The internet lit up earlier this week when Oprah Winfrey told People magazine that she's been using a weight loss drug to lose and maintain her weight. The media powerhouse said the drug has been a relief, a redemption and a gift.

"I'm absolutely done with the shaming from other people and particularly myself," Winfrey told the magazine.

Winfrey is giving voice to what countless people have felt since embracing a class of drugs that were originally approved for diabetes, but are now being widely used for weight loss.

WeightWatchers, the long-running weight loss and weight management program, is also embracing the drugs, which are known as GLP1s. It's a massive shift for a company that has spent 60 years advising people to count their calories – or their points – and use will power.

The company's CEO Sima Sistani spoke with All Things Considered host Juana Summers about the decision and what Winfrey's revelation signals about the weight loss drugs.

This interview has been edited for brevity and clarity.


Interview highlights

Juana Summers: This has been incredibly big news for people who have or are struggling with their weight and who have looked to Oprah Winfrey as a source of inspiration. I mean, Oprah's fluctuating weight in her body and the treatment she's received because of it has been a topic of public discussion for as long as I can remember. And Oprah is also the kind of person who clearly does not suffer from a lack of grit and resilience and determination. I want to start by asking you, what example does her latest revelation that she is using these class of medications give people who are struggling with weight loss on their own?

Sima Sistani: Look, I think it's really important that we acknowledge that there has been a decades-long narrative that has painted weight loss as a mere test of willpower, and it's perpetuated this sense of shame and misunderstanding around what it means to live with overweight and obesity. So for some, different solutions like these new clinical interventions are really needed.

Summers: At the same time, I mean, listening to Oprah talk about the liberation that she feels, the ability to better manage her weight, to take a dose of one of these drugs before Thanksgiving, when, you know, like many of us, she's going to have a big dinner — it's a powerful message. But she is also someone who's invested in your company. Do you think that dilutes the power of the message that she's giving to people who are facing similar struggles?

Sistani: Ms. Winfrey, along with the rest of our board, stands by our business vision and our program offerings. But we all know that her story has been one that has been a generational story and one that mimics so many people who, on a day to day basis, struggle with the same shame and bias where weight loss has been associated with a preoccupation around thinness. And what we're trying to do is reshape that conversation around weight health. It's not a matter of vanity. This is about the degree to which weight impacts your health and your quality of life. And for decades, we've discussed weight and dieting and obesity in terms that isolate people and often demotivate them.

Summers: So does that mean that the advice that WeightWatchers gave people, including myself – I should note I'm one of those people who turned to WeightWatchers at various points in my own journey, struggling with my own weight – was the advice that we were given for years about what it takes to lose weight, that focus on determination and resilience and willpower, was that advice just wrong?

Sistani: I'm going to say, as somebody who was very humbled to take this role — because WeightWatchers also worked for me — yes, that advice was wrong. Because we said it was choice, not chance. And the truth is that this is a chronic condition. And ultimately, for every one person that we helped, there was one person who our program did not work for because they were dealing with a chronic relapsing condition, with biology and genetics and environmental underpinnings. So, in order for us to reintroduce ourselves, we need to acknowledge the part that we had in the past.


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Summers: I do want to address the question of access and cost here. Many people can't afford to take these drugs. People talk about spending hundreds, if not more than $1,000 to access prescription drugs like Wegovy and Ozempic if they're not covered by insurance. And I would imagine then that there are more who can't afford to take these medications indefinitely. Do you worry at all that this sets people who are eager for solutions and eager to lose weight up for long term frustration?

Sistani: Well, I think you're bringing up a really important cultural conversation, which is these medications right now are incredibly expensive and they should be covered. It is criminal, in my opinion, that they aren't covered and they are put in the same category right now as, you know, medications for hair loss and erectile dysfunction. This is a reflection of our health care system being based on a disease model, versus thinking about preventative measures for weight health. And so we are having that conversation at a policy level as well, so that we can make sure that everyone can have access to support and care that they need.

Summers: I'd like to ask you a question from one of our editors on the show, if I can. She is someone who has used WeightWatchers successfully at times, less successfully at others, to try and maintain a healthy weight and to feel good about herself. And one thing she told me that she has noticed in WeightWatchers social communities since the announcement that you all were going to start offering and allowing folks to have access and helping them get access to these medications, is that among some people, there's this sense of betrayal at the companies embrace of these drugs. What do you say to those customers?

Sistani: So, I understand that. You know, change is hard, and we've all been a part of that culture and that narrative. But what I have shared to our team and to our members is that what makes WeightWatchers unique is that so many of us choose to be here because we believe in the mission and we believe in the power of community-driven health. And so that has to come with an unwavering commitment to radical candor.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

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