Four years ago, when Oprah managed to get down to a trim and fit 160 pounds, she thought she'd hit on a foolproof formula for permanent weight loss. Then life—in the form of a thyroid problem and a killer schedule—intervened. Last year she was back up to the 200-pound mark and knew something had to change. After a desperately needed time-out to reflect and recharge, here's what she's learned, what she's doing differently, and what's next.
You know how bad you feel when you have a special event, a reunion, a wedding, a bar mitzvah, and you wanted to lose that extra 10 to 40 pounds, and you didn't do it? So the day comes and now you've got to try to find something to wear that makes you feel halfway decent, and you have to figure out how to hold in your stomach all night and walk backward out of the room so no one sees that your butt keeps moving even when you stop. Multiply that feeling by a million—make that more than 2.4 million for every O reader—and you'll know how I've felt over the past year every time I had to shoot a cover for O. If you're a regular subscriber, you'll notice you've not seen a head-to-toe shot all year. Why? Because I didn't want to be seen. "

O Magazine January 2005 cover In 1992 I reached my heaviest, 237 pounds. I was 38. Then, four years ago, I made it a goal to lose weight, and I appeared on the January 2005 cover (left) at a toned 160 pounds. I thought I was finished with the weight battle. I was done. I'd conquered it. I was so sure, I was even cocky. I had the nerve to say to friends who were struggling, "All you have to do is work out harder and eat less! Get your 10,000 steps in! None of that starchy stuff!"

Bam! Karma is a bear of a thing.

So here I stand, 40 pounds heavier than I was in 2006. (Yes, you're adding correctly; that means the dreaded 2-0-0.) I'm mad at myself. I'm embarrassed. I can't believe that after all these years, all the things I know how to do, I'm still talking about my weight. I look at my thinner self and think, "How did I let this happen again?"

It happened slowly. In February 2007, at 53, I started to have some health issues. At first I was unable to sleep for days. My legs started swelling. My weight started creeping up, first 5 pounds, then 10 pounds. I was lethargic and irritable. My internal clock seemed totally out of whack. I began having rushing heart palpitations every time I worked out. Okay, I've never loved daily exercise, but this was different. I actually developed a fear of working out. I was scared that I would pass out. Or worse. I felt as if I didn't know my own body anymore.

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