What Oprah Got Wrong about Weight and GLP-1s

Like many of you, I tuned in to primetime TV to watch Oprah’s special on ABC about weight and GLP-1s, titled Shame, Blame and the Weight Loss Revolution. And I have so many thoughts.

I do applaud Oprah for her honesty and openness about her struggles with weight. As someone who has PCOS and has lived most of my life in a bigger body, I know firsthand what it feels like to be judged for your size and all the shame that comes with it (add being a dietitian on top of it!).

There is so much shame among those who suffer from PCOS, especially when we have gained weight out of the blue, without changing how we eat or exercise.

I am in support of people taking medications that they need, including GLP-1s.

But here’s just a few places where Oprah got it wrong about weight and GLP-1s.

There are Side Effects from Taking GLP-1 Medications

The main focus of the special was about how GLP-1 medications can help with weight loss. These medications can cause side effects, mostly GI. In the special, it mentions 17% of people experienced significant side effects in a Wegovy study and had to stop taking it. So, when side effects came up, and Oprah brought in Dr. Jennifer Ashton to comment on them, I was disappointed that this was glossed over and not addressed by her at all. One of the doctors who is paid by the drug companies, mentioned that these GLP-1 medications do not cause serious side effects. Tell that to the lady sitting next to them who ended up in the emergency room from vomiting from taking a GLP-1, only to have Oprah ask her if she will try another one!

Accessibility and Affordability of GLP-1s

I wish Oprah highlighted how expensive GLP-1 medications are and that not everyone has access to these medications. Keep in mind, only recently, Wegovy and Zepbound were approved specifically for weight loss. Ozempic and Mounjaro are indicated for people with type 2 diabetes. This doesn’t stop celebrities and the rich from obtaining them though, leaving the people who need it to go without.

Lack of Long-Term Research or Safety

There is NO research to show long term use of GLP medications are effective for weight loss or what happens when people take these medications long-term. Studies available show that weight gain can occur over time while people are still taking GLP-1s and that weight gain is likely to happen when they are stopped.

Weight Loss is Superior in Society

I am in total support of people finding medications that work for them and have written about the pros and cons of GLP-1s for PCOS. But the entire one hour episode was glorifying people who have lost weight. This contributes to diet culture, weight stigma and implies that you are not good enough unless you lose weight. Keep in mind, not everyone who takes a GLP loses weight. What about them? Talk about shame.

While I am not against weight loss or wanting to lose weight, I am not in support of the pursuit of weight loss that comes with it. Dieting, overexercising, fasting, detoxing and the like, are just not sustainable. Most people who lose weight doing these things, regain it and that can worsen health-both physical and emotional health.

You can improve your health and PCOS symptoms, including fertility, without dieting. We have good studies to support this.

My background is treating people with eating disorders, which many people with PCOS suffer from. Dieting leads to eating disorders and causes people to hate their bodies even more.

I encourage and educate other health care providers about a sustainable approach to health that doesn’t focus on weight loss but rather evidence-based lifestyle changes that are effective for improving PCOS. These lifestyle changes may or may not include using GLP-1s.

So, surprise! Instead of helping people, Oprah’s special only contributed to more shame and blame around weight.