Oprah Winfrey discusses weight loss with GLP-1 drugs

Although GLP-1 medications such as Ozempic and Wegovy are effective, there has historically been a stigma attached to using these types of drugs.

“It’s always great to have someone with such a large audience bring these issues into the forefront, especially with Oprah since she has always been very public about her struggle with weight,” said Dr. Peminda Cabandugama, the diirector of Digital Obesity and an endocrinologist and obesity medicine physician at the Cleveland Clinic.

Experts say many people can benefit from taking weight-loss medication and Winfrey is a testament to this fact.

“Oprah is an excellent example of how weight set point and hormones (satiety and hunger hormones play a significant role in long-standing obesity,” explained Dr. Minisha Sood, an endocrinologist at Northwell Lenox Hill Hospital in New York. “By sharing her medication use as a trusted public figure, she’s helping to acknowledge that many persons with obesity would benefit from hormonal therapy for weight management.”

Along with the medication, Winfrey is exercising regularly and adopting healthier eating habits.

“The incretin hormones used for weight loss (semaglutide, tirzepatide) certainly do help suppress appetite, but if a person overeats despite the satiety signal provided by these medications, they will not necessary lose weight,” Sood told Healthline. “The people who see the most improvement in weight and weight-related co-morbidities are those who pair diet and exercise with medication use.”

While GLP-1 drugs may kickstart you on your weight loss journey, they are not a cure-all.

“The main goal should be sustained weight loss,” Cabandugama told Healthline. “When you have a comprehensive program in place, with the help of a nutritionist, exercise physiologist, etc., that’s what helps patients in the long run.”

“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,” Winfrey said. “Obesity is a disease. It’s not about willpower — it’s about the brain.”

Many people do feel shame for being overweight, but in many cases, there is an underlying mental or physiological issue that needs to be addressed.

“There are a variety of factors that come into play,” Cabandugama stated. “Weight is something you can see and therefore it can be judged. Oprah looked at her weight gain as her fault and her giving this interview is important so the public understands ‘I’m not the only person going through this.’”

He continued, “When it comes to weight, yes there is some degree of self-control, but the self-control is influenced by genetics, enzymes and hormones, and socioeconomic status, which causes us to eat certain foods,” he added. “The GLP medication helps cut down food cravings.”

When it comes to obesity, experts say willpower is a minor part of the equation.

“Losing weight is a very difficult process and in the last decade alone, we’ve seen that more people in the United States are becoming obese,” said Dr. Carlo Manzana, a family medicine physician with PlushCare. “Understanding that obesity involves complex factors beyond willpower is essential. There are genetic, environmental, psychological, and physiological components that contribute to obesity.”

“Recognizing obesity as a disease, rather than solely a consequence of lack of willpower, is critical to destigmatizing weight-related issues,” he added. “It also allows for acceptance that there are treatments that can assist with weight loss alongside any other possible underlying factors that may be present.”

“If you’ve struggled with long-standing obesity and have tried diet/exercise for at least six months in the past with an inability to sustain weight loss through that route then you may be a candidate for incretin hormone therapy,” Sood said.

As with any new medication, discussing your health needs and medical history with a healthcare professional is important.

“Every individual is different and it is important to recognize that an individualized approach is the best approach to determining whether these medications are right for you,” said Manzana. “While Ozempic and Wegovy technically have the same active ingredient, which is semaglutide, Ozempic is FDA approved for type 2 diabetes and Wegovy is FDA approved for weight loss. This matters as some insurance companies tend to use the FDA approvals for coverage of medications.”

In other words, Ozempic may only be covered if a person has type 2 diabetes whereas Wegovy might be covered for qualifying body mass indexes.

“Most weight loss medications are FDA approved for patients with a BMI of less than 30 or a BMI of less than 27 and a weight-related comorbidity such as high blood pressure, high cholesterol, high sugars, sleep apnea, etc.,” Manzana explained.