Why I Am Deeply Uncomfortable With Oprah’s GLP-1 Narrative (by Donna Aston)
I have long respected Oprah Winfrey for her influence, storytelling and ability to bring important conversations into the mainstream. Which is exactly why I find her recent positioning around GLP-1 agonist drugs so deeply disappointing.
Oprah has publicly shared her personal experience using GLP-1 medications such as Ozempic, Wegovy and Mounjaro, alongside the release and promotion of a book on the topic. She has spoken openly about being told by a doctor that she would never be able to lose weight without pharmaceutical intervention, and from that experience appears to have drawn a broader conclusion that this is effectively the case for most people. That weight loss without drugs is futile. That willpower, lifestyle change, education and long term metabolic rehabilitation are largely a waste of time.
This is where I take issue. Not with her personal choice. But with the leap from personal experience to public prescription.
Oprah is not a clinician. She is not a nutrition scientist. She is not a metabolic researcher. She is a person who had an experience. A valid experience. But still just one experience.
To illustrate why this matters, consider a parallel.
Imagine I had a back injury. Let us say there was genuine debate among experts as to whether it could be rehabilitated through conservative therapy or whether surgery was required. I tried rehabilitation for years. Eventually, I chose surgery. Two years later, the surgery appears successful. I feel better. I believe I made the right decision for me.
Now imagine that the surgeon pays me, or I profit financially, to publicly promote that surgery. Imagine I then tell every person with a back injury that rehabilitation does not work, that they are wasting their time trying, and that surgery is the only solution. Despite having no medical training. Despite knowing nothing about their injury, their context, their capacity to heal, or the long term outcomes they may face.
Most people would immediately recognise the ethical problem. Personal success does not confer authority. Experience does not equal expertise. And financial gain attached to medical advocacy should always trigger scrutiny, not applause.
Yet in the context of weight loss and GLP-1 drugs, this scrutiny seems to vanish.
What concerns me most is not the existence of these medications. There are clear clinical scenarios where they may be appropriate. Nor is it the fact that some people feel helped by them in the short term. What concerns me is the cultural message being amplified by one of the most powerful voices in the world.
The message that if you have struggled with weight, your body is broken.
That effort without medication is pointless.
That lifestyle intervention is naive.
That biology is destiny and pharmaceuticals are the only answer.
This is not empowering. It is profoundly disempowering.
It strips people of agency. It dismisses decades of emerging science around insulin resistance, muscle mass, metabolic flexibility, circadian biology, sleep, stress, gut health and personalised nutrition. It ignores the reality that many people have never actually been given the tools, education or structured support required to improve their metabolic health in the first place.
Most people have not failed at weight loss. They have been failed by oversimplified advice, poor systems and a lack of proper guidance.
There is also the uncomfortable issue of conflict of interest. When financial gain, publicity and personal brand expansion intersect with medical narratives, we should all pause. Especially when the person promoting the message holds enormous influence over millions of people who may already feel hopeless about their bodies.
This is not about shaming medication users. It is not about denying that some people may need pharmacological support. It is about resisting the dangerous idea that one person’s experience should become a universal truth, particularly when that narrative conveniently aligns with profit.
Weight loss is not a moral failure. But neither is it a condition that should automatically medicalised for life without first addressing the modifiable drivers beneath it.
Oprah had a choice. Her choice may have been right for her. But she does not get to tell the world to stop trying.
And the fact that so many are celebrating this uncritically is what truly baffles me.
Because when we stop asking who benefits, who decides, and who is being silenced in the process, we stop protecting people. And that should concern all of us.
