After more than a decade, Oprah Winfrey returned to prime-time TV last week for an ABC special titled “Shame, Blame and the Weight Loss Revolution” to share her public battle with weight and her decision to use new GLP-1 medications to help manage it.
In the hour-long TV special that Oprah hosted, set on a stage reminiscent of her iconic talk show, the talk show icon said, “I took on the shame that the world gave to me. For 25 years, making fun of my weight was national sport.”
The latest phase of Oprah’s weight loss journey brought her to GLP-1 receptor agonist drugs, which have taken Hollywood and social media by storm. Oprah revealed last year that she had given prescription weight loss medications a shot but didn’t reveal which one she had chosen.
The drugs, which include Novo Nordisk’s semaglutide products Ozempic and Weogvy as well as Victoza (liraglutide), and Eli Lilly’s tirzepatide formulation for type 2 diabetes Mounjaro and obesity version Zepbound, have sparked both enthusiasm and debate within the medical community and the public. The medications were the focus of Oprah’s discussion, which aimed to demystify their use, benefits and side effects.
The show acknowledged that most of these medications were first designed for treating type 2 diabetes. Throughout the show, Oprah also repeatedly called for an end to “the stigma and the shame and the judgment” around obesity.
The program included personal stories from Americans across the country, medical experts and executives from Novo Nordisk and Eli Lilly, who Oprah claimed were appearing together “for the first time in 100 years.”
“It is a very personal topic for me and for the hundreds of millions of people impacted around the globe who have for years struggled with weight and obesity,” Oprah said in a statement. “This special will bring together medical experts, leaders in the space and people in the day-to-day struggle to talk about health equity and obesity with the intention to ultimately release the shame, judgment and stigma surrounding weight.”
GLP-1 receptor agonists, a class of drugs initially developed to treat type 2 diabetes, have been found to have significant effects on weight loss. They work by mimicking the action of the naturally occurring hormone GLP-1, which is involved in regulating blood sugar and appetite. By enhancing the action of GLP-1, these drugs slow gastric emptying, reduce appetite and increase feelings of fullness, leading to a reduction in calorie intake and significant weight loss in many users.
The TV special heralded GLP-1 agonist medications as a “miracle tool” for many people that “could put a dent in America’s obesity epidemic,” citing that “Nearly one in three Americans are overweight and close to 40 percent qualify as obese.”
“We’re seeing double the amount of weight loss you can achieve with this class of medications compared to what we’ve had in our toolbox for the last several decades, in combination of course with a healthy lifestyle,” said Amanda Velazquez, MD, director of obesity medicine at Cedars-Sinai, in the TV special.
Related: Eli Lilly’s Oscars Commercial Takes Aim at Hollywood’s Use of Obesity Medicines for ‘Vanity’
The program offered some free positive marketing for GLP-1 drugs, which are predicted to become the best-selling class of drugs in 2024.
Both Novo and Lilly said they had no financial involvement in Monday night’s special. In a statement, Novo confirmed it did not provide “any funding or sponsorship” to ABC to support the broadcast, nor had any control over the program’s production, content or guests.
Oprah’s special opened with personal stories from individuals who struggled with their weight for many years and who used GLP-1 drugs recounting the profound impact they have had on their lives. From dramatic weight loss journeys to improved health markers and enhanced self-esteem, the testimonials presented a compelling picture of the potential benefits of GLP-1 receptor agonists.
Oprah’s Public Weight Loss Battles
During the TV special, Oprah recalls a defining moment in 1990 when she saw herself on the cover of TV Guide featuring a headline calling her “bumpy, lumpy and downright dumpy.”
In one of her significant weight loss attempts, Oprah said she starved herself for nearly five months and, on her show, triumphantly wheeled out a wagon of fat equivalent to the 67 pounds she lost on a liquid diet. She said the very next day, she started to gain it back.
Oprah’s account of her weight loss struggles kickstarted a conversation with medical experts and personal stories, including the recent rapid rise in the use of prescription medication for weight loss.
In an interview with People magazine in December 2023, when she revealed she uses weight loss medication as a “maintenance tool,” Oprah recounted how she began using them. After undergoing knee surgery in 2021, she was having a good recovery, hiking and eating healthy, which made her feel “stronger, more fit and more alive than I’d felt in years.”
“I eat my last meal at 4 o’clock, drink a gallon of water a day, and use the WeightWatchers principles of counting points. I had an awareness of [weight-loss] medications but I felt I had to prove I had the willpower to do it. I now no longer feel that way.”
She said she had one of her famous ‘aha moments’ about using pharmaceuticals for weight loss during a panel conversation with weight loss experts and clinicians, called “The State of Weight” and part of “Oprah Daily’s Life You Want” series.
“I had the biggest aha along with many people in that audience,” she recalls of the discussion. “I realized I’d been blaming myself all these years for being overweight, and I have a predisposition that no amount of willpower is going to control.”
“Obesity is a disease. It’s not about willpower — it’s about the brain,” she said after learning more about the science.
Oprah said she then “released my own shame about it” and consulted her doctor, who prescribed a weight loss medication. “I now use it as I feel I need it, as a tool to manage not yo-yoing,” she said.
“The fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for. I’m absolutely done with the shaming from other people and particularly myself.”
‘Changing Lives Around the Country’
In addition to Oprah’s personal struggles with weight, the TV special featured other Americans who faced challenges with their weight and their experiences with GLP-1 drugs.
This included a mother and her teenage daughter, Erika and Maggie Ervie, both of whom are currently taking Novo Nordisk’s Victoza (semaglutide) for weight loss. Maggie began taking the drug at the age of 13 and has lost more than 100 pounds while on it.
Now 16 and a sophomore in college, Maggie said she struggled with weight since childhood and was her heaviest at 285 lbs, at which point she started wearing her dad’s T-shirt. After having bariatric surgery that didn’t stop her cravings to eat more than she needed to, according to Erika, she started taking Victoza.
Maggie is one of the youngest people to have taken the drug and was featured as a teen GLP-1 user in The Cut. In a controversial decision, the medication’s use was expanded to adolescents, which is a concern since research suggests the drugs must be taken for life in order to maintain results.
Erika said she’s seen Maggie’s physical health dramatically change with normal blood work, non-fatty liver and not being pre-diabetic. Maggie’s social life has also changed for the better as she’s busy hanging out with friends and joined the cheerleader team, feeling strong, confident and finally “seen” for her personality and not weight, she said.
Amy is another user who was featured in the program. As a sufferer of polycystic ovarian syndrome (PCOS), Amy said it’s very challenging to lose weight with the condition. When she was later diagnosed with diabetes, she said that was her “breaking point.”
After losing 60 lbs on her own by overhauling her diet and lifestyle and reaching a plateau, an endocrinologist suggested she try Eli Lilly’s Mounjaro (tirzepatide). Amy said the medication “has saved her life not just physically, but also emotionally in a lot of ways.” She thinks the reason it was so effective was because she remained committed to overhauling her diet, lifestyle and worked on her mental health while taking the drug. “It felt impossible for me to do it before, this medication allowed it to feel possible.” She has now lost more than 160 lbs in total and shares her story and lifestyle with more than 50,000 followers on TikTok.
Novo Nordisk, Eli Lilly and Medical Experts Come Together for Oprah’s GLP-1 TV Special
The leaders from both companies were asked about the high costs of some of the drugs. While agreeing that there is a lack of coverage, they were unable to present any solutions or suggestions for lowering out-of-pocket costs for patients, much less lowering the list prices for their drugs.
“Access is complex, just like the disease itself is complex,” said Negelle Morris, Novo’s senior VP of cardiometabolic sales. Rhonda Pacheco, Lilly’s group VP of diabetes and obesity, admitted that “When you look at obesity, it’s nowhere near the coverage that we need.”
Oprah asked why coverage of weight loss drugs is still limited. W. Scott Butsch, MD, director of obesity medicine within the Cleveland Clinic’s Bariatric and Metabolic Institute, postulated that insurers still hesitate to see obesity as a disease and hence to cover treatments for it.
In addition to steering clear of in-depth cost conversations, the program also didn’t delve deeply into some of the concerns around GLP-1 drugs, including side effects and unintended uses, such as use for aesthetic weight loss and use of diabetes versions for weight loss. Recently, Eli Lilly took shots at the growing cosmetic use of GLP-1 drugs, particularly in Hollywood, in a TV commercial aired during the Oscars.
Oprah noted results of a study that showed around 17 percent of people discontinue semaglutide because of side effects, most of which are gastrointestinal. She spoke to a woman who could only take the drug for four months after which excessive nausea and vomiting landed her in the emergency room, compelling her to stop taking the GLP-1 drug that she did not mention by name.
But when experts were asked about the side effects, most were dismissive of them.
“I think that they’ve gotten overhyped. Medicines have side effects, but the important part is that they’re mild to moderate in the research studies,” said Velazquez.
“There’s been a lot of hype around pancreatitis, gallbladder complications, concerns for thyroid cancer — so, this has really not been shown in human studies, that this is a downstream complication. And, really, the risk is less than one percent,” she explained. She noted that some of those complications were due to the improper prescribing of GLP-1s to patients with contraindications like medullary thyroid cancer.
Of note, Velazquez and Butsch have both been paid consultants to GLP-1 drug makers.
WeightWatchers Also Buys In
Oprah also brought in WeightWatchers CEO Sima Sistani to ask, “Why do we need WeightWatchers when we’ve got Zepbound and Wegovy?”
Sistani answered that the company offers more of a holistic, community-focused approach to weight management. She also said the company had mostly focused on lifestyle changes up until now, but that WeightWatchers recently added the missing “biology” component to its approach by acquiring telehealth weight-loss drugs prescriber, Sequence. Through the partnership, WeightWatchers is offering a membership plan for members taking GLP-1 prescription drugs such as Ozempic and Wegovy.
Oprah has served as an ambassador for WeightWatchers and on its board of directors since 2015. However, she announced in February that she would end her almost decade-long tenure with the company. During the program, she announced that she had donated her company shares to the National Museum of African American History and Culture so that she could openly speak on the TV special.
Shortly after the program aired on Monday, Sistani was called out by a social media influencer named Katie Sturino who is the author of “Body Talk: How to Embrace Your Body and Start Living Your Best Life” and founder of Megababe Beauty.
“Speaking of WeightWatchers, they had the CEO of WeightWatchers on the program for like 30 seconds last night and she got so close to apologizing on behalf of WeightWatchers,” Sturino said in a video shared on Instagram. “She got so close to saying, ‘We really got this wrong and we’re sorry for saying it was just willpower, or that like one body is worse than the other, and we’re sorry for all the toxic things we put into diet culture.’”
After seeing Sturino’s message, Sistani said she “couldn’t stop thinking about what she posted,” calling it a “brave discussion.”
“And she noted that I participated and that I came this close to apologizing,” Sistani said. “Katie, I want you to know I am sorry.” She also added, “Part of that is acknowledging the past where we played any part in the shame that people carry with them, and, so, Katie, thank you for engaging in this discussion so productively.”
She also acknowledged “every Katie whose out there who hasn’t heard this message … it is important for me that you hear it because we can only start to hope for advocacy and health equity when we address our internalized bias.”
“For a long time, the messaging was, ‘get some willpower, go to the gym, eat less, why can’t you lose weight?’ It’s not about a lack of strength, these medications are helping people with chronic disease like obesity to live a better life. This is a huge turning point,” said Amy.
Oprah said she wanted to do the TV special to share her journey and to try to erase the stigma around obesity.
“I come to this conversation with the hope that we can start releasing the stigma and the shame and the judgment, to stop shaming other people for being overweight or how they choose to lose — or not lose — weight and, most importantly, to stop shaming ourselves.”
“If you feel like being in a bigger body is great, and you don’t want to do anything about that, and you feel fine, that is beautiful. I really admire people who really believe that,” Oprah said. “Whatever works for you. One of the reasons I wanted to do [the special] is [to] let people make their own choices for their health and well-being.”
The TV special is also available for streaming on Hulu.
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