Oprah Says She is Stepping Down from the Board of WeightWatchers

Removing the stigma

“She obviously knew she was taking a risk when she admitted this and that there would be criticism, but she did it anyway,” said Rabinor, who once appeared as a guest on Oprah’s show to discuss body dysmorphic disorder. “She doesn’t care. She has always been very honest about her weight struggles and I think it’s fabulous she is being so open.”

Rabinor hoped Winfrey’s transparency will help remove some of stigma associated with both obesity and the decision to take weight-loss drugs — and give women the confidence to silence their inner and outer critics. “If people have struggled with being overweight their whole life and now there’s suddenly a medication that can help them get healthier, why should they be made to feel guilty?”

A ‘champion’ for the pressures facing women

This isn’t the first time the mega-mogul has courted controversy. In 1988, after losing nearly 70 pounds by not eating a single morsel of solid food for four months on the Optifast liquid diet, Winfrey devised a brilliant, albeit shocking, plan for sharing the news with her audience.

“I had lost a lot of weight and I knew people would want to know how,” Winfrey explained at the time. And so, after arranging for Moo & Oink, a local Chicago barbecue joint, to deliver 67 pounds of animal fat to The Oprah Winfrey Show, she piled that mountain of fat onto a Radio Flyer wagon and trotted it out on stage like a special guest.

“She got a lot of flak for that episode,” said Rabinor. “But it was still very brave. She’s been a champion of bringing attention to the unrealistic pressures women face to be thin for a very long time.”

The new class of drugs

Though Winfrey did not name the drug she is taking, New York City endocrinologist and weight-loss specialist Rocio Salas-Whalen, M.D., said she is likely referring to incretins, the now famous class of drugs more commonly known by brand names such as Ozempic, Wegovy and Mounjaro.

“Ozempic [Novo Nordisk] and Mounjaro [Eli Lilly] are both approved for type 2 diabetes, but they are frequently prescribed off-label for weight loss,” she said, noting that Mounjaro has become more popular in recent years because it tends to be more effective and have fewer side effects.

Wegovy [Novo Nordisk], which until recently was the only class of incretins approved for weight loss, now has a competitor in Eli Lilly’s newest FDA-approved drug for obesity, Zepbound, which uses the same active ingredient (tirzepatide) found in Mounjaro.

“The drugs are incredibly effective,” said Salas-Whalen. “They have completely changed the game in terms of how we can treat obesity.”    

The big drawback: cost

The number of people commenting “Eat the rich” on People’s post underlines one of the thorniest issues with incretin treatment: While clearly beneficial to more than half the population, these medications — which run around $1,000 for a month’s supply — are prohibitively expensive without a prescription for all but the very rich.

While Medicare Part D covers Ozempic for diabetes, it does not cover the drug (or other weight loss drugs) to treat obesity. And, unfortunately, insurance companies keep raising the bar, making it more and more difficult for people to get the medications covered, according to Salas-Whalen. “Now, to meet the criteria for incretins, you need to have a BMI above 27.” Put in perspective, a 5-foot-7-inch woman would need to weigh at least 172 pounds to qualify.

In addition to the lack of democratic access, long-standing prejudice against people who are overweight seems to be fueling the mean-spirited dialogue online. “People who have never struggled with their weight will always talk about willpower,” said Rabinor. “But obesity is more complicated than that for most people.”