Live Your Best Life Ever!

The thread-lift craze, such as it was, did not last long. "You never hear anything about them now," says Dr. Alan Gold of the American Society for Aesthetic Plastic Surgery. "That procedure turned out to have major downsides and rapidly fell into disrepute."

You would not know this from watching Oprah. The New York Times noted problems with the treatment in a 2006 article specifically about the Oprah show's tendency to hype plastic surgery without mentioning the risks. But Oprah never circled back to warn her viewers that they just might want to cross it off their to-do list. Grossman says Oprah never gave her an opening to talk about the downsides, and in the moment it didn't occur to her to raise them herself. If she went on the show again, she says, she'd do things differently. "We should have said, 'This is a new procedure. It looks interesting and exciting, but we don't know everything about it yet and there may be risks that haven't come up yet'."

Oprah was also one of the first to feature a procedure called Thermage. It smooths wrinkles by using radio waves to tighten skin. The Times article noted that Oprah was one of the first to call attention to the $30,000 Thermage machines after they were released in 2003. "The show drove so much interest that our sales reps were selling machines over the phone," the president of the company told the paper. In the years since, Oprah has featured the product numerous times on her TV show and Web site and in her magazine.

In February 2004, dermatologist Brandith Irwin appeared on an episode called "Look Younger! Live Longer!" The show aired again twice over the next two years. Irwin came on the program to promote a book and to talk about cosmetic procedures. She had nothing but praise for Thermage, which was then still a relatively new treatment. "I tell my patients they'll lose about half a day, and then you go back to your normal activities the next day." Neither Oprah nor Irwin said anything about a significant downside to the procedure: it hurt, a lot. And it didn't always work. On her own Web site, Irwin acknowledges that in those early days of Thermage, "the treatments were painful without sedation (we sedated everyone in our office), and the results were inconsistent." O magazine recently ranked Thermage as a four on a pain scale of one to five. Five was "agony." There was also no mention on the show about the potential risks, which included burns and scars.

The makers of Thermage say the latest generation of machines are more effective and far less painful. And the risk of complications is very low. Stephen Fanning, the company's CEO, says Oprah certainly helped drive sales and interest. But he is uncomfortable when his product is promoted without giving people the whole picture. "I think any time you're dealing with a cosmetic device, you always have to present a balanced approach. Oprah didn't." Fanning believes Oprah should have made it clear that Thermage isn't for everyone. "Who isn't a good candidate? Someone who smokes a lot, someone who consumes a lot of alcohol, is not going to get the kind of results they want. The same can be said for someone who has spent a lot of time in the sun."

Yet Irwin says there was no time on the Oprah show to go into these kinds of details. "It was meant to stimulate interest, and then people could go find out about it from their doctor and decide what's appropriate for them. That's what the Web site and the book and office visits are for," Irwin says. "I am in sympathy with the idea of doing better medical segments," she says. "We can't do that in 15 seconds."

Right about now is when you might be asking, is there anything Oprah gets right? In fact, there is. For one, she gives excellent diet and fitness tips. Two of her longest-serving resident experts, Dr. Mehmet Oz and trainer Bob Greene, routinely offer sound, high-quality advice to Oprah and her audience on how to lose weight and improve overall health. For the most part, it is free of the usual diet-industry hype, perhaps because so many of her viewers are on to those scams by now. Oz's and Greene's philosophy amounts to: eat nutritious foods, and exercise.

Oz, fit and handsome, is particularly good at connecting with Oprah's audience. He is a cardiac surgeon at Columbia University and generally sticks to the facts. He is also a natural showman who comes onstage in surgical scrubs, as if he might be asked to perform an emergency heart transplant at any moment. He sometimes arrives carrying preserved body parts as visual aids. On one show, "Everybody Poops," Oz conducted a genuinely fascinating seminar on what comes out the other end. (It should be shaped like an S and "hit the water like a diver from Acapulco." Who knew?)

Oz isn't without his faults. He sometimes keeps quiet on the show when Oprah's out-there experts are spouting their questionable theories. There seems to be an unwritten rule that one Oprah expert may not criticize or correct another, and Oz has an interest in keeping Oprah happy. She has turned his books into mega-bestsellers, and features him on her Web site and in her magazine. Her production company is also bankrolling his own syndicated TV show, Dr. Oz, which debuts in the fall. "My role on The Oprah Winfrey Show was never to assume editorial control or in any way to debate the position that other guests might take," Oz said in a statement. "My participation on the program, much like that of any physician on television, was never intended to replace the discussion necessary between patients and their personal health-care provider."

Oprah, of course, is notoriously bad at sticking with the advice Oz and Greene dispense, especially when it comes to her weight. She laments her inability to keep off the pounds. In January she embarked on yet another attempt to trim down, which means all of Oprah's viewers are now—actually or vicariously—on a diet too. She will lose the weight, and there will be much remarking upon it. But then, in a year, or two, or three, experience teaches us that the fat will likely come back. And she will lament. And then she will do it all over again, with a whole new set of experts armed with the latest breakthrough theories on how to live our next best life and all-new, must-have books and gadgets and ointments to ease the way.