Oprah Winfrey’s New Obesity TV Special: 5 Key Takeaways

2. Obesity is “a disease, not a character flaw”

Winfrey reported the findings of top scientists and researchers that many patients struggling with obesity are just wired differently in their brains. “Some people are more prone to holding on to their fat,” said W. Scott Butsch, M.D., director of obesity medicine at the Cleveland Clinic’s Bariatric and Metabolic Institute, explaining that when such patients restrict their calorie intake on diets “it’s like trying to hold their breath underwater.”

“It’s not a matter of willpower,” Butsch said. “People who perhaps are thin might never think about food the way people who have obesity [do].” One teen, who began taking a predecessor of Ozempic after hitting nearly 300 pounds at age 11, explained how her body didn’t function the way others’ do: “My brain never told me when I was full.”

3. Weight loss drugs have changed the game

Winfrey used the bulk of the special to beat the drum for this form of treatment. She brought in experts to explain how the medications work — by mimicking the hormones the body releases when you eat food to tell the brain you’re full — and spoke to regular women who shared their success on medications like Ozempic, Wegovy and Victoza (which is approved for use by adolescents).

Oprah sang the praises of the drug and how it’s changed her perspective on food. “I’m not constantly thinking about what the next meal is going to be,” she said.

And the results are not just anecdotal. “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 tool box for the last several decades,” said Amanda Velasquez, M.D., director of obesity medicine at L.A. Cedars-Sinai Medical Center.

4. Weight loss drugs are not a magic bullet

Winfrey was careful to note that despite her personal success with a weight loss medication, the drug alone is not an all-inclusive solution. “I use it as a tool combined also with hiking three to five miles a day, or running,” she said. “It’s not just one thing, it’s multiple things. It’s weight resistance training. And a healthy diet.”

Since obesity and weight issues are complex, experts urge people to take a multidisciplinary approach — “the same way we would treat cancer,” Velasquez said. “You wouldn’t just go in and grab some chemo.”

5. There are downsides — including side effects and cost

Winfrey did spend time addressing side effects that some patients have experienced — including diarrhea, nausea and hair loss — but noted that these are generally rare. Experts also weighed in about the bad outcomes people are likely to experience if they fail to address obesity and weight issues at all.

But the biggest challenge for many is the cost of the new drugs — and that many insurance companies don’t pay for them. Butsch chalked this up to lingering bias and a failure to recognize the biological roots of obesity as a disease. “If you don’t believe obesity is a disease and you’re a policy plan, what are you going to [say to] convince your members?” he said. “You’re going to say, ‘Why should we bother giving a drug to somebody who should just eat less?’” (The show did not include health insurance executives.)