Oprah Winfrey, a longtime figure in the national conversation about dieting and weight bias, devoted an hourlong prime-time special on Monday to the rise of weight loss drugs. Her goal, she said, was to “start releasing the stigma and the shame and the judgment” around weight and weight loss — starting with her own, she said.
“For 25 years, making fun of my weight was national sport,” Ms. Winfrey said in the show, titled “An Oprah Special: Shame, Blame and the Weight Loss Revolution.”
Shame has become a focal point in that conversation as new drugs like Ozempic and Mounjaro, which are widely used for weight loss, shift how people think about treating obesity. When Ms. Winfrey disclosed in December that she was taking a medication to manage her weight, she said she was “done with the shaming” that had followed her through decades of dieting.
Many patients who start taking these medications say they have felt shamed for struggling with their weight, and then shamed for taking weight loss drugs, said Dr. Michelle Hauser, the obesity medicine director of the Stanford Lifestyle and Weight Management Center, who was not involved with the special.
“People just are constantly getting this message, both internal bias and then external bias from other people,” she said. Some might think, “‘I shouldn’t have to rely on medication, I shouldn’t be dependent on them,’” she added.
Dr. Hauser tells patients to instead ask themselves: “Would you tell someone that about their blood pressure medication?”
Ms. Winfrey did not name the medication she took, but said that after she started the drug, she understood for the first time that “all these years, I thought all of the people who never had to diet were just using their willpower, and they were for some reason stronger than me.”
Ms. Winfrey and others interviewed on the program — which included doctors who have consulted for the makers of these drugs — referred throughout the hour to the incessant internal chatter that some people experience around eating, also called “food noise.” Many patients who have taken drugs like Ozempic have said that noise fades away on medication.
“I felt like I was freed,” said Amy Kane, who joined Ms. Winfrey onstage to discuss losing 160 pounds on Mounjaro.
The drugs, however, have notable side effects: One of the patients Ms. Winfrey spoke with said that she stopped taking a weight loss medication after she vomited blood and landed in the emergency room.
Dr. Amanda Velazquez, an obesity expert at Cedars-Sinai and one of the doctors who has consulted for a weight loss drugmaker, said in the special that she considered the side effects “overhyped.” Outside experts have said that the drugs can lead to nausea, dizziness, constipation, diarrhea, acid reflux and in severe cases, malnutrition if a person consumes too few nutrients.
Many patients have also struggled to access the medications, some of which are used to treat diabetes in addition to obesity. Some insurers do not cover the drugs for weight loss, and drugmakers have also faced difficulties keeping up with demand. Nearly all doses of Wegovy are currently in short supply, according to a Food and Drug Administration database.
Ms. Winfrey, who said shortly before announcing her special that she would not seek re-election for her position on the board of Weight Watchers, has long been public about her efforts to lose weight. In 1988, she tugged a red wagon filled with fat across the stage of her television show, a symbol for the 67 pounds she had lost while on a liquid diet. The day after that episode, she started gaining weight back, Ms. Winfrey said in the new special. At one point during the program, she pointed to an image of the cover of TV Guide from 1990 that labeled her as “bumpy, lumpy and downright dumpy.”
“She’s been subject to so much policing, so much surveillance, so much scrutiny about her body,” said Kate Manne, an associate professor of philosophy at Cornell University and author of the book “Unshrinking: How to Face Fatphobia.”
“After a lifetime of people speculating about her weight and often jeering at her weight when she gained it, and applauding her for losing weight, I can really sympathize with her sense that her body is a problem that needs to be solved,” Dr. Manne said. But she said she was concerned about the potential harms of conversations focused so squarely on weight loss.
“I feel worried that she will be again perpetuating a social sense that people’s variations in size and shape really need to be addressed as a medical problem,” Dr. Manne said.
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