The meds that ended my struggle and set me free

For decades, the shame of not being able to manage my weight took up so much space in my brain. I tried everything, and yet nothing worked. I was convinced that I just needed more willpower.

Because it hadn’t always been like this. Growing up with my grandmother, we had a little farm in the back of her property down in Kosciusko, Mississippi. We raised our own chickens, grew our own vegetables. The meals were simple and delicious. Back then food meant you were prosperous enough to have it. But years later, when I moved to Baltimore, I had to eat alone in my kitchen. For company, I would walk over to the mall and “shop” for dinner at the food court.

First I’d visit the baked-potato bar with all the fixins’. Then the salad bar, with more fixins’, heavy on the bacon bits. Then the chocolate chip cookie stand.

From the outside, I’d made it — I was one of the city’s youngest local news anchors. But on set, my co-host, Jerry Turner, was not happy to have me there. This middle-aged, white-haired anchorman was used to doing the show by himself and didn’t want a 22-year-old taking up his airtime. He made that very clear. I remember him asking me, “What school did you go to? Is that accredited?” Another time he said, “You’re from Mississippi? Can you name all the tributaries of the Mississippi River?” I looked at him, feeling inadequate. Unbelievably, I thought, “I’ve got to go right home and memorise all the tributaries of the Mississippi River.”

At home, after long days of this kind of belittlement, food became my solace, my comfort, my reward. I didn’t realise I was using food to avoid conflict or sadness. I went to see my first doctor about my size in 1977.

From then on — for more than five decades — much of my life would be dedicated to fighting my weight. I had the success and the acclaim, but I still would gain … and lose … and repeat the cycle over and over again.

Years later, I remember going with Stedman [Graham, Winfrey’s longtime partner] to a World Heavyweight Championship and the announcer saying Mike Tyson’s weight — 218 pounds (98.8kg). I was also 218. In that moment, I felt sorry for Stedman. Here’s this beautiful, handsome guy, and he’s with someone who weighs as much as the heavyweight champion of the world. I was determined to do something about it — and I did. You may have seen the clip of me in 1988, pulling a red wagon with 67 pounds (30.4kg) of fat, to show how much weight I’d lost after four months of a meal-replacement diet. During those months, I’d cancelled any events that had to do with food, including my first trip to Venice. Who can go to Italy and not eat? All to prove I could get back into a pair of size 10 Calvin Klein jeans.

Even though all the naysayers said: “You’ll put the weight back on,”

I thought my four months of discipline would prove them wrong. Within two weeks of stopping the diet, I’d gained back eight pounds. The star of Miami Vice, Don Johnson, invited me to his holiday party that year, but I stayed home because I thought, “I’m too fat to go to his party.” I was so disappointed in myself for gaining weight back. For letting it happen again.

Had I learnt my lesson 10 years later? No, I had not. When Anna Wintour suggested I lose 20 pounds before appearing on the cover of Vogue, I worked my behind off, literally. I did everything I could to get in shape, and it paid off. I was transformed into their October cover girl.

But then the weight came back.

I spent years like this, yo-yoing, trying and failing. “Why can’t I just conquer this thing?” I said to myself over and over. “Why can’t I solve this problem?” In 2009, I even appeared on the cover of O, The Oprah Magazine, standing next to my thinner self from 2005, under the headline “How Did I Let This Happen Again?” I thought, “Oh, if I say it myself, then other people can’t say it.” I swallowed my shame. I accepted that I’d brought this on myself. The cycle continued.

In 2018, a friend mentioned they were taking a drug meant for people with diabetes that helped them control their weight. They said they could help me get on it — a shot to the belly. I said no. Number one, it’s for people with diabetes, and I did not have diabetes. Number two, if I went on it, everybody would say I took the easy way out. I still thought my weight was my fault — and if it was my fault, I believed it was my responsibility to fix.

In 2021, I got my new knees. Grateful to be walking without pain, I started hiking religiously. I was up to five or six miles a day and eating one small meal at 4pm. I lost some weight. People started to comment. And I thought, “Maybe that’s the answer — one meal a day and putting in the miles.” Then the holidays came, and I still gained eight pounds. I cannot tell you how demoralising that was. Here I was exerting all this energy, the mental load, the cognitive load of fighting the wish to eat. The battle was constant.

In 2023, I hosted a panel conversation with weight-loss experts and clinicians called “The State of Weight”, as part of Oprah Daily’s “Life You Want” digital series. I had the biggest “aha”, along with many people in that audience, when one of the doctors said that in 2013 the American Medical Association had recognised obesity as a disease.

I realised I’d been blaming myself — and my lack of willpower — for years. It’s not about willpower — it’s about the brain! Immediately after that conversation, I called my doctor and said, “You mean it’s not my fault? I have something that causes this to happen within my body? Are you kidding me? Get me on the meds today!”

Within days, I noticed a change. We have the best English muffins in the world in our house. They’re from this little place, the Model Bakery, in Napa Valley. Before the medication, I could eat two of those English muffins without thinking — one with jam and then another with honey. Now I couldn’t finish a whole one. I was satisfied with half. I’d had enough.

Something happens in your brain on the medication. You eat only when you’re hungry, and you stop when you’re full. I couldn’t believe it. This is what it’s like to be free from the constant pull of food, I realised. Free from the constant chatter in your head about what to eat, how much to eat, how much you just ate, how many calories it cost you, and what it’s going to take to burn off those calories.

An aperture had opened in my mind — I saw new possibilities. And I see them now every day. I say yes to life. I no longer turn down invitations to parties or trips to Venice because of my weight. I look back and understand why I made those decisions then — I felt ashamed of not being able to manage my weight. Even when I was first offered the shot, I was still feeling embarrassed I couldn’t do it myself. But hear me when I say that life with these medications has ended the struggle with my weight. I use them as a tool to enhance all aspects of my health. Having the food noise go silent created a space for so much more. I now look forward to exercising without feeling like it’s punishment. I move because it’s easier for me and makes me feel so much better — not just physically but emotionally, mentally, even spiritually. I feel connected to myself. I feel whole.

Doing a panel discussion on weight in 2024, I met Dr Ania Jastreboff, an endocrinologist and professor at the Yale School of Medicine. She has been studying obesity for nearly 20 years and researching the GLP-1-based medications for a decade and a half. In this book, she answers the questions so many have regarding these medications. Dr Ania shares story after story about the people with obesity who found these medications to be life-changing. She breaks down the science, the treatments, and, yes, the biology. Most important, she explains that the goal in treating obesity is not just weight reduction. It’s about improving and optimising your overall health. I can say amen to that.

• This is an edited extract from Enough: Your Health, Your Weight, and What It’s Like to Be Free by Dr Ania Jastreboff and Oprah Winfrey