Probably the residual after effects of the Viagra he prescribed himself from the night before.
you are correct,
this is a 50-something guy, a hi profile MD who rakes in MILLIONS by working in the Oprahized mass media, who probably prescribed himself Viagra for this foto shoot
this is a high profile individual, working with Oprah and all the rest, and THERE IS NO WAY (HEAR ME) that this foto would have made its way onto the mass marked "accidentally"
NO WAY
he is for sure, a good looking guy in his 50s, an MD with credible scientific credentials, and all the rest. but the pants bulge is a complete creation for media hype and he is getting what they wanted.
the fact that we are even commenting on it is prima facia evidence that the media hype works