that will trip up her audience's wishes and anxieties. Health woo tends to rely on a few principles to keep people's interest and money flowing:

1) Bad things don't happen to good people.*

2) There must be a way of understanding the body that doesn't involve actually gaining difficult and often embarrassing knowledge.

3) The world is out to get me.

4) There must be a quick, easy solution out of any problem, and it's just a matter of finding out what it is.

Since Oprah's audience is largely female, they aren't completely off in their sense that the world is out to get them. But the reasons for this and the ways to fight it that Oprah offers are fucked up. Yes, people routinely discredit women's intelligence. But the solution is not, as Oprah protege Jenny McCarthy suggests, to claim a special female-only "mommy knowledge" that automatically trumps evidence and reason. Reading the article, I really began to see why McCarthy's anti-vaccination campaign is such a hit with so many mothers. She is exploiting the already-present frustration women have with everyone and their dog thinking they're smarter than you and need to make all your decisions for you, frustration that amps up when you have a kid and you start to feel the Perfect Mommy pressure from every side. McCarthy's schtick is to imply that rebelling against vaccinations is the perfect way to soothe that hurt ego. Of course you're smart! Giving birth automatically confers more understanding of the body than centuries of research could ever create. Who doesn't want to believe that it's that easy?

What really cinched it for me with regards to Oprah's remarkable ability to laser pinpoint women's anxieties is her constant reliance on Christine Northrup, who is an utter genius as playing on women's anxieties. See, Oprah put on weight, which she blamed on her thyroid (which is possible, but it also could have been an convenient excuse that fits into #4). So, Northrup came on to assure women that they put on weight because the world is so unfair to them.

But Northrup believes thyroid problems can also be the result of something else. As she explains in her book, "in many women, thyroid dysfunction develops because of an energy blockage in the throat region, the result of a lifetime of 'swallowing' words one is aching to say."

On the show, she told Oprah that "your body gives you signals: 'Hey, you've been putting too much stuff under the carpet ...' "

Oh god, it's genius. Who doesn't want to believe that all you need to do to lose weight is start telling more people that have it coming to fuck off? It's so tempting that I was half buying it, even though I know that it's 100% bullshit. But talk about knowing your audience. Most women are well-trained to suffer people's bullshit and to take on a bunch of extra responsibilities because saying no is unladylike. But here is this doctor telling you that your obligation to be demure is conflicting with your obligation to be thin, and so you have a perfect excuse to speak your mind without violating the rules of femininity. You're not speaking up because you want to! Oh no, it's your new diet plan.

Northrup is a renegade gynecologist, who exploits women's desire to find the perfect balance between the requirement to be excellent in bed with the requirement not to seem too knowledgeable or experienced at it. So, you get a lot of shit on Oprah about improving your orgasm through chi channeling, instead of the old-fashioned way of mucking around in your genitals to know what actually works, a most unladylike behavior. So it's really no surprise that she bought into the hostility to the HPV vaccine, hostility that I've found in surprising corners that is unsurprisingly related to belief #1. Seriously, I've even been in rooms with feminists who are happy to imply that there's not really a need for the vaccine for everyone, since it's sexually transmitted and.....I guess not everyone is a bad girl who has sex? What number of partners do you have to have before HPV spontaneously generates as a slut punishment? I'm guessing the magic number is always two more than the person dropping the hints.

Northrup isn't that crude, but she happily invokes the image of a pure, good woman who can't get HPV.

McCarthy is not the only guest who has warned Oprah's viewers off vaccines. Last summer Dr. Christiane Northrup, a physician and one of Oprah's regular experts, took questions from the audience. One woman asked about the HPV vaccine, which protects women against a sexually transmitted virus that can cause cervical cancer. Northrup advised against getting the shot. "I'm a little against my own profession," she said. "My own profession feels that everyone should be vaccinated." But Northrup cautioned, "There have been some deaths from the vaccine." She suggested a different approach. "Where I'd put my money is getting everybody on a dietary program that would enhance their immunity, and then they would be able to resist that sort of thing. All right?"

It's not exactly the "only sluts get STDs" routine, but it's close in that it's another variation of claiming that STDs are the result of not treating the body like a temple, instead of, you know, being exposed to the bacteria or virus that causes an STD. But I'd argue that it's in the same category, since food and sex are closely intertwined in the American imagination as dual sins, especially with women. It's easy to see why, since both are about breaching the boundaries between inside and outside the body, so both are subject to purity fantasies. Eating right, like not being a slut, goes back to the same thing in this system---it's more about what you don't put in your body than what you do. That bowl of ice cream or bad boy who wouldn't call you the next day are why you have an STD. You don't get those things from broccoli or husbands.

And let's not even talk about "The Secret", which got so out of control that Oprah actually found herself in the uncomfortable position of realizing one of her fans was going to forgo cancer treatment and hope the power of positive thinking would save her from breast cancer.

Again, my one criticism of the article is that the authors get so entranced, as everyone does, with Oprah's cult of personality that they think that must be the problem. In other words, Oprah pushes woo because Oprah believes in woo. She may believe in it, or she may be a complete huckster, though I suspect the truth lay somewhere in between those two poles. What's relevant is that she has a remarkable ear for what her largely female audience wants to hear. She may have that ear because she shares their concerns or because she's got a lot of practice, but probably some of both. But the stuff she's hustling is all over daytime TV. Believe me; I monitor a lot of morning talk shows for my podcast, because they are always on about the dangers of sluttitude. I imagine if I monitored them for other kinds of woo, I'd find that as well. The main difference is that Oprah can up the ante on the outrageous claims because she's got such an authoritative presence.

*Otherwise known as the Megan McArdle "why I'm comfortable with 3rd trimester abortion bans" principle.