Weight-loss drugs like Ozempic, Wegovy, and Zepbound are already extremely popular: by 2030, about 10% of the U.S. population will be on one of these drugs and the category’s sales will surpass $100 billion, according to some projections. On March 18, they got another major cultural boost from Oprah Winfrey, who shared her own experience with—and support for—these medications in an ABC special called “Shame, Blame and the Weight Loss Revolution.”
During the special, Winfrey talked about how using one of these weight-loss drugs (she did not say which) changed her life and opened her eyes to the reality that obesity is a disease, rather than a choice. “All these years, I thought all of the people who never had to diet were just using their willpower, and they were for some reason stronger than me,” Winfrey said.
After taking medication, however, she realized that she thought about food differently than people who had no trouble keeping weight off. Her brain was working against her. "You weren't thinking about the food! You weren't obsessing about it!" she said. “That is the big thing I learned."
The special, which will be available on Hulu starting March 19, spotlights a class of drugs known as GLP-1 agonists, which mimic a hormone that suppresses appetite and controls blood sugar, helping some patients lose roughly 20% of their body weight. These medications include Ozempic and Mounjaro (which are approved to treat Type 2 diabetes, but are also used off-label for weight loss) and Wegovy and Zepbound (which are approved as anti-obesity medications).
About three-quarters of Americans say they’re familiar with these drugs, recent polling data from Pew Research Center show, and that number will likely rise even more after Winfrey’s special. At times, that felt like the program’s whole aim. Winfrey interviewed people who have lost large amounts of weight on GLP-1 drugs, along with executives and paid medical consultants from the pharmaceutical companies that make them. (Ozempic and Wegovy are made by Novo Nordisk, while Mounjaro and Zepbound are made by Eli Lilly.)
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Making a television special about these drugs was so important to Winfrey that in February, she announced she would leave WeightWatchers’ board and donate her company stock to the National Museum of African American History and Culture, in part to “eliminate any perceived conflict of interest” since WeightWatchers now embraces anti-obesity medications and even started a program to prescribe them. The company’s CEO, Sima Sistani, was interviewed about that shift on Winfrey’s special. “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.
Even as drugs like Wegovy and Zepbound soar in popularity, however, skepticism remains about their widespread use, particularly among people who just want to drop a few pounds. In the February Pew poll, 62% of respondents said these medications are not good options for those who do not have a weight-related health problem—a view shared by some physicians, who argue weight loss is not always medically necessary.
Even for people who do have weight-associated health conditions, GLP-1 drugs can come with side effects, including gastrointestinal distress, headaches, pancreatitis, and obstructions of the digestive system. Some researchers have also raised concerns that they may contribute to an elevated risk of thyroid cancer.
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On Winfrey’s special, Dr. Amanda Velazquez, a weight-loss specialist at Cedars-Sinai Medical Center and a paid consultant for pharmaceutical companies that make weight-loss medications, called side effects “over-hyped,” noting that they’re “mild to moderate in the research studies.”
But other research suggests GLP-1 side effects are bad enough that a significant portion of patients stop using them, which typically results in gaining back much of the weight they lost. In the special, Velazquez acknowledged that people will likely have to take these drugs their entire lives to maintain their weight loss.
As she closed her special, Winfrey said weight-loss drugs are not for everyone, and that some people may choose not to lose weight or to do so with diet and exercise. But “for the people who think that this could be the relief and support and freedom…that you’ve been looking for your whole life,” she said, “bless you.”
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Write to Jamie Ducharme at jamie.ducharme@time.com