Paula Deen, the butter queen, has had a tough week. On Tuesday's "Today" show, the Food Network chef famous for her over-the-top, indulgent, Southern-style cooking, confirmed rumors that she has had Type 2 diabetes for several years. She also announced that she and her sons had signed a promotional deal with pharmaceutical company Novo Nordisk, makers of the diabetes drug Victoza, which Ms. Deen is taking.
Predictably, name-calling followed.
"Paula Deen's given her fans so much: obesity, heart problems, now shares the love by announcing diabetes! Guess she eats what she dishes out," read one Tweet on Thursday, while another asked: "Do I feel bad for Paula Deen? Yes. Do I also think she's an awful chef who peddles toxic food? Yes."
Even on Ms. Deen's own Facebook page, among the expressions of support and birthday wishes (Ms. Deen turned 65 on Jan. 19), a number of posts criticized her partnership with Novo Nordisk, and her decision to promote calorie-laden dishes, even as she experienced some of the health consequences.
The ever-optimistic, always-smiling Southern lady hasn't done much to help her own cause. It seems obvious that she waited to disclose her condition until a lucrative endorsement deal was offered, and the drug she's tacitly endorsing (and taking) comes with a high price tag and some serious side effects.
But her biggest PR problem is the food that is her brand. Ms. Deen says that her infamous dishes such as fried cheesecake and bacon-wrapped breadsticks were always meant for special occasions, but it's hard to preach moderation when even a recipe for stewed collard greens calls for an entire stick of butter and eight slices of bacon.
Robyn Webb, food editor for the American Diabetes Association's magazine Diabetes Forecast, isn't a big fan of Ms. Deen's cooking, but she has a lot of sympathy for her situation.
"I'm not shocked that she hasn't said anything for three years. She probably went into some form of denial, which is absolutely natural."
Ms. Webb, whose own cookbooks include "Diabetes Comfort Food Cooking," has plenty of experience "diabetize-ing" recipes for the Forecast website and magazine. She believes that Ms. Deen can absolutely keep cooking Southern food while also managing her disease. She just needs to decrease saturated fat and try to restrict carbohydrates to fruits, vegetables and whole grains. She also recommends that Ms. Deen cut down on meat and "really look and analyze. Does she need that stick of butter?"
At the same time, she and other experts cautioned against placing all the blame on Ms. Deen's (or anyone else's) eating habits.
"Genetics are probably the strongest determinant of who will eventually get diabetes," said Trevor Orchard, professor of epidemiology, pediatrics and medicine at the University of Pittsburgh. "We can attribute about two-thirds of the diabetes in this country to [people] being overweight or obese," but not every obese or overweight person will get diabetes.
The two conditions are intertwined, and as incidents of obesity have increased, so have incidents of Type 2 diabetes. According to the most recent data, about 8.3 percent of Americans, more than 25 million people, have Type 2 diabetes.
When blood-sugar reaches a certain level, people are said to have diabetes, but in reality, it's slightly more complicated. "It's a little arbitrary when we call someone diabetic as opposed to nondiabetic. It is part of a spectrum," said Dr. Orchard.
"Blood sugar still predicts heart disease even below the levels we associate with diabetes." As blood sugar rises, so do the risks of serious complications such as nerve damage, blindness and heart and kidney disease.
The good news is that positive changes in diet and lifestyle can also bring blood-sugar levels down, sometimes even permanently. A Diabetes Prevention Program studied by Dr. Orchard demonstrated that the risk of diabetes could be decreased by 58 percent over a three-year period when patients reduced their weight by 7 percent and engaged in moderate-intensity exercise for 150 minutes per week.
"For many people, all that's needed is simple walking 30 minutes a day at a fairly brisk pace and moderating the diet," said Dr. Orchard.
It seems that Ms. Deen has gotten similar advice. She says she's cut out sweet tea, which she used to drink all day long, is being more careful about portion sizes and is walking more. Recently, she posted on Twitter a photo of herself walking on her treadmill along with the comment: "They say Southern girls don't sweat, but honey, I'm willing to argue that after my workout today!"
And she's clearly taken some of her critics' words to heart. On Wednesday, she announced that she and her sons will donate part of their compensation from Novo Nordisk to the American Diabetes Association, and an ADA spokesperson confirmed that the Deens will be appearing without pay at upcoming events.
Those changes may seem small, and they're hardly the mea culpa that many people crave, but they're also realistic enough to maintain. The butter queen may not be our ideal celebrity diabetes representative. She's not going to go on a vegan diet, throw out her deep-fryer or train for a marathon. And it's really no surprise that she endorsed a diabetes drug -- after all, this is a woman who has already endorsed everything from wooden spoons to mattresses to Smithfield hams.
But for someone with as loud a voice and as big a platform as Ms. Deen, even small changes could have a positive effect on her millions of fans.