Sanchez: [ Breathing heavily ] Five...
six...
seven...
eight.
♪
Two...
three.
♪
The earliest memory I have as weight being a thing for me
was being taken by my mom to a class on Saturdays
that was basically, like,
a weight-management class for kids.
And I was probably 8 or 9.
Luxmore: Taking up space is definitely something
that has been on my mind, like, my whole life,
just because my size has significantly affected
every aspect of my life.
I was the big kid, definitely.
Arrellin: I was little-- was a little girl,
and then I started to, like, gain weight.
Something was obviously wrong.
Sanchez: When I first heard of GLP-1s,
it sounded like this thing in Hollywood
that all the celebrities were using.
- ...Kelly Clarkson... - ...Whoopi Goldberg...
Reporter: Television icon Oprah Winfrey
revealing she's using medication for weight loss.
Sanchez: I started hearing from other women,
and the success they were having was pretty significant.
In the first couple weeks, I was losing weight immediately.
Luxmore: All of the extreme distress
that I had been feeling with just instantly gone.
[ Sighs ]
[ Voice breaking ] It is such an incredible sense of relief.
Arrellin: My doctor is trying everything she can
to make it better for me.
I want to lose weight more than anything on Earth, I swear.
This is unquestionably a medical innovation.
Reporter #2: Weight loss is something
that Americans have been chasing for decades.
There's a new class of drugs that could be a game changer.
Allen: This is not just a pharmaceutical drug.
This is a cultural shift that we're seeing.
- I lost eight pounds. - What are you eating? Muffins?
Strudels? Put it down and let me talk to you for a second.
Winfrey: Whether you have $10 or $10 million,
a fat butt is a fat butt.
Diet culture set the stage for these drugs.
I was, like, the unhealthiest I've been in my entire life,
but I was also the thinnest.
Gay: People treat thinness as a virtue.
It's practically biblical for a lot of people.
I wouldn't recommend anybody be fat in this world.
It is so traumatizing.
I have a fear of fat people on planes.
What are you scared of? Them being near me.
Woman: They're in a shortage.
They can't make enough to actually meet the demand.
Tovar: The path we're on right now,
the path where we don't reckon with our attitudes
about higher-weight people...
Reporter #3: ...drug market could eventually
hit $100 billion in sales a year.
...is a path of destruction.
♪
Interviewer: You look very unhappy in that picture.
I thought fat men were supposed to be jolly.
What did she model, car covers?
I'm really gonna have to go on a crash diet.
Some girl ate Monica!
Stern: I don't think you're aware that you're a heavyset woman.
- ...trying to lose weight. - What's with the gut?
- Lay off me! I'm starving! - There you go.
Beautiful.
We're gonna start with some deep breaths.
Blum: Over the years, we have treated obesity
as this problem to fix.
Simmons: Next 45 minutes is your time.
Blum: There have been diets, there have been drugs
that hit the market that seemed promising.
Man: Keep away from salt, white flour, white sugar...
Blum: But throughout all of this,
obesity rates have continued to climb.
We know that obesity is linked to a range
of pretty devastating conditions.
Man #2: Americans will do almost anything to lose weight.
Blum: But also, our entire culture
incentivizes weight loss. Woman: Obsession.
Blum: So while I think there's a lot of excitement around GLP-1s
and there's reason to be excited,
there's also reason to look at history
and just be careful and approach these drugs
seriously and with caution.
♪
[ Child speaking in background ]
Sanchez: If you look at photos of me...
...as far as I recall,
I was not an overweight child.
♪ Get in shape, girl ♪
♪ You got the feeling ♪
♪ Get in shape, girl ♪
According to the growth chart from my pediatrician,
I must have been in the higher numbers.
My mom definitely had body-image issues,
and I think hearing from the pediatrician
that maybe I was on a higher end of the growth chart
triggered something in her,
and she then projected it on me
and was always trying to fix me.
And unfortunately, that trailed into teenage years,
young adulthood.
Binge eating created almost a coping mechanism
that I would use in high-anxiety situations.
At my 18th birthday,
I opened a gift from my parents, and when I opened the box,
it was an image of my personal trainer
that I was being gifted and workout clothes.
And that was from her. [ Chuckles ]
And that's a core memory.
And push, and push out and in.
All right, kick swings right here.
Up, two. Okay, tap it, tap it...
[ Clicking ] Oh, there you go.
Ooh.
You want to season it with some salt?
Sanchez: I think the diet culture that entered our home
created a very dangerous dynamic for me,
already putting a complexity on the size I was.
My weight hit a peak in my mid-20s.
I needed help.
What causes someone to be obese, um,
is really complicated, right?
So not only is it an interplay between environment and biology,
genetics and individual choices,
but it's also about societal expectations.
Society tries in every way possible
to make you feel like an outcast.
As a fat person, you are just used to the way
that society treats you, but you don't understand
how badly you are treated until you lose weight.
I think it's very easy to know something intellectually,
to know I have every right to be in this world exactly as I am,
but it's a lot harder to maintain that
while you actually live in a world
that is pretty inhospitable to fatness.
Things I hate as a fat person--
concert seating because, oh, my God,
this is, like, actively discriminatory.
Gay: We know that many, many people in this country
are fat, and yet there are very few stores
that cater to fat people for clothing.
Doctors refuse to treat you for what you actually
are trying to see them for, like a sore throat
or a cold or a broken ankle.
They're always trying to address fatness.
Everything looks good.
We'll call you with your pap results when they come in.
Okay. Thank you.
And I'm sure Dr. Lishen has mentioned this to you before,
but you should think about gastric bypass.
Okay. Um... but we didn't do, like,
any bloodwork or anything today.
Isn't that something that maybe you should look at
before you recommend a major surgery?
I think there's so much hatred
of weight gain and of larger-bodied people,
and there's so much praise to be had
for being seen as dieting and losing weight.
I just know what it's like to sort of have that feeling
that all eyes are on me,
I'm losing money or work or respect because of my body,
and I could make it all go away if I just... blank.
You're so tall. Wow.
Sanchez: I made the decision to have the drastic change
of gastric bypass,
and, really, the idea was sold to me that this will fix things.
Dropped about 120 pounds.
It really worked for me.
I wish I had done it 10 years ago.
Sanchez: And it was successful.
I lost 110 pounds within that first year.
I felt great.
It gave me the opportunity
to have beautiful wedding pictures
and fit into a dress
that I don't think I ever would have fit into before that.
There you go.
Even after losing 110 pounds,
the portion of my body
that wouldn't change drastically
was my lower legs and my hips.
And within the last year
oddly enough, through a TikTok,
I learned what lipedema was.
Woman: Lipedema usually affects the legs.
It can affect the arms, but usually it's the legs.
Everyone with lipedema will present differently.
Sanchez: I could sit there going,
"That's exactly what my legs are."
I wanted to talk a little more about what lipedema is.
It's a genetic fat disorder, um,
where you basically have
a layer of diseased fat under your skin.
It's not just in my head.
It's not just me failing at trying to lose weight.
The other thing is, I didn't know it was hereditary.
It was something that was in my genes.
I don't know what it feels like, at the end of the day,
to not have heavy legs.
And it would be nice to know.
And the more research I did in my lipidema communities,
I was hearing and seeing results from other women taking GLP-1s
having reduction in their lipedema.
And when I got on Mounjaro, and all those things suddenly
started to, like, subside.
Sanchez: So that helped me realize
I need a better tool to help fix this.
♪
Luxmore: Thinking about weight is probably the number-one item
that's on my mind most of the time.
Like, I'm always comparing myself to everyone around me.
I sized up this crew when they walked in
and, like, the first thing is like,
"Yep, I'm definitely bigger than all these people."
Or it's like a game. Like, the game is,
"Am I the biggest person in the room?"
I have this negative internal narrative about my weight
that's always been there.
I don't know if my family, to this day,
understands the implications of weight.
We know, of course,
that obesity is associated with a number of health risks.
It just wasn't a topic.
There are clear, undeniable instances
where my weight has, like, caused a social interaction
to go a certain way.
Dating is a great example.
Like, you know, there's really not any other way to do it
where, like, you're chatting and then you're like,
"Hey, let's send each other photos."
And then that person drops off the face of the planet.
I think that's a pretty clear indication, right?
What I want is I want to look...
it's such a loaded word, but I want to look "normal."
The reality of a GLP-1 med becoming available
was sometime in 2023, like,
because these articles started popping up.
The part that stood out to me was this concept of food noise.
You're eating breakfast and you're thinking,
"What am I gonna have for lunch?"
When I read people saying the food noise just went away,
I was like, "That's not possible."
Okay, friends, it's dinner time.
Give you a little preview of what's for dinner today.
I have some of this vegetable mélange.
I like saying that word.
Dr. Rich: Hunger is a necessary
biologic, um, impulse,
so that you don't starve.
And satiety, which says, "That's enough,"
is necessary so that you don't overeat.
And everyone's been trying to find out
what shuts on and off those signals.
If we could either turn on satiety
or shut off hunger,
we can get people to lose weight.
There's a brand-new drug that's just been FDA-approved
called Byetta, which comes from the saliva
of the Gila monster.
It's actually synthetic lizard spit.
- Oh, my goodness. - You're making this up.
And so you inject it. and the beauty of it is,
is that your diabetes gets better
and you don't gain weight.
Decades ago, we were looking at other diseases like diabetes.
And that's where hormones such as GLP-1
came into the picture.
Some really smart researcher found out
that the Gila monster only eats three to four times a year,
and he found out that the spit of it
is just like a hormone called GLP-1 in humans.
These are hormones that help the body process sugar,
and people were able to isolate them,
to study them for treatment.
Reporter: It will be used as a twice-a-day injection...
And they're effective for diabetes,
which is extremely exciting.
But they also induce this very welcome side effect,
which is weight loss.
After two years on Byetta, patients lost 10 pounds.
Blum: GLP-1s slow down the rate
at which food leaves your stomach,
so you basically are feeling fuller for much longer.
What I find really fascinating
is that the drugs also target the brain.
Man: They help us not to want to eat the things we shouldn't.
Dr. Rich: So then they started to scratch their head--
maybe this could be a weight-loss drug, as well.
This is the once-weekly, single-use Zepbound pen.
Announcer: Ask your doctor about once-weekly Mounjaro.
People taking Wegovy lost an average of 35 pounds.
♪ Oh, oh, oh, oh, Ozempic ♪
There are two pharmaceutical companies right now
that are the major players.
Novo Nordisk makes Ozempic and Wegovy,
and both of those medications contain semaglutide,
which is sort of the active molecule in those drugs.
The big rival is Eli Lilly,
which makes Mounjaro for diabetes
and Zepbound for weight loss.
And those drugs contain a molecule
that's called tirzepatide.
I don't know that anyone expected
quite the demand that we're seeing.
This is unprecedented demand.
[ Overlapping voices ]
Day one of Ozempic.
- Currently on week 23. - I got my Ozempic yesterday.
Woman: Being on a GLP-1 has changed my life.
I'm no longer obsessed with food 24/7.
Recently lost 15 pounds due to Ozempic.
I lost 2 more pounds this week, so I'm 243.
Weight-loss drugs like Ozempic
are incredibly popular right now.
Fallon: You look great!
How are you staying in shape these days?
Well, that's Ozempic.
Everybody looks so great.
When I look around this room, I can't help but wonder,
is Ozempic right for me?
That all, of course, comes at a really expensive cost.
Out of pocket, it will run you about $1,000 a month...
Blum: These are really expensive medications.
And in terms of actually getting insurance coverage,
it's really a moving target
'cause our entire medical system still views obesity
as a vanity project if you're trying to lose weight.
Reporter: Starting April 1, North Carolina will stop paying
for obesity drug coverage in its state health plan
as the costs soared to $100 million last year.
Sanchez: My insurance didn't cover weight-loss meds.
"Your prior authorization for Ozempic has been denied."
I felt I needed to take it into my own hands,
and if I can find it, I'm gonna buy it and use it,
regardless of where it came from.
It's led to these compounding pharmacies--
I don't know if you're familiar with the term.
But compounding pharmacies
are these pharmacies
that are allowed to, quote, "manufacture"
the drug in their pharmacy
to do an end-around from your doctor
and from your insurance company,
so you can have this drug.
Luxmore: I scheduled an appointment with my primary-care provider,
and I said, "I think I want to try, uh,
Eli Lilly's Zepbound. My insurance doesn't cover it."
She just responded like, "Well, we'll need to do
some tests and stuff."
And I was like, "Ah, screw this."
And a week later,
the medication was at my house.
The compounded medication that I used--
about $450 a month.
I know that I'm very fortunate in having an income
that can support that,
and I know a lot of people can't.
Sanchez: A friend of mine mentioned
that she had learned about these peptides
and work just the same at a less cost
than paying out of pocket for the brand name,
because it's in a wholesale type of environment.
I said, "Why not?"
The most money I would have lost out of pocket
at the time for it was $100.
People were being sent to compound pharmacies
and paying double what I'm paying.
So I'm doing this on my own.
So my tirzepatide comes from a company
that sources the medication,
just the main ingredient,
and sends it to me in a powdered form.
It comes from China.
Sorry, but the truth is, a lot of them do.
They are marked "For research purposes only."
And when it comes to me in a vial,
I need to use a solution that we call "bac water."
And you mix that into that vial,
and it creates the solution that is your medication.
There's no prescription needed for these.
There's no FDA regulations.
And a lot of us that use peptides,
we are conducting our own research on how it works on us.
So for the tirzepatide peptide,
we pinch the skin for the syringe.
Kraftson: You are injecting something in your body
and you don't-- you don't have a lot of validation
about what it is, how safe it is,
whether it actually is the medicine at all.
Sanchez: I don't need anyone's permission.
This just gets me one step further in my health journey
and feeling better physically, mentally, and emotionally,
because it's no longer this battle that I'll never win.
Woman: Drugs, alcohol, cancer, whatever your problems, people are sympathetic unless you're fat,
and then you're supposed to be ashamed.
Everything's set up to tell you that--
magazine covers, clothes.
I mean, if you're not thin, you're not neat.
And that's it.
Tovar: I used to believe strongly--
and I think all larger-body people are encouraged to believe
that our fat body is a temporary body,
and it's an alien body and it's an unwelcome body,
and that there is an authentic, thin person inside of us,
and that that person is real.
But it speaks to this idea
that fat people exist as a product of error.
McMillan Cottom: We still have this really latent assumption
that a body reflects who you really are,
that thin bodies are not just better bodies,
but they are morally superior bodies.
Around, you know, the late 1800s,
we started to see the emergence of the Gibson Girl.
And then that aesthetic got even thinner
with the emergence of the flapper ideal in the 1920s.
We start to see thin bodies selling products.
And that really continued throughout the early 1900s
through the 1960s.
And those were the fashion ideals.
Diet culture is very feminine. It's very white.
It's very focused on things
that straight women are supposed to want
and-- and creating a reality
where weight is a condition of getting those things.
[ Indistinct conversations ]
Man: Watch yourself, fellas.
[ Indistinct conversation ]
Weight Watchers Started in 1963.
It's on this kind of diet that, uh,
you're allowed to lose weight?
Right. As long as they eat it in moderation,
they could have great variety and still lose weight.
And it really pushes diet culture to the forefront.
I guess you went into this together.
We sure did.
We were fat together and we got thin together.
Every woman knows the Weight Watchers model.
Count every single thing that goes into your mouth
and track your weight obsessively.
Rosemary has lost 80 pounds.
Weight Watchers were in schools.
They were in hospitals. They were in workplaces.
You had a Weight Watchers in a strip mall in Idaho.
Sanchez: They would have a weekly meeting.
[ Woman speaks indistinctly ]
And you got weighed where everyone is.
They marked that down on your sheet.
It was something I was told to do.
I hear the name and I just cringe.
Blum: In the '80s, we really start to see this idea
of obesity as a public-health crisis take hold.
And in response, there becomes this sort of
American obsession with cutting fat as much as possible.
Viva tastes so fresh and creamy,
nobody realizes that it's low-fat.
And it's non-fat.
How could this not have any fat?
It's too good.
A lot of the foods in our house were low-fat,
fat-free, and very fake, produced foods.
And I think a lot of that was diet-culture influence
that was pushed at the time.
[ Upbeat music plays ]
Hi, everybody.
This is a very, very personal show for me
because I have received thousands--
you wouldn't believe the letters
my office has received--
hundreds of calls every day,
and every place I go out on the street--
"Hey, Oprah! Okrie girl!
How'd you lose all that weight?"
Gay: Oprah is like all of us.
And that really was what made her audience gravitate.
And the fact that she has publicly struggled with weight
mirrors our private struggles with weight.
You know, "Oh, my gosh. She's just like us,
and she's a billionaire."
You know, I'm tired of having to deal with,
what is wrong with me that I can't solve this problem
that I have with myself?
Harrison: Oprah had incredible pressures on her
to achieve this thin ideal,
and was facing so much scrutiny from tabloids,
from media at large, from other celebrities, even.
They told me you're a beauty-contest winner.
Yeah, uh, 50 pounds ago or so.
So how'd you gain the weight?
I ate a lot.
[ Laughter ]
No, no, no, no, no, no, no. You said 50 pounds.
You shouldn't let that happen to you.
You're very pretty. Joan, do you know what?
No, I don't want to hear.
Let me tell you this. Let me tell you something.
You're a pretty girl and you're single.
You must lose the weight.
But she was also very much a spokesperson for diet culture.
We are now-- "A.M. Chicago," in Chicago--
we're starting A Diet With Oprah.
- Great. - Yes.
So that I have been put under pressure to finally do it.
And so when she tried something, a lot of people tried it, too.
Today we get the motivation and inspiration we need
to start the Oprah Potato a Day Diet.
McMillan Cottom: No matter what her show was about that Tuesday,
the metanarrative of Oprah's show was,
how happy is she with her body today?
I wake up in the morning.
I go and look in the mirror sometimes,
and one of the reasons why I realized
I don't have a handgun is because
I would have shot off my thighs years ago.
And that metanarrative really shaped
how women in particular talked about themselves...
I start on a diet like I started another one yesterday.
McMillan Cottom: ...the expectations they set for themselves...
I still hate myself because of my weight.
...and the expectations that they passed on
to their daughters, which I think is also
just particularly complex.
I lost...
I have lost, as of this morning,
67 pounds since July 7th.
This is what 67 pounds of fat looks like.
Harrison: I think that wagon-of-fat moment
was so iconic, perhaps,
because people had seen her struggle for so long
and, you know, the visual of a wagon of fat,
and I think it sort of taps into that desire of, "Yeah,
if I could just, you know, cut these parts off myself,
I would be okay. I would be perfect."
How do you feel about your girlfriend losing all this weight?
McMillan Cottom: If you watch that whole show,
she brings out her longtime partner, Stedman,
to sort of perform, like, her validation of herself.
Stedman: Since the beginning, every time we walk into a room,
I would see how people would react to you.
And, uh, you know, they-- I could see on their faces,
they said, "Yeah, she's, you know, she's this or she's that,
but she's overweight."
And, you know, I've had to deal with that
for months and months and months.
And I saw, you know--
I saw, uh, a diamond in the rough.
Harrison: I think she was really, at the time,
like, very pleased and proud.
Diets lure us in.
Every day I mix my little protein pack,
this Optifast.
I drank this five times a day
every day for three and a half months.
But they aren't sustainable, right,
because the body fights weight loss.
Winfrey: In all, I've gained 17 pounds
of the 67 pounds I lost last year.
It is a battle that I'm still fighting
every waking moment of my life.
We want to talk about the toxicity of diet culture,
I think it's important to keep in mind
that not even being a billionaire mega celebrity
bought Oprah Winfrey out of it.
Harrison: And that's really convenient for the diet industry, right?
Because people are dieting their way up the scale,
and they're looking for a new solution.
Dr. Rich: The reality is
there is a medical issue here.
We need to treat people like they have a disease
and not like they are just not strong enough
to say no.
If you can believe in yourself
and believe that this is the most important thing
in your life, you can conquer it.
of people using the GLP-1 medications,
but there is a dark side and we have to talk about it.
It's Friday night, 10:30 p.m.
I'm specifically trying to take it kind of late at night
so that if I have any side effects,
I'll hopefully just sleep through them.
Just grab a little bit of the fat,
which there's plenty of that, and then just boom.
I guess I've been very fortunate with the side effects--
very minimal.
I have sort of been experiencing, like, heartburn,
um, kind of feeling a bit lately.
I read people's accounts religiously,
and some people reported some truly horrendous things.
I've actually gotten really, really bad.
Like, I'll drink water,
and just, like, immediately have to throw it up.
Nauseous, vomiting, um, hunched over in pain.
Woman: There are rarer reports of pancreatitis
as well as acute kidney injury.
Sanchez: I was lightheaded for a week straight.
And it was affecting my lifts really bad.
Allen: We know what it looks like for people
who have been using them for diabetes,
but we don't know what the longer-term implications are
of being on these medications for weight loss.
[ Grunts ] I thought I was gonna pass out.
Kraftson: Our patients will describe it--
"Oh, I feel weak,"
or, "I don't feel like I have the same stamina."
I...
quickly went to my community on Facebook,
and another lady had the same exact experience.
She goes, "Go back down to 7.5 and you'll feel better,"
and I did.
Kraftson: And when you lose a lot of weight,
you just hope, "Oh, it's all gonna be fat."
But that is actually not what happens.
We are worried about that muscle loss that can happen.
♪
Luxmore: There's more studies coming out.
They're talking about longer--
longer effects of being on these medications.
And, you know, I'm thinking about like,
"Oh, am I gonna take this medication forever?
Is that fine?"
My early days of thinking about GLP-1 drugs was,
"Oh, I remember this.
We've done this before."
Reporter: Wouldn't it be nice to treat obesity with a pill?
Now we can.
Two drugs, fenfluramine and phentermine,
when taken together, help you control your appetite.
The program is called Fen-Phen.
By giving them the pills, it makes them not hungry,
and it makes them satiated.
♪
Dr. Rich: Fenfluramine...
which is one of the drugs in the Fen-Phen name...
was a drug developed by Servier Pharmaceuticals,
a French pharmaceutical company.
♪
But women taking the fenfluramine
started to develop pulmonary hypertension,
which is a cause of serious heart failure.
♪
Well, Servier pushed back, and they said,
"We're not going to take this off the market
unless there's proof."
So the health authorities in Europe
agreed with Servier to put together a plan
for an epidemiologic study.
♪
At the end of the trial,
we've showed what's the chance of you getting this disease
if you take these diet pills.
So, the odds ratio-- to give you some comparisons--
the odds ratio for lung cancer and cigarette smoking
would be about four.
In general, you are four times more likely
to get lung cancer if you smoke than if you don't.
The odds ratio for severe pulmonary hypertension
was 23...
with 3 months' exposure.
But Servier's partner in the United States
had a subsidiary called Wyeth-Ayerst.
They went to the FDA to get the drug approved.
So the FDA asked me to present the data
from the European study.
And then it passed, 6 to 5, to get this drug on the market.
I don't crave anything.
My most successful patient has lost
over 100 pounds in a year.
Reporter: Gary dropped from size 44 to 36.
Woman: I tried all kinds of diets all my life.
[ Microwave dings ] Hmm.
Woman: This is the first time I've been able to keep it off.
Everyone wanted on.
Woman: I have a lot more self-esteem.
I have a lot more energy.
My bowling average has gone up 10 pins.
It was skyrocketing.
We're definitely seeing a revolution
in the way we think about obesity.
Dr. Rich: I mean, it was devastating to me
because I knew, from the patients' side,
what the consequence of this was going to be.
It's 7:19 now.
Once again, here's Bryant in Chicago.
All right, Katie. Thanks.
Of late, more than 60,000 new customers a week
have taken to trying the newest trendy diet.
The diet is called Fen-Phen.
Problem is, those pills could also be linked to a serious
and sometimes fatal lung disease.
That news comes from a study published today
in "The New England Journal of Medicine."
Dr. Stuart Rich from the University of Illinois
is one of those who authored that study.
Doctor, welcome.
This drug produces. Pulmonary hypertension,
a very uncommon but very fatal illness.
Dr. Rich: When I appeared on the "Today" show,
the drug was just on the market,
being hailed as the Great American Dream.
Would it be fair to say that even with the increased risks,
the chance is minuscule?
No, far from minuscule.
So now physicians were really confused.
This drug got approved, and here's this paper
in "The New England Journal" saying it's not so safe?
Lauer: Cardiologists at the Mayo Clinic
have found that 24 women on these drugs
developed some severe heart problems.
Dr. Rich: And it didn't take too long
before there was another paper
showing damage to the heart from these diet pills
that came out of the Mayo Clinic.
They knew that they had far more cases of pulmonary hypertension
and deaths associated with that
than they told the doctors about.
There are figures coming out, four or five deaths.
Don't use it. It's a deadly drug.
Reporter: She took the drug for just a few weeks
when her symptoms began.
Nearly nine months later, she was dead.
♪
It was the nail in the coffin.
♪
I remember there was a woman in my community here
who was on Fen-Phen...
...who stopped me on the street and yelled at me
that I was the reason why
she couldn't take her diet pill any longer.
How dare I be part of all of this?
McMillan Cottom: Imagine what it means to say
it is more important for you to risk dying
than it is for you to live being obese.
Man: A new lawsuit is alleging that some diabetes drugs,
which have become popular for their weight-loss effects,
are causing stomach paralysis in some users.
Man #2: Their symptoms are so difficult to control
that they have to be admitted to the hospital.
Luxmore: And I mentioned before
that I had felt a little, like, heartburn.
And other people have reported that, too,
and it was pretty minor,
but it actually-- I kind of, like, enjoyed that
I had a little bit of heartburn.
I was like, "Ah, that's the medication, man."
There's so many questions, you know,
about what's gonna happen over the long-term.
I honestly don't even care about the long-term effects.
And that's really where I'm at today is like, okay,
let's say in five years I have stomach cancer and it's bad,
like, I had a good run.
Like, I'm assuming that I can just be normal for a while.
Like, I would take that if it meant a terrible ending.
It's more like, okay, let's just see what happens, you know?
[ Woman speaks indistinctly ]
Arrellin: My lizard's name is Buford,
and he's a citrus bearded dragon.
He's so, so pretty. I love him.
I feed him this vegetable mix that he really likes.
I feed him-- I don't know what they're called,
but they're little worms and they're blue,
and they explode when they bite them.
My name is Jennavecia, and I'm 14 years old.
I was 10 when I was diagnosed with PCOS.
♪
You have more testosterone than most women.
It intensifies hair growth and acne
and weight gain.
And everything that nobody wants to deal with
is what we get.
♪
When I first started to notice that I was gaining weight,
I cried. I cried so much.
I was super self-conscious, was not comfortable in my own skin.
So after a while I, like, avoided going swimming,
I avoided doing so, so, so much
because I didn't like how it looked.
I look like Satan in that. This one?
Yes. You're actually ungodly excited at that point.
Hernandez: I, too, had struggled with my weight.
My perception on weight was very, um, jaded.
It was terrible.
What if I told you that in 10 days
you could lose two inches around your waist
and drop a dress size?
Dr. Mehmet Oz is back,
and he claims he has the real weapon against fat.
In the 2000s, it was very unrealistic, the way
that they were trying to have women look,
especially to teenagers.
You know Natalie, who works here?
Woman: The chubby girl?
Ooh, would call her chubby?
Hernandez: I ended up developing
anorexia and stuff through those years.
Reporter: Now it looks like Jess is enjoying
a whole lot of Southern cooking.
- I know what you're saying. - What am I saying?
- That I'm overweight. - You really are.
- How much does she weigh? - 350 pounds.
On TV, you are a little fuller, a little bit more thicker.
I wouldn't call myself thick. I'm just standing next to Paris
who's the skinniest person in the world.
There's a wealth of research that shows that
the more the toxic culture of the 2000s
really took hold on television and later on social media...
Is your weight back to normal?
- Yeah, it is. - Can I check? Do you mind?
Blum: ...the more that young girls started
to develop eating disorders.
You know, I remember Pro-Ana Tumblr
and just the total way in which young girls
were sharing their strategies,
what tools to use to make yourself as skinny as possible.
It was really damaging and pervasive.
I know for me personally, when I was struggling
with my own eating disorder around that time,
it was just the sense I could never be thin enough,
and I did not see myself clearly.
But I think it happened to so many of us
in our society, like, en masse around that time.
Tovar: You know, pretty early on I'm starting to restrict food,
and the behavior gets worse over time,
and I'm just restricting more and more and more.
I hate my body. I literally wake up every day
and I'm like, "I hate this body.
I will do anything not to have this body."
It's not like it was just my peers or just my doctor.
It was, like, my peers, the doctor, the media,
everything I was watching.
Unless you faint, puke, or die, keep walking!
Go, go, go!
I want you to run through the pain.
They've helped 114 people lose over 10,000 pounds.
Man: I literally was just like,
"I have got my work cut out for me right now."
Woman: Kathy's plan features liposuction
in six different areas.
No more cookies. Say it every time.
No more cookies!
McMillan Cottom: Then there's the social-media revolution.
...the fastest way to lose 30 pounds.
For breakfast, I'm having half of a large watermelon.
Four six-ounce tri-tip sirloin steaks.
The Internet overall amplified diet culture.
If you want to lose weight and you don't know where to start,
listen to this.
McMillan Cottom: And it's also made it harder
to regulate and rein in.
Man: This is day two of trying to lose 35 pounds
of water weight in one single day.
Blum: It's like you can never really get away
from this narrative
that is telling you the worst thing you can be
is someone in a larger body.
Hernandez: It hurt to see my daughter
go through being bullied
for those things that she couldn't control.
Arrellin: It was the boys.
They were honestly the worst part of it.
I remember specifically, I was in eighth grade
and I walked my friend home, and he drove by and he was like,
he yelled out the window, "Fat,"
very unkind word, the B-word.
And I was like, "Well, that's mean.
I don't even know you."
Reporter: The FDA approving Wegovy
as a treatment for teenagers with obesity.
Reporter #2: Drugs for weight loss now being prescribed
to kids as young as 12.
Arrellin: The test study that I am in right now
is the Wegovy test study.
My doctor is trying to--
she's trying everything she can to make it better for me.
Jenny, come on back.
So we're just gonna grab your height and weight.
Cree: Adult women with PCOS who struggle with weight
have an eight times higher rate of developing type-two diabetes.
So the number-one recommendation for PCOS
is weight loss.
Hernandez: We had a sense of hope.
Not relief yet, but hope.
Arrellin: My first time on Wegovy shot,
I think it hurt really bad.
It's 8:05 p.m.,
and I'm about to take my shot of Wegovy.
[ Gasps ]
I would not leave my bed. It was terrible.
It was just all puke.
I couldn't eat. I couldn't drink. It was bad.
All right.
So you said you're having the sweating and the shaking,
but it's mostly before meals?
Cree: One of the concerns for the GLP-1s
is the amount of time
that somebody would be on these medications.
Well, it's actually so sad.
My favorite food-- um, we went to
a Mexican restaurant and I got flautas.
They were so gross. I was so sad.
I love flautas.
Looks like the part of your brain
where you make those decisions,
um, it's changed relative to where you take your calories in.
Are we actually rewiring the brain
in a developing individual?
And what does this do long-term?
We just don't know.
Cree: Do you want to know how much weight you've lost?
- Yeah. - Yes.
Today you are 86.3 kilos.
You've lost 10 pounds.
Oh, my God. I did it.
That is good.
Arrellin: The Wegovy test-study trial is 10 months long.
If I keep on what I'm doing now, I will be a lot healthier.
I'll be better. I'll be amazing.
But my fear is that all of my progress
that I've made on the Wegovy could just disappear
after I get off of it.
I think that's it for me.
That means we're ready to go up on the next doses.
Do you feel ready to go up on the next doses? Mm-hmm.
Arrellin: I'm scared of that.
I'm scared of doing all of this for nothing at the end.
Arrellin: I have more motivation to do things around the house.
I love cooking and cleaning now.
It's, like, my favorite thing to do, ever.
And sometimes I make, like, a little dessert.
It's great. I don't ever eat the dessert.
But everybody else likes it, so that makes me happy.
♪
We went grocery shopping earlier.
Publix had these shrimp trays-- buy one, get one.
Readily available, ready to go, low-calorie, high-ish protein.
$10 a tray. Not bad.
What I'm having is a bowl
with, uh, some super greens,
some green-bean chicken.
I'm going to have a fortune cookie.
I love fortune cookies.
The part of Pueblo that I live in,
it's technically like a borough town.
It's not fully connected, but it's connected.
Here itself, there's not that much.
There's a little restaurant up the street from the house,
which is, like, an hour and a half, hour walk.
Man on TV: The term "food desert"
is used to describe neighborhoods
where there are few, if any, markets
to buy fresh and nutritious food at a reasonable price.
McMillan Cottom: GLP-1s are a blockbuster
because they promise to solve a social problem
without changing anything else.
It is the height of hypocrisy
that American social policy,
from everything from housing to transportation to agriculture,
incentivizes things that make it difficult
for people to be healthy.
Good morning.
Cardiovascular heart disease is the leading cause of deat h
in the United States today,
and costs society over $60 billion in direct
and indirect health costs each year.
Blum: Over the years,
the government has rolled out a number of different programs
to try to get more involved in people's health.
Metzenbaum: I do look at labels,
and I'm more confused every time I look at them.
People who represent industry have an obligation
to be concerned about the health of the people of this country.
And there have been some changes.
The idea is that they will put the nutrition information
out for the consumer at fast-food restaurants.
There was Let's Move, Michelle Obama's campaign
to try to increase physical activity.
We can't afford not to give our kids nutritious food.
Harrison: It was so tied to rhetoric
around the obesity epidemic
and how this initiative was going to help ameliorate it.
Man on TV: The public-health purpose
is to get consumers to make healthier choices.
Kraftson: We need a lot more encouragement to people
to choose healthier diets.
McMillan Cottom: You can make all the individual changes
that you want,
but if the environment makes it easier
for you to eat more calories and to move less,
then it is not an individual problem.
And when we come up with individual solutions
and put people in a catch-22 of available options,
then we create the system that blames people
for things that really are beyond their control.
Before I had any critical awareness
of weight discrimination or diet culture,
I used to listen avidly to any advice about eating.
We don't need more advice on how to eat.
No more rules, no more advice.
We need less of the stuff that actually harms people.
One of the most powerful things that social media did
was to basically create a reality
in which larger-bodied people could be the authors
of their own story for the first time in history,
and it created enough space to say, "Oh, my God,
if this plus-size woman is showing me
that they're dating and wearing cute bikinis
and going, like, on trips
and having these meaningful moments,
it was just like it was a cognitive dissonance
because I've been told there's no path to dignity,
no path to love, no path to beauty."
I don't starve myself.
Luxmore: You know, I want to be very supportive of people,
and I am very supportive of people.
Like. other people who are large,
like, I understand their experience
and I want to support them.
But when I think about body positivity, for me,
like, it doesn't apply.
So if somebody came at me with body positivity,
like, "You just need to feel better about yourself,"
I'd be like, "You need to go fuck off."
I started getting e-mail
from third-party marketing companies
that wanted me to take GLP-1s
and share my journey.
What made it noteworthy to me was if they vetted my platform,
they either don't care about my values
or they actually believe I'm lying.
There was a cynicism that felt very familiar
and it also felt very toxic.
What GLP-1 did is that it made everybody prove
just how body-positive they were.
I don't like people complimenting
or not complimenting on how you look.
Having said that, I welcome you to call me a skinny bitch.
McMillan Cottom: It is something else
to be committed to body positivity
when, for enough money, you can buy your way out of it.
♪
Look at this.
This is basically two sizes down from what I was wearing.
I'm just getting ready
to go to a work-reunion event,
and I guess I'm kind of curious to see
if anyone will say anything.
Like, if it did come up, would I even tell the person?
I mean, the short answer is no.
In 2021, I got my first e-bike.
The idea was like, "Okay, if I get this e-bike,
I'm still putting out a lot of effort."
But, you know, when you're on an e-bike,
you can do more laps,
you can go farther, you can go faster.
And it's interesting with e-bikes
because it sort of mirrors
what's happening right now with GLP-1 meds
in that people who are anti-e-bike
are just like, "You're not earning it."
♪
"For $1,000, just get a meal service and go to the gym."
♪
McMillan Cottom: GLP-1s
do threaten our unexamined belief
that fat people deserve the way we treat them.
"We can't be sure. Who do we judge now?
Who-- How much should I judge them?"
That is a threat to my own social position.
Are we going to continue to pretend
like a lot of these conversations
aren't rooted in the gatekeeping of thin?
It's very clear that the people who have that mentality
don't have the experience that people like me have had.
Winfrey: I never dreamed
that we would be talking about medicines
that are providing hope for people like me,
who have struggled for years
with being overweight or with obesity.
As these drugs get more and more popular,
the cultural dialogue really goes to a fever pitch.
And of course, that's the point
that Oprah re-enters this conversation.
Hi, everybody. I wanted to do this special...
Blum: In March of 2024, Oprah does this entire special
that is devoted to weight-loss drugs
and how revolutionary they are.
In losing, you have now gained so much
in terms of your own health.
- Absolutely. - Yes.
And she says that she is taking a medication for weight loss.
She pretty pointedly doesn't say which one.
I use it as a tool.
Blum: It's really fascinating to have Oprah,
who has been for so long this sort of cultural avatar,
say that she is now to the point where she is in on this, too.
Winfrey: The two pharmaceutical companies
who are behind the meds, Ozempic and Wegovy,
Mounjaro and Zepbound, are here.
I think a lot of people felt almost betrayed.
It basically looked like
the manufacturers paid her to promote it.
Man: They come across as trying to be
some sort of neutral reporter, which is certainly not the case.
So, about two months later, Oprah does a whole new special,
and it is totally steeped in this language
of body positivity.
Winfrey: We have reached a pivotal moment
in the way we talk about
and the way we think about our bodies.
It was extremely surreal because I was watching Oprah
and this carousel of celebrities get up there
and use this kind of, like, "my body, my choice" rhetoric
around weight-loss drugs.
And our body is being up for debate,
our body is being weaponized,
our body is being used for legislation by bad actors,
and I've just had it.
And I was kind of looking around, watching
everyone in the room go through those mental gymnastics
of like, "Okay, it's empowering,
but the reason we're losing weight
is to fit into a body standard that's been foisted upon us,
but we're choosing to do it, so it's okay."
We want women's bodies to be off-topic.
It was just this total knot
that we were all trying to untangle.
And at a certain point, you just give up
because it's too interconnected.
Thanks, everybody.
Blum: I think the narrative around obesity and weight
stigma and shame gets even more complicated
when the drug companies get involved
and start putting out promos
that are basically staking out their own position
in a conversation about all the ways
in which our culture has demonized having a larger body.
Man: I was always told,
because I was overweight, I must be lazy.
Blum: These are forever drugs.
These are medications
that people need to stay on in perpetuity
if they want to keep the weight off.
And so these drug companies really stand to profit
from presenting themselves as the solution.
Man: We must stop fat-shaming.
Tovar: The proposition that a pharmaceutical company
can end weight discrimination
is ludicrous.
You're going to end weight stigma?
How?
By getting rid of every fat person
on the planet and the United States?
Okay, what does that actually look like?
It means that every person,
whether they want to take it or not, have to.
At the end of the day, what will happen is
that we won't have dealt with fat phobia.
We'll still be a society that has fat phobia.
We're not eradicating stigma.
We're eradicating the people who experience stigma.
ve been on my shots for six months now.
Throughout everything, I have lost 26 pounds.
Pretty close to 30.
I haven't done a weigh-in in a little bit,
so I could be there.
Luxmore: So, I've lost 64 pounds while being on the GLP-1 drugs.
It is... [Sighs]
20-some years of relief.
I've lost about 50 pounds since I started a GLP-1.
[ Exhaling sharply ]
This is the first time in my life
that I've ever been on a weight-loss journey
and my legs have actually transformed.
And I don't think I realized how much
I was living in pain in my legs before,
because I just tolerated it.
Right up there? Yeah?
Blum: GLP-1s are extremely exciting.
They were revolutionary.
I've never heard the word "miracle"
come up so many times in my reporting.
It's really easy to get swept up in the hype
around these medications.
Arrellin: It's already helped all the PCOS stuff.
Like a normal girl now, honestly.
I'm in a size 9 in my jeans,
so that's pretty nice.
Luxmore: The forum I'm on a lot on Reddit,
they talk about NSV-- non-scale victory.
There's, like, an NSV, like, every day.
These are much better.
So it gives a lot of hope now.
I'm not mad about that.
So, this is what we call a non-scale victory.
[ Sighs ]
This was supposed to be the easy interview.
[ Sighs ]
♪
Luxmore: The goal, really, I think,
is to have more social connections.
So maybe I can go on dates now, and I could convince myself
that my size isn't really a factor.
♪
I think I'm ready to start trying that again.
[ Camera timer beeping ]
One of my dream scenarios would be, like,
I go on a date and my date would say,
"By the way, I'm taking Ozempic."
Like, if I heard that, I'd just be like, "I love you."
Sanchez: I think, with any type of medical treatment,
there's risk involved, so I think
it's up to your choice
what level of risk you're willing to take.
I finally got approved for Zepbound
because my insurance company now covers it,
and my copay is $25 a month.
My goal is to just have Zepbound
only for financial reasons.
However, that could change overnight,
so I'll still have a backup plan--
a plan B with my peptides.
Just in case. [ Chuckles ]
I know so many people are so mad at me for saying this.
GLP-1s are a diet.
At the end of the day,
diets are when you restrict food
in order to change your body size.
That is what a GLP-1 does.
It does it in kind of an elaborate way.
It does it in kind of, like, a more medicalized way,
but, fundamentally, it is a food-restriction program.
Luxmore: So, right now, I weigh 259 pounds.
At my lowest weight, without GLP-1,
I had gotten to, like, 261.
And I'd done that through diet and exercise.
At that point, I did feel really confident.
But this time around, I'm not really having that.
That feeling is not explicitly tied to your size.
It's tied to other things.
And I haven't nailed down what that is.
Today I slept all day because I wasn't feeling good at all.
Very, very difficult.
I don't like how sick it makes me feel.
I'm very happy for what it's doing to me,
and I'm very happy that I got to be
a part of the study that I'm in.
That was me when I-- on my 13th birthday.
I was a lot bigger then. I'm very happy I've lost weight.
I just don't like feeling sick.
Tovar: Chronic nausea, gastroparesis, hair loss,
the idea that you might have to pay out-of-pocket
$20,000 a year for the rest of your life.
Why aren't any of those things worthy of headlines?
Why is the only thing that's worthy of headlines
that this is a quote, unquote, miracle drug?
Luxmore: My expectation is that I'm going to be taking GLP-1s
indefinitely, which is expensive.
I'm very fortunate that I can afford--
If I had to pay full price, I can still afford it.
Arrellin: After the trial ends, my doctor said
that I won't be on it anymore unless something happens
and it becomes, like, an actual PCOS med.
I don't want to end up where I was in the beginning.
McMillan Cottom: As they stand now,
GLP-1 drugs for weight loss
are for people who are at risk
for losing social status and money
if they aren't thin,
and for people who can afford to take that risk.
As a country, we need to decide if we are okay with that.
I'm happy to, like, confidently wear this.
Harrison: To really improve people's well-being,
we need to focus on ending the cultural obsession
with dieting and body image...
Woman: There's been a more than 930% increase
in patients getting prescription semaglutide.
Harrison: ...helping people develop resilience to that.
And it looks good, and it makes me feel good.
Gay: If we could just let people live
and be who they are,
and try and address some of the stigmas around fatness,
maybe you would see fewer fat people.
I don't know. We could try it.
But we won't.
♪