Pacing in front of 80 students of clinical nutrition, Dr. Judith Stern calls out an unsettling list of side effects from the herbs that some people embrace as a natural approach to what ails them.
Fever. High blood pressure. Liver toxicity. Low blood pressure. Mouth ulcers. Allergies that can sometimes turn lethal.
"Not minor side effects," Stern says, pausing in mid-pace and raising both hands, index fingers pointing skyward, to underscore her point.
Before her students leave for the morning, they all know that Stern thinks herbal supplements should be regulated like medications, that the FDA isn't doing enough, and that garlic, her personal favorite, "should be added to all foods except chocolate."
No one could accuse Stern of reticence. Not in front of her students at the University of California, Davis, not on national advisory panels and not in the field of obesity research.
"I'm ornery," Stern says.
When she sat on a federal advisory panel that recommended a new demarcation between normal weight and overweight, Stern did not hesitate to tell reporters she had dissented, arguing the data was too weak. If her view had prevailed in 1998, and "overweight" had begun at a body mass index of 27 instead of 25, more than 30 million Americans would have escaped being labeled unhealthily hefty.
Later, Stern and Dr. Richard Atkinson, co-founders of the American Obesity Association, went to bat against the IRS to fight for better tax treatment for combating obesity. In 2002, under pressure from the obesity association and other groups, the IRS agreed to let people deduct the cost of their obesity treatments like most other medical expenses. That took obesity out of the realm of looks -- most cosmetic surgery is not tax deductible -- and firmly into the realm of health.
"If you just say Judy Stern, people think of policy," Atkinson said. "She has been very big in obesity policy."
In 2006, she and Atkinson were the first recipients of an Obesity Society award named after them, given to those who have significantly improved the lives of people affected by obesity.
Stern, a professor of nutrition at UC Davis, has a quick smile, an infectious laugh, and twin slashes of dark eyebrows as forceful as she is.
In any 15 minutes, she can cover vast territories, sharing her views on walking, clothes, dessert, university politics and the care of lab animals -- with time left over to ask all about her listener.
She is fond of paraphrasing a university report that suggested, as interpreted by Stern, "one of the things the faculty is supposed to do is to make trouble. That way we can make changes."
Stern enjoys advocating for change, within academia and beyond. She has written for Redbook and other popular magazines, and dabbled at blogging.
She's working on another book about obesity, which she hopes will interest general readers although it's aimed at health care professionals.
In researching one of the chapters, Stern has been delving deeply into herbs and traditional medicine of several cultures, including India and China.
In many ways, side effects and all, she likes what she sees.
"We should show respect for the history of medicine that is longer than ours and (that) for some things has a better record," Stern says. "Things they were doing a thousand years ago, we're doing now and it works. We should take an opportunity to learn and also give them credit for having developed it."
Over the years, Stern has been involved in research that showed that exercise raises people's metabolic rate for at least 12 hours after a workout, and that people on very strict diets, whose metabolisms tend to slow, can reverse some of that decline with exercise.
Stern has also studied Zucker rats, a strain of rats genetically programmed for obesity, monitoring their exercise habits, their fat cells and the disorders that kill them. Her current collaboration involves trying to pinpoint the stretch of DNA that leaves certain offspring of obese and normal rats more vulnerable to developing kidney disease.
The obesity question that Stern would most like science to answer is the same one that nags at anyone who has stared wistfully at a perpetually slim friend.
What makes certain people become obese when others don't?
"It's beyond genetics," Stern says. "I'm not going to be able to do it, but I want to see it done. And then, boy, do I want to change policy."
She wants to change the sneering and the belittling.
"Obesity is a disease, and we don't treat it with respect, and we don't treat obese people with respect," Stern says.