Oprah – a woman so famous that she only requires one name. Ozempic – one of the multiple injectable medications, known as GLP-1 agonists, currently being promoted as the “cure” to the “disease” of o*esity.
The other “O” words? Overweight. Obesity. Note, that is the only time I will use those words in this post. O*erwei*ht implies there is some specific number that is the perfect weight for people. Otherwise, how could someone be over it? O*esity, learn more here, is a descriptor based off the BMI (body mass index). The BMI is a formula created by a mathematician/astronomer to test a hypothesis related to the individual height and weight of European men. The BMI is not, nor was it ever, a medical formula meant to be applied to large groups of people. NPR even reported on the nonsense of this measure as far back as 2009.
A Word About Oprah
A few weeks ago, Oprah hosted a primetime TV special titled “An Oprah Special: Shame, Blame and the Weight Loss Revolution.” This came on the heels of Oprah stepping down from the Board of Directors at Weight Watchers due to her choice to utilize a GLP-1 agonist, or weight loss injectable.
Any readers who are at least 30 years of age are likely familiar with Oprah’s ongoing battle with her weight. She has been in the public eye since the 1980s and we have seen her body change over the years. Keep in mind that bodies are intended to change as we grow and age and experience life.
We have seen Oprah pull a wagon of “fat” onto the stage after subjecting herself to a juice-only fast. We have seen the comments from media when she returned to eating actual food and her body became a larger size. We’ve watched her join Weight Watchers, and promote it as the “solution” to her battle with weight. And now, we’ve seen her host what boils down to a prime time infomercial for medications that are being used off-label and without thorough, long-term, objective studies.
Oprah and Diet Culture
This post is not meant to be anti-Oprah. Oprah is a woman who has been in the public eye for decades, within a culture obsessed with women’s appearances. The expectations on women in media, especially when Oprah was first becoming well-known, tend to focus on being white (or light skinned), thin, and ageless. Oprah was already fighting an uphill battle in being taken seriously and finding sucess in media based on her race alone. Her body size only added fuel to the flame of a culture obsessed with women being as small as possible (both literally and figuratively).
A Black, intelligent, well-spoken woman who created a platform based on speaking her mind is already a threat to the status quo (even more so at the debut of her talk show in the mid-80s than today). Having a body that does not naturally conform to the thin ideal only increased the backlash Oprah has experienced.
She is a victim of diet culture – the hierarchical view of people that places thin, white, able-bodied folks at the top.
Oprah is also a perpetrator of diet culture. Because of her fame and wealth, she has had access (at least for the past 35-40 years) to specially prepared cuisine from professional chefs, to personalized exercise programs created just for her, to all varieties of nutritionists and dieticians, and to any type of medical provider she may have wanted to seek out. Yet, she has not been able to re-model her body to fit the ideal.
However, she has continued to battle with her weight, rather than accept her body. She has continued to support and promote diets, weight loss programs, points systems, and now medications in an effort to make both her body and the body of others more palatable in a culture obsessed with thinness.
Let me be clear. I believe that EVERY person deserves to have bodily autonomy! Oprah is no different – she deserves to do with her body what she believes is best. Whether I or anyone else agrees with her choices, is irrelevant.
The flip side of that is that folks don’t truly have bodily autonomy if they aren’t presented with all the information in order to make an informed decision about what they choose to do to/with their body. This is where I do take issue with Oprah and the recent primetime special – the full story was not presented, and a famous person, with no medical degree, was promoting (regardless of the 5-second disclaimer at the end of the special) that folks make a serious medical decision without all the information.
Takeaways From the Special
Here are a few of the things that stood out to me as I watched the special:
- Oprah acknowledged her history of “this is it” moments where she was very vocal about having found the solution to her body struggles. She then continued to promote GLP-1 agonists as the current “this is it” moment in shrinking bodies. The irony would be humorous if these fads and products didn’t leave such a trail of destruction behind them.
- The vocabulary being utilized to discuss o*esity has shifted with the introduction of these GLP-1 agonists. Folks are now speaking of having a larger body as a “brain disease.” Proponents of these medications focus on discussion of decreasing the shame around body size. However, their solution doesn’t decrease the shame or create a less shaming environment, it’s the same old focus on encouraging folks to shrink their bodies.
- The medical providers who were introduced as “experts” during the special were all people who are connected to and receive payments from the pharmaceutical companies who make these drugs. That is not unbiased, and it’s certainly not good science!
- There was only a brief mention of the fact that 17% of people quit the medications due to side effects. These side effects can include GI distress, irreparable damage to your digestive tract, and increased risk for certain cancers. Almost 1 in 5 of the people who try these medications stop them due to the side effects. This doesn’t account for the thousands of people who continue to take them because they’d rather deal with daily GI issues (cramps, diarrhea, constipation, etc.) than exist in this world as a fat person.
- The special included reference to how GLP-1 agonists “quiet the food noise.” I have seen this statement in many places in reference to the positive effects of these medications. However, I haven’t seen anyone really explain what they mean by “food noise.” Is that hunger? Keep in mind that hunger is an important messenger that helps us meet a basic human need, so not hearing that message will likely lead to negative outcomes. For those with a history of eating disorders, that “food noise” can be all out of whack, and part of healing often includes getting back in tune with that so-called “noise.”
- Speaking of eating disorders….. There was nothing in this special that addressed the fact that these medications are not appropriate for, and can be deadly, for those who have a history of eating disorders. I’ve read quite a bit of the research around GLP-1 agonists, and one of the main contraindications for use is having a history of EDs (i.e. if someone has struggled with an eating disorder in the past, they should not be prescribed these drugs). Like this special, mainstream and social media don’t address this danger. In fact, my own medical provider attempted to prescribe these medications for me twice despite my own history of an eating disorder (I’m not seeing that provider anymore).
- The show featured a child who underwent bariatric surgery at age 13. This young lady is now also taking an injectable because the surgery didn’t have the expected effects. She was there to promote the wonders of these medications and the reasons they should be available to children. Yet, she appeared so incredibly uncomfortable – like she was longing for someone to celebrate her, just as she is, and tell her she is valuable and acceptable regardless of her appearance or size.
- As I mentioned previously, I wholeheartedly believe that consenting adults have the right to full bodily autonomy. But does that apply in the same way for bodies that are still developing? I struggle with the concept of providing organ-altering surgeries to still developing bodies that are the homes to still developing brains. I hate that the current push of the pharmaceutical companies is to get GLP-1 agonists approved for younger and younger people, without fully understanding the possible consequences. And it makes me irate that diet culture consumes us to the point that parents, caregivers, medical professionals, and society would tell a young child that their body is too large and they need to take such drastic measures to try and shrink it.
- There was no mention in the special about the fact that there are no long-term studies on the use of GLP-1 agonists in the dosages being prescribed for weight loss. Yes, there are years of studies of some of these medications at much lower dosages and for use in controlling blood sugars in individuals with diabetes. However, no studies of the higher dosages used for weight loss have tracked patients beyond a year, with many studies following patients for much less time than that. And do you know what was happening as those patients approached the 1-year mark on the medications? They were beginning to regain the weight — the same outcome we see with every other attempt to shrink bodies.
Some Final Thoughts
This Oprah special was a primetime infomercial for serious medications that can have life-altering consequences. It did not present good science. It did use a celebrity, who has borne the cruelty of diet culture herself, to give social credibility to the use of extremely high doses of medications in a way that elicits an increase in a desired side effect (i.e. weight loss) for some. Despite the claim about “losing the shame”, to me, this felt like a program geared toward shaming approximately ½ of the US population who falls into those arbitrary BMI categories of o*erw*ight and o*ese.
This propaganda works! See the image below for a screenshot from a comment thread on a recent Instagram reel where someone was sharing their weight loss using Ozempic. The captured comment is in response to someone telling the original poster (OP) that she could’ve have lost weight with diet and exercise (which is not always true, but that’s for another day). The OP responds, “definitely! But I wouldn’t be able to sustain a 1,400 calorie diet [emphasis mine] without Ozempic. I tried allllll the diets and failed every time before.”
Of course this adult person could not sustain a 1,4000 calorie diet without extreme measures. Do you know who can survive and thrive on 1400 calories a day, generally speaking? A 3-5 year old child! Adult individuals need much higher amounts of energy, that’s what calories are after all, in order to survive and sustain over time.
The world is cruel to folks in larger bodies. It’s so cruel that folks go to extreme measures to not have a larger body. Measures that include starvation, purging, major surgeries, and taking medications that may cause harmful side effects. It makes sense that Oprah (and every other person represented on the special) was able to say they feel more confident in a smaller body. They are more accepted, more likely to be financially secure and working in a job they enjoy, more likely to have supportive relationships in their lives, and definitely more likely to have access to clothing and seating that fits their body well when their body is smaller. Those are facts of the world we live in.
What would it look like if we all worked to create a world that is more size inclusive? Imagine a world where folks don’t live a life of shame, literally trying to shrink themselves, in order to avoid the cruelty that abounds.
Michelle F. Moseley is a Licensed Mental Health Counselor in NC. She believes ALL people deserve respect, compassion, and access to mental and physical healthcare. Michelle specializes in working with survivors of religious trauma and with those who have body image concerns, finding there is frequent overlap in these areas. You can learn more about Michelle by visiting her website at MichelleFMoseley.com or following her on Instagram – @therapy_with_michelle
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