Understanding Body Image: Oprah's Take on Weight Loss and GLP-1s
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For my entire adult life, I have never been thin. Just the thought of donuts seems to expand my waistline. Society often portrays individuals with larger bodies as lazy, comparing us to characters from the movie Wall-E, suggesting that we merely roll around searching for snacks. This stereotype implies that those of us who are fluffy are emotionless beings, with our worth measured by our body size, often relegated to the status of punchlines in jokes.
Navigating these damaging stereotypes has been a challenge, and I often find myself questioning their validity. I believe my fluffiness stems from a lack of self-discipline, a belief that Oprah Winfrey has challenged through her recent ABC News special titled Shame, Blame, and the Weight Loss Revolution. This program examines GLP-1 medications, such as Ozempic, Wegovy, and Zepbound, and their role in weight loss.
Oprah's special emphasized that obesity is a medical condition and that those seeking these medications deserve compassion rather than judgment. For the first time, I felt a sense of understanding, akin to Matt Damon's character in Good Will Hunting. My fluffiness is not a result of laziness; I am active, averaging five miles a day. Instead, it is a biological predisposition that drives me to eat and retain fat.
It's liberating to acknowledge that my body shape is not my fault. Thanks to new medications, the overwhelming hunger I experience can be managed. Oprah, who previously represented Weight Watchers, divested her shares to focus on this special and destigmatize the use of weight loss medications.
As I watched, hope surged through me. Could it be possible that I might finally see my toes instead of my belly? However, I still harbor concerns regarding GLP-1 medications.
The two experts featured in the program received backing from pharmaceutical companies, raising questions about their impartiality. Additionally, the special did not address the potential misuse of these drugs, such as being prescribed for cosmetic purposes rather than their intended use, along with the rise of telehealth services providing inadequate oversight.
Such misuse complicates access for those who genuinely need these medications. As someone without serious health issues, I worry about taking away resources from those who do.
While these drugs may be effective, they also carry risks that warrant caution. We must ensure that the potential benefits are not overshadowed by the possibility of misuse.
Ending Fat Shaming: GLP-1s as a Solution
The CDC reports that 42% of American adults are classified as obese. Yet, the stigma attached to being overweight can be isolating. Oprah's reflections on her public struggles with weight deeply resonated with me. She shared a poignant story about a mother who lost over 150 pounds and noted the positive change in how others treated her children. This struck a chord, reminding me of a moment when my son questioned what being "fat" meant after a classmate's comment during my volunteering.
As Oprah and her experts noted, being fat is not a conscious choice. Many individuals struggle with weight due to psychological or biological factors. After analyzing my childhood photos, I realized that I transitioned from an average weight to being overweight due to genetic influences.
Oprah's insights have been healing. It's crucial to recognize obesity as a disease, and those who opt for GLP-1 medications shouldn't face shame. For many, these medications represent a viable path to better health.
Several friends and family members have experienced transformative results with GLP-1s, reporting reduced cravings and improved health. Their medical professionals indicated that without weight loss, their long-term health would be at risk. For them, using these medications was a justifiable decision.
I genuinely believe that for many individuals, these drugs can be life-altering.
Acknowledging Drug Risks
While I advocate for these medications when suitable, I feel that Oprah's special downplayed their potential risks, including muscle loss, pancreatitis, and thyroid cancer. The experts involved, who disclosed their connections to pharmaceutical companies, presented an overly optimistic view.
One guest who experienced severe side effects was not featured prominently alongside other success stories. Furthermore, Dr. Amanda Velasquez claimed that the associated risks were exaggerated, but it’s essential to remember that this is a new class of drugs, and the data is still developing. My close friend developed a thyroid growth after a year on a GLP-1, only to have it resolve after discontinuation.
My other friend expressed concerns about his muscle mass decreasing alongside fat loss. He was unaware of this risk until after a workout injury prompted a discussion with his doctor. He is anxious about regaining fat rather than muscle once he stops the medication, especially since both experts suggested that long-term use may be necessary to maintain weight loss.
The Absence of a Clear Exit Strategy
It struck me that the experts did not address the implications of long-term medication use, despite the uncertainty surrounding it. Oprah also consulted with Jennifer Ashton, who spoke about the safety data from trials involving these medications for type 2 diabetes. However, the distinction between dosages for diabetes and weight loss wasn’t made clear.
As a former pharmaceutical litigation attorney, I found it perplexing that the experts exuded such confidence amid significant unknowns. Lawsuits have already emerged against GLP-1s, reminiscent of past legal battles involving other weight loss medications that led to severe health consequences.
Preventing Misuse of GLP-1 Drugs
The specialists on Oprah's program advised viewers to discuss side effects with their doctors and to adopt a comprehensive approach that includes medical oversight alongside medication. I fear that not everyone will receive the necessary guidance, as not all of us have access to the resources Oprah possesses. With growing interest in these drugs, online pharmacies and telehealth services are starting to sell them with minimal oversight.
While doctors can prescribe FDA-approved medications for off-label uses, pharmaceutical companies are restricted in how they market their products. For example, Ozempic and Mounjaro are only approved for type 2 diabetes, and promoting them for weight loss is not permitted. Wegovy and Zepbound, however, do have some approval for weight loss under specific conditions.
Pharmaceutical companies are generally not held accountable for informing patients about risks, relying instead on doctors to convey this information. However, with the rise of social media and direct-to-consumer advertising, drugs are increasingly marketed to the public, which could be both a blessing and a curse.
While it may encourage someone like me to seek help, it could also lead to prioritizing access over quality care. Ethical practitioners will continue to monitor their patients closely, but there's a valid concern about unethical providers who might prescribe medications without proper patient evaluation.
I’m not suggesting that GLP-1s are akin to narcotics, but the potential for profit could compromise patient care, similar to what happened during the opioid crisis. The market for these medications is booming, and I’ve seen countless online promotions for low-cost semaglutide, an unregulated alternative to Ozempic.
One family member switched from a medical spa that provided oversight to a telehealth service that lacked proper protocols. Her experience left her uneasy, leading her to discontinue the medication.
This environment of off-label prescribing is fraught with risk for patients. Eli Lilly, the maker of Mounjaro, has openly condemned misuse, seeking to ensure their medications are used correctly. However, many spas and online pharmacies are not dispensing Ozempic but rather compounded versions that are not approved by the FDA.
Novo Nordisk, the producer of Ozempic, has warned doctors about the dangers of using compounded semaglutide, as the FDA has noted an uptick in adverse events related to these products.
Medications Containing Semaglutide
#### Semaglutide for diabetes type 2 and weight loss is in shortage and being compounded. www.fda.gov
The FDA urges consumers to be vigilant when using compounded semaglutide. However, many may not realize when they are receiving compounded versions instead of Ozempic. Pharmaceutical companies now face the additional burden of monitoring compounding practices, which will likely lead to higher costs passed on to consumers.
Insurance companies are tightening coverage due to an increase in off-label use, which negatively impacts those who genuinely require these medications.
Given the current landscape, where greed could undermine healthcare, it is crucial for patients to choose their healthcare providers wisely. We must all take responsibility for our own education and understanding of these medications.
Could GLP-1s Increase Body Shaming?
At the heart of Oprah's special was a discussion about the psychological impact of being overweight. Unfortunately, the potential cosmetic misuse of GLP-1 drugs could exacerbate body shaming. On social media, the perception of a healthy weight has shifted, making many feel self-conscious about their bodies.
I grapple with my own body image and recognize that while I might qualify for these medications, I would be using them primarily for aesthetic reasons. This raises a genuine question: does the risk-benefit analysis account for feelings of inadequacy? For many, the mental toll of being overweight can be significant. Personally, I believe that the medications should be reserved for those with pressing health needs, especially until more safety data is available.
A respected endocrinologist once told me that the complexities of genetics and obesity are becoming clearer, and he believes that GLP-1s could be revolutionary. Identifying the right candidates for medical intervention will be essential in weighing the risks of obesity against potential unknowns related to these drugs.
I deeply appreciate Oprah's special for its validation of obesity as a medical condition and for removing the stigma surrounding those seeking treatment. Being fluffy does not diminish our worth, and as we navigate this new landscape, it’s vital to work closely with qualified medical professionals to monitor the long-term effects of these medications.
Thank you for reading. If you enjoyed this essay, feel free to follow my Medium account and Instagram at @julie.calidonio.
An Oprah Special: Shame, Blame, and the Weight Loss Revolution is currently available for streaming on Hulu.