Oprah Winfrey, a longtime figure in the national conversation about dieting and weight bias, devoted an hour-long prime-time special on Monday to the rise of weight-loss drugs. Her goal, she said, was to let go of “the stigma, shame and judgment” around weight and weight loss — starting with her own, she said.
“For 25 years, making fun of my weight was a national sport,” Ms. Winfrey said on the show, titled “An Oprah Special: Shame, Blame and the Weight Loss Revolution.”
Shame has become a central point in that conversation as new drugs like Ozempic and Mounjaro, which are widely used for weight loss, are changing the way people think about treating obesity. When Ms. Winfrey announced in December that she was taking medication to control her weight, she said she was “done with the shame” that had followed her through decades of dieting.
Many patients who start taking these medications say they felt ashamed about struggling with their weight, and then felt ashamed about taking weight-loss medications, said Dr. Michelle Hauser, director of obesity medicine at the Stanford Lifestyle and Weight Management Center, who is there was not involved. with the special.
“People hear this message all the time, both internal biases and external biases from other people,” she said. Some may think, “I shouldn’t have to depend on medication, I shouldn’t have to depend on it,” she added.
Dr. Hauser tells patients to ask themselves, “Would you tell that to someone about their blood pressure medication?”
Ms. Winfrey did not name the medication she was taking, but said that after starting the drug she understood for the first time that “all those years I thought all the people who never dieted were just using their willpower, and they were stronger than me for some reason.
Ms. Winfrey and others interviewed on the program — including doctors who have advised the makers of these drugs — referred throughout the hour to the incessant internal chatter some people experience around food, known as “food noise.” Many patients who have taken medications such as Ozempic say that the sound disappears when they take medications.
“I felt like I was liberated,” said Amy Kane, who joined Ms. Winfrey on stage to discuss how she lost 160 pounds on Mounjaro.
However, the drugs have notable side effects: One of the patients Ms. Winfrey spoke to said she stopped taking weight-loss drugs after vomiting blood and ending up in the emergency room.
Dr. Amanda Velazquez, an obesity expert at Cedars-Sinai and one of the doctors a drugmaker consulted for weight loss, said in the special that she thought the side effects were “overhyped.” Outside experts have said the drugs can cause nausea, dizziness, constipation, diarrhea, acid reflux and, in severe cases, malnutrition if a person does not consume enough nutrients.
Many patients also struggle to access the medications, some of which are used to treat diabetes in addition to obesity. Some insurers don’t cover the weight loss drugs, and drug makers have also struggled to meet demand. Nearly all Wegovy doses are currently in short supply, according to a Food and Drug Administration report database.
Ms. Winfrey, who said shortly before announcing her special that she would not seek re-election to her position on the Weight Watchers board, has long been public about her weight-loss efforts. In 1988, she pulled a red wagon filled with grease across the stage of her television show, a symbol of the 67 pounds she had lost on a liquid diet. The day after that episode, she started gaining weight again, Ms. Winfrey said in the new special. At one point during the program, she pointed to an image from the 1990 cover of TV Guide that labeled her as “lumpy, lumpy and downright dumpy.”
“She is subject to so much police, so much surveillance, so much surveillance of 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 speculating about her weight and often laughing at her weight when she gained it, and applauding her for losing weight, I can really sympathize with her feeling that her body is a problem that needs to be resolved,” says Dr. said Manne. But she said she worried about the potential harm of conversations focused so heavily on weight loss.
“I worry that she will once again perpetuate the social feeling that people’s variations in size and shape really should be addressed as a medical problem,” said Dr. Male.