‘I Took on the Shame That the World Gave to Me’

Oprah Winfrey held back tears during the airing of her ABC special, Shame, Blame and the Weight Loss Revolution Monday night as she spoke to a woman who participated in Oprah Daily’s “The State of Weight” Panel last September who’s since lost 85 pounds after using an unnamed weight loss medication.

“There is now a sense of hope, and you no longer blame yourself,” Winfrey said as her voice began to crack. “When I tell you how many times I have blamed myself because you think, ‘I’m smart enough to figure this out,’ and then to hear all along it’s you fighting your brain.”

The special, which will be available for streaming on Hulu on Tuesday along with an exclusive audience Q&A, brought together medical experts, patients and members of the pharmaceutical and weight loss industries to discuss the growing popularity of weight loss drugs such as Ozempic, Mounjaro and Wegovy, which Winfrey revealed she’d first been introduced to while recovering from knee surgery in 2021 during the previous panel. Though at the time she had no interest in the budding medical intervention, saying she felt, “I’ve got to do this on my own because if I take the drug, that’s the easy way out,” in a December 2023 People cover story, Winfrey shared that her views on weight management injectables had changed.  Admitting to use of an unspecified weight loss medication, she told the outlet, “I had the biggest aha along with many people in that audience. 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.”

That sentiment was the crux of the one-hour special “created for the more than 100 million people in the United States and the over 100 billion people around the world who are living with obesity,” Winfrey said as the program began. “I come to this conversation in 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, more importantly, to stop shaming ourselves.

“I have to say that I took on the shame that the world gave to me,” Oprah continued before reciting a series of headlines that have been written about her over the past two decades. “For more than 25 years, making fun of my weight was national sport,” she said. “I was ridiculed on every late night talk show for 25 years and on tabloid covers for 25 years.”

In addition to discussing her widely documented personal struggle with weight, Winfrey also addressed her decision to step down from the board of Weight Watchers last month after being the face of the brand for nearly 10 years.

“I recently made the decision to not continue serving on the board of Weight Watchers and I made that decision because I wanted no perceived conflict of interest for this special. I also donated all of my shares in Weight Watchers to the Smithsonian Museum of African American History and Culture so that I could have a conversation with you, Sima Sistani,” Winfrey said introducing the CEO of Weight Watchers who spoke about the brand’s new philosophy and its decision to purchase a weight loss medication company.

“We are the most clinically tested, evidence-based, science-backed, behavior-change program, but we were missing the third prong, which was biology,” Sistani said. “There could be somebody who needs medication because they have that biological underpinning, and what was so important is for us to provide that care and also to help people release the shame.

“For all those people who came side-by-side and took on the behavior change, some of them walked away without the success,” Sistani continued. “And to those people I want to say, it’s not your fault.”

Likening the conversation around the concept of obesity as a disease to the discussions had on The Oprah Winfrey show in the late ‘80s and early ‘90s when alcoholism was first understood to be a disease and not a choice, Winfrey invited Dr. W. Scott Butsch, Director of Obesity Medicine in the Bariatric and Metabolic Institute at the Cleveland Clinic, and Dr. Amanda Velazquez, Director of Obesity Medicine at Cedars-Sinai, to speak to the biological factors that play into weight gain and the mechanisms by which weight loss drugs can counter them. It was disclosed that both physicians are consultants to weight loss drug companies.

“There’s a spectrum of obesity, it’s not one disease, it’s many different subtypes of a disease,” Butsch stated before addressing the pervasive belief that individuals who are overweight and obese have simply failed to control their weight through diet and exercise.

 “This is just a reflection of someone’s uneducated belief that this is a self-inflicted condition, as if people who have obesity want to have obesity,” he said.” That these are weaker people who have no willpower and who can’t cut it and people who are thin have willpower and can cut it.”

Though Winfrey never disclosed which medication she’s been prescribed, she spoke with two guests about their positive experience on two of the seven drugs that have now been approved for weight loss. The first was Amy, a diabetic mother whose A1C, cholesterol and liver enzymes have all reached normal levels since losing a significant amount of weight on Mounjaro. And Maggie, a teenager who had bariatric surgery at the age of 13 and was prescribed Victoza, approved by the FDA for weight management in pediatric patients, thereafter, which has helped her stay in a healthy range.

Winfrey also called on Dr. Jennifer Ashton, ABC News medical correspondent, to speak to the negative side effects of weight loss medications which have been widely reported on and noted to include gastrointestinal issues such as nausea, diarrhea, vomiting, constipation and stomach pain.

“If a risk is noted to occur one out of every 100,000 times, that’s rare, that’s one case, but if all of a sudden a million people are on that drug, you’re going to see that rare risk or side effect ten times [more],” Dr. Ashton stated.

“What I tell patients is, if you had high blood pressure, if you had high cholesterol, if you had depression, you would treat it. It is conclusively known that the conditions of overweight and obesity are complex chronic disease states, not character flaws, so they should be managed accordingly.”

Wrapping up the special, Winfrey reiterated her intention to release the judgement surrounding obesity and spoke directly to viewers at home with differing opinions on weight loss medications. “For people who feel happy and healthy celebrating life in a bigger body and don’t want the medications, I say bless you. And for all the people who believe diet and exercise is the best and only way to lose excess weight, bless you too if that works for you,” she stated.

“And for the people who think that this could be the relief and support and freedom that you’ve been looking for your whole life, bless you too because there is space for all points of view.”