Even Oprah Doesn’t Know How to Talk About Weight Loss Now

Nearly 13 years after the final episode of The Oprah Winfrey Show, it’s easy to forget just how vicious the public scrutiny of Winfrey’s body was during her talk show’s decades-long run. But those memories haven’t left Winfrey, and they take center stage in her new prime-time special, Shame, Blame and the Weight Loss Revolution. “For 25 years, making fun of my weight was national sport,” she recalls in the opening monologue, which addresses the stigma of obesity and the emerging culture around weight-loss drugs. As evidence, she cites several tabloid headlines that ran while she was on the air: “‘Oprah—Fatter Than Ever’; ‘Oprah Hits 246 Pounds’; ‘Final Showdown With Steadman Sends Her Into Feeding Frenzy’; ‘Oprah Warned—Diet or Die.’”

It wasn’t just weight gain that had inspired ridicule—in response to this relentless commentary, Winfrey staged gimmicky, sometimes dangerous segments devoted to her many attempts to lose weight. Most infamously, after losing 67 pounds on an all-liquid diet in 1988, she wheeled out a wagon containing 67 pounds of animal fat onstage. For years, she’s acknowledged how silly this was; in the special, she specifically says the stunt was born out of “shame.” What Winfrey didn’t understand then, and what she wants others to know now, is that obesity is a serious, chronic disease. But in its eagerness to prove that obesity isn’t a moral failure, Shame, Blame and the Weight Loss Revolution ends up reinforcing some of the troubling cultural attitudes that overweight and obese people still face in many walks of life.

Much of the new special hinges on the American Medical Association officially classifying obesity as a disease in 2013, which has led to some notable shifts in public opinion. A recent Pew survey showed that a majority of Americans now believe that willpower may not be enough to lose weight, and that newly popular weight-loss medications such as Ozempic can be good options for those who struggle with obesity. As Winfrey says in the special, these medications offer a way out of painful cycles of self-blame and social ostracization, in part because they serve as proof that being overweight isn’t evidence of someone’s laziness. To the extent that Winfrey has always sold her fans on how to “live their best life,” this special fits right into her personal-responsibility ethos: She repeatedly counsels viewers to release the negativity they feel about their own body, and to “stop shaming other people for being overweight or how they choose to lose or not lose weight.”

In some of the special’s most powerful moments, Winfrey is extremely candid about coming to terms with her personal choice to use medication. After her first time taking a weight-loss drug, she says, she finally abandoned her deeply held belief that people who never need to diet are, “for some reason, stronger than me.” That paradigm-shifting realization is shared by a number of the guests on the special who discuss their experiences with GLP-1-agonist medications, which work partly by mimicking the action of a hormone that increases the production of insulin and helps inhibit food intake. (Though not all of them are FDA-approved for weight loss, these different medicines are better known by their brand names, such as Ozempic, Wegovy, Mounjaro, Zepbound, and Victoza.)

When the special leans into the power of these personal testimonies, it’s reliably compelling—peak Oprah sentimentalism, with real-world stakes. Watching a teenager gush about feeling comfortable enough in her body to attend prom is undeniably moving, no matter what stance a viewer might have on weight-loss medications. But in general, the special struggles with navigating more complicated stories—medically as well as socially. For many people, GLP-1 medications either don’t work at all or come with untenable side effects. Yet only one guest speaks about having a bad experience with such treatment, a segment that Winfrey introduces more than 30 minutes into the 42-minute special by telling viewers that “it’s not all pretty.” She also hosts a panel of physicians who explain how these medications work, two of whom have consulted for the companies that produce them—and all of whom downplay the risks of taking the drugs by pointing to the dangers of obesity itself.

Although obesity can indeed lead to other serious complications, watching medical professionals brush over the possible issues with taking weight-loss medications is jarring, especially because no airtime is given to more skeptical physicians. The special also features sales reps from both Novo Nordisk and Eli Lilly, the pharmaceutical companies that produce the most popular GLP-1 medications. Their presence makes it easy for the special’s other guests—the doctors and GLP-1 users—to frame the drugs’ high cost (which, for some patients, is easily $1,000 a month) as the sole fault of greedy insurance companies, rather than something that manufacturers can absolutely control themselves.

[Read: The Ozempic revolution is stuck]

Shame, Blame and the Weight Loss Revolution often gives more oxygen to the negative interpersonal consequences of weight-loss-drug usage: Winfrey asks her guests about the judgment they’ve received for either taking the medications themselves or allowing a child to, and concludes that naysayers have no business opining on people’s health choices. In that, the special occasionally feels like a project designed to blunt any public disapproval of Winfrey herself using weight-loss medication. But the mean-spirited comments that her guests have received are different from the kind of critique that Winfrey has gotten. Although some of the public obsession with her body is still baselessly vitriolic, Winfrey has, perhaps more than any other figure, helped popularize some of the most harmful weight-loss myths and unsustainable diets.

Last year, during a panel for Oprah Daily called “The Life You Want Class: The State of Weight,” Winfrey said that weight-loss drugs were “the easy way out.” At the time, she was still on the board of Weight Watchers, which has historically counseled its users—mostly women—on losing weight through behavior modification alone. Then, last month, she announced her departure from the board, and said she would donate her shares in the company to the Smithsonian’s National Museum of African American History and Culture. During Monday night’s special, Winfrey clarifies that this decision was made so that she could interview the Weight Watchers CEO for the show without any perceived conflict.

But distancing herself from Weight Watchers now doesn’t change that Winfrey was its public face for nearly a decade, or that there have been plenty of other ways that she’s propped up diet culture without even trying to promote health. Winfrey’s endorsement drives massive attention to any product, person, or lifestyle—and not always to positive effect. Decades before the Weight Watchers partnership, the wagon-of-fat stunt became (and remains) the most-watched Oprah episode in history. As Aubrey Gordon, a co-host of the podcast Maintenance Phase, noted of the 1988 episode, Winfrey’s public weight loss led to unprecedented sales for the company that sold her 400-calorie-a-day liquid diet: OptiFast, which is still around today, said it received 200,000 calls after the wagon episode aired.

Shame, Blame and the Weight Loss Revolution doesn’t really account for these kinds of downstream effects, or delve into Winfrey’s sheer influence. That’s a tall order, and it would take much longer than one hour to seriously reckon with the complexity of Winfrey (the person) being a victim of diet culture, and Winfrey (the media phenomenon) being an accelerant of its ideals. But doing at least some of that work should be a prerequisite for any Winfrey-led special that focuses on the shame associated with body image among women—especially Black women, considering how racism and sexism inform people’s views of our bodies.

Not all fans and commentators who reacted harshly to the news of Winfrey using a weight-loss drug did so because they refuse to believe that obesity is a real disease, or because they felt abandoned by a public figure they once found relatable. Many people have taken issue with what they see as her uncritical praise of the drugs, and with her repeated conflation of weight loss and health. As industries such as entertainment, fashion, and even health care continue to walk back the progress of the body-positivity movement, maybe some shame and blame just need to be redirected to the people profiting from the stigma that others still face.