Oprah Winfrey, a media mogul, has been public about her weight struggles for decades. Her journey took a new turn with the use of weight-loss medications. This culminated in "An Oprah Special: Shame, Blame, and the Weight Loss Revolution," which aired on ABC on March 18, 2024. The special addressed the complexities of obesity, the role of new medications, and the societal shame associated with weight.
A History of Public Scrutiny
Winfrey has faced public ridicule for her weight fluctuations for over 25 years. She has openly discussed the blame and shame she has experienced and inflicted upon herself. In December 2023, at the premiere of "The Color Purple," she told Entertainment Tonight that her weight loss journey was multifaceted, not just one thing.
Obesity as a Disease
Winfrey now views obesity as a disease. She expressed relief and gratitude for the development of medically approved prescriptions for managing weight. Winfrey believes that accepting the science behind weight-loss drugs helped her release her own shame about it.
The ABC Special: Aims and Scope
Winfrey created the ABC special to provide a safe space for individuals who have struggled with chronic weight gain and management to share their experiences. "I wanted to do this special for the more than 100 million people in the United States and the over 1 billion people around the world living with obesity," Winfrey said. She also expressed her hope that the special would provide hope to those who have struggled with being overweight or obese for years.
The special included experts such as Dr. W. Scott Butsch, Director of Obesity Medicine at the Cleveland Clinic's Bariatric and Metabolic Institute, and Dr. Amanda Velazquez, an obesity expert at Cedars-Sinai in Los Angeles. These experts provided insights into obesity and weight-loss medications.
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Key Takeaways from the Special
Weight Stigma and Men
One of the most rewarding things Winfrey learned from the special was how weight stigma impacts men. She realized that men who are overweight are also ostracized, although she had previously believed that men were treated differently than women in this regard.
Obesity as a Disease: The Underwater Metaphor
An expert on the special shared a metaphor that helped Winfrey understand obesity as a disease that causes people to gain weight and necessitates medical intervention. The doctor compared obesity to holding one's breath underwater and trying not to rise. Winfrey realized that she had been doing this for years, going on diets and trying not to rise, but then rising again and not understanding why.
The Role of Medication
Winfrey shared that she decided to start using weight-loss medication because she could no longer work out, climb, or run any faster. She was also eating only one meal a day. She emphasized that medication is not the only solution and that she is also making other efforts to lose weight.
The Importance of Choice and Acceptance
Winfrey emphasized that people should make their own choices for their health and well-being. She admires people who feel great in a bigger body and do not want to do anything about it.
The Science Behind Weight-Loss Drugs
The special touched on the science behind weight-loss drugs like Ozempic, Wegovy, Mounjaro, and Zepbound. These drugs mimic hormones that the body releases when a person eats food, which reduces appetite and makes people feel full sooner. Semaglutide, the active ingredient in Ozempic and Wegovy, targets the GLP-1 hormone, while tirzepatide, the active ingredient in Mounjaro and Zepbound, targets both GIP and GLP-1 hormones.
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Clinical trials have shown that patients can lose about 15% to 20% of their body weight with these treatments. However, they also come with side effects, such as nausea, diarrhea, vomiting, and stomach pain. More serious side effects, such as pancreatitis, are also possible.
The drugs are self-injected once a week, and people have to keep taking them to maintain weight loss. They can also be expensive without insurance, costing more than $1,000 per month.
Personal Stories of Transformation
The special featured personal stories from individuals who have struggled with their weight for many years and who have used GLP-1 drugs. These individuals shared the profound impact that the drugs have had on their lives.
One story featured a mother and her teenage daughter, Erika and Maggie Ervie, who are both taking Victoza for weight loss. Maggie had struggled with weight since childhood and was her heaviest at 285 lbs. Erika said that Maggie's physical health has dramatically changed with normal blood work, non-fatty liver, and not being pre-diabetic.
Another story featured Amy, who suffers from polycystic ovarian syndrome (PCOS). Amy found it very challenging to lose weight with the condition. After losing 60 lbs on her own, she tried Mounjaro and said that the medication has saved her life not just physically, but also emotionally.
Read also: Oprah's Journey to Weight Loss
Addressing Concerns and Criticisms
The special also addressed some of the concerns and criticisms surrounding GLP-1 drugs, such as side effects and unintended uses. Winfrey noted that about 17 percent of people discontinue semaglutide because of side effects, most of which are gastrointestinal.
Dr. Sistani explained that the risk of pancreatitis, gallbladder complications, and thyroid cancer is less than one percent.
Oprah's Personal Journey with Weight-Loss Medication
Oprah revealed that she uses weight loss medication as a "maintenance tool." She eats her last meal at 4 o'clock, drinks a gallon of water a day, and uses the WeightWatchers principles of counting points. She had initially felt that she had to prove she had the willpower to lose weight on her own, but she eventually realized that obesity is a disease.
The Cost and Accessibility of Weight-Loss Drugs
The special touched on the high costs of some of the drugs and the limited coverage of weight loss drugs. Negelle Morris, Novo's senior VP of cardiometabolic sales, said that access is complex, just like the disease itself is complex.
The Role of WeightWatchers
The CEO of WeightWatchers appeared on the program and noted that WeightWatchers recently added the missing "biology" component to its approach by acquiring telehealth weight-loss drugs prescriber, Sequence.
The Importance of Holistic Approach
Amy, who was featured in the program, emphasized the importance of overhauling her diet, lifestyle, and working on her mental health while taking the drug.