body image · fitness · weight loss · weight stigma

Scary trifecta: Weight Watchers, Oprah, and Ozempic

abstract photo of a bridge railing in a diamond patter, captured using ICM (intentional camera movement) to create blur. Photo by Tracy Isaacs
Image description: abstract photo of a bridge railing in a diamond patter, captured using ICM (intentional camera movement) to create blur. Photo by Tracy Isaacs

CONTENT WARNING: this post talks about Weight Watchers and medications used for weight loss.

We have been dissing Weight Watchers here for a long time, from Sam’s “I hate you, Weight Watchers” post more than a decade ago to my “Oprah: Eating Bread, Making Bread,” when Oprah took shares in the company and joined the board in 2016. It’s a business. Businesses are interested in making money. Oprah is a brand unto herself. She too is interested in making money.

The culture of weight loss and diet has a well-entrenched stronghold still today, but the oppositional voices are getting louder. Many of us here at the blog are fans of the Maintenance Phase podcast and host Aubrey Gordon’s book about weight loss myths. We’ve read Kate Manne’s Unshrinking and written about it. And we’ve consistently talked about body image, body acceptance, anti-diet perspectives, the disentangling of size and health, rejection of body-shaming — too many posts to count.

And so it was with interest and not a little bit of suspicion and skepticism that I tuned in to the Oprah/Weight Watchers YouTube livestream “event” the other day to find out what new message WW could possibly be peddling under the title: “Making the Shift: A New Way to Think about Weight.” Could they finally, finally be changing to a new narrative that, despite their brand, is NOT about weight loss?

We have been here before, where they have gone from “Weight Watchers” to “WW,” and where they have gone from “dieting” to “lifestyle” and “healthy habits.” None of these shifts has been enough to change their game entirely. I mean, in the end their users are joining to lose weight. What, I wondered, are they up to now?

The event started off inspiring confidence that maybe, just maybe, real change is afoot. Oprah, in her “girlfriend” way, started with a story of total humiliation during her first appearance on the Tonight Show in 1985, when Joan Rivers asked her how she gained “the weight” and had her promising to lose 15 pounds by the end of the show (after which she gained 25). She lamented her contribution to narratives of “weight loss success” over the years, including pushing liquid diets as a path to weight loss. She claimed that one of her career lowpoints, about which she is filled with regret, is that time she rolled a cart of fat equalling in weight the fat she’d lost, onto her stage.

But in her preamble, right after she told her stories, she identified obesity as a “disease” for which no one should carry shame. We should all, she said, love our bodies. She listed of a range of possible ways to go, none of which anyone is obligated to pursue. You do not deserve to be shamed, she said, “whether you choose to start moving more, whether you want to eat differently, whether you want to change your lifestyle, whether you want to take the medications, or whether you choose to do absolutely nothing.” To be satisfied the way you are, where you are, is totally “up to you.” Then the CEO of Weight Watchers, Sima Sistani, came on and apologized for her company’s contribution to diet culture and the harm it has caused to the people who did not reach their goals on their program.

This “event” is part of a series of media moments paving the way for Weight Watchers to start promoting the use of weight loss medications. This is not brand new news, but it was news to me. And I have to say, if you had asked me to predict that “we should all love ourselves without shame” would end up at “and if that includes taking medications to lose weight so you can conform to the cultural standard for acceptable bodies,” I would not have landed there.

With the diet/points program failing to help people achieve long-term weight loss (because diets don’t work), it had two choices: become irrelevant or start encouraging people to take medication. I’ve had it pointed out to me that in some ways this strategy is more on point with the truth of what is required for successful weight loss. And that may be the case.

What I find most egregious about the live-stream is the mixed messaging. I have never thought that the only reason diet culture is harmful is that it’s almost impossible to lose weight and keep it off. That is a harm, to be sure, if people are going to continue to chase an unattainable goal and support the industry that promotes it. But I continue to think that more serious harm is that it reinforces the idea that the only acceptable body type is slimmer. Whether through diet or exercise or medication, weight loss is still the goal. Are we resigned to maintaining this picture and keeping weight loss as a life goal?

This tweak to the weight loss narrative adds a further layer of personal responsibility onto a problem of cultural harm. Keep in mind too that the drugs work by making it easier to consume fewer calories. So in the end, they reinforce the connection between calorie intake and weight gain or loss, thus offering credence to the view that dieting would work but for the dieter eating more than they “should.”

If we could rewrite that conversation with Oprah and Joan Rivers, the gist of it would still be that Oprah should lose the weight, and if that means taking the meds, then take the meds. But is it not more concerning still, is it not, that Joan Rivers felt she had the right to call out Oprah’s size (at all, nevermind so publicly on national television)? Of course Oprah has now very publicly affirmed her use of the new weight loss drugs, like Ozempic, for the purposes of weight loss. And these have now been built into Weight Watchers’ business plan.

It’s tricky of course. No one wants to say we don’t have choices, and that if people opt for a certain choice that’s their business. But there is a tension in broadening the range of pathways to body-acceptance to include new forms of weight loss. It falls into the same category of tension, I think, as anti-aging cosmetic procedures like fillers and surgeries. The more people opt for these “treatments,” the more the prizing of youthful appearance and the rejection of aging faces and bodies remains the normative standard. Does that mean these things shouldn’t be available as options? No. But does it mean that there would be less harm and more opportunity for a healthier and more realistic range, if fewer people chose them. And it would be better if we didn’t feel that normative pressure so strongly. But it’s tough to be an outlier and it takes energy, effort, and awareness to reject the messaging.

To me Oprah + Weight Watchers + weight loss meds is a scary trifecta. The mixed messages have hit a new low. Their contribution to the fear of being fat has not stopped. It has simply evolved with the times to generate a new and profitable income-stream.

health · illness · running

Is My Fitness Fake if I’m Taking Medication?

I ran three days in a row for the first time in I-don’t-know-how-many-years. Not even three short runs. The first two alone, 7 miles, then 8 miles, felt solid and shocking. One day. Two days. And … I felt good. I rinsed and repeated because I couldn’t believe it was true. The third day was giving into the temptation to see how far this feeling good could really go. Another 8 miles, it turned out.

On that third day, I was so surprised to be running, that I started playing. I ran short stretches backwards, because I once heard that helps to balance the muscles and stretch the legs and I figured my legs, which might be in as much shock as my mind, could use the variation. Each time I turned forward again, my legs felt momentarily tired and disoriented. Then I’d catch my groove again. I threw in a few sections of running faster. Not exactly speedwork, more just seeing what the engine could take. Most of the run was on a long causeway that juts out into Lake Champlain. The dirt path was flat and gently curved. So, it was easy to designate far ahead trees as my destination for each of these backwards and forwards interludes.   

When I finished that third run, I felt good. Like there was still a little gas in the tank.

For the last many years (at least 5, possibly 10), there’s always been some objection from my body to running even two days in a row. A tweaky toe. A hampered hamstring. A pesky plantar. And then last year, it was the increasingly extreme fatigue of what was eventually diagnosed as Addison’s Disease. I’m now on daily (multiple times a day) medication, which, along with a low potassium diet, has returned me to health.

And I wonder …

When I got back from that third run, the friend I was staying with commented on my level of fitness, expressing her frustration that she couldn’t run those distances days in a row anymore. A good and healthy response might have been to just say, Thank you. Instead, I started by attributing the runs to luck (maybe it was total eclipse energy) and to the incredibly restorative Normatec leg massage device she has, that I used after each of the runs.

Then I got to the heart of my hesitation to receive her compliment. Maybe I could run three days in a row only because of my medication. I’m not talking about the fact that without my medication I would not be here, because my potassium would have spiked to a fatal level, as it almost did last year when I spent 3 days in an emergency room. Certainly, the fact that my medication keeps me alive allows me to run and do pretty much everything else that’s involved in this business of living. Still, that’s not the heart of my hesitation. It’s that one of my medications is hydrocortisone, which is used to treat adrenocortical deficiency (that’s me), and swelling and inflammation and/or replaces the cortisol hormone that helps your body respond to stress. In other words, maybe if I weren’t taking this steroid, I would not have the energy to do those runs (because my body couldn’t handle the stress), not to mention the anti-inflammatory benefits.

Pill bottle spilling out multi-colour pills, by towfiqu barbhuiya on unsplash

In other, other words, maybe my fitness level is fake. My ability to recover from the runs is rigged, because I’m taking a performance enhancing medication. I’m a Running Ripley (I just started watching Andrew Scott’s formidable performance in this role). I can’t take any credit for the myriad ways in which I work to maintain my fitness level (my foray into Chi running), because none of my effort has real impact, it’s just the drugs. I should just feel lucky and leave it at that. (Recently, a friend pointed out that we need to stop shoulding on others … and ourselves). So, to re-frame, I want to just feel lucky and I’m not quite there.

I am indeed ultra-grateful for all my body does for me. And, I notice there’s a part of me that wants to take credit, to point to this or that training, or eating, or sleep habit. I want my fitness to be the appropriate reward for the Protestant work ethic I grew up with (in a Jewish household). I want to be grateful and feel like I have some control over what my body can do. The conundrum is that the Addison’s took away that feeling of control and the medication gave me back a feeling of control, which I now question.   

This is the psychological wrestling match going on between different parts of myself.

At the moment, there’s nothing to change. I can’t stop taking my medication.

The bottom line is likely the same as it always is: Be grateful. Every day.