GLP-1 drugs—which include blockbusters like Eli Lilly’s Mounjaro and Novo Nordisk’s Ozempic and Wegovy, and which are expected to supplant PD-1 inhibitors as the best-selling drug class by the end of this year—received an hour of free, overwhelmingly positive publicity on Monday night.
It came courtesy of Oprah Winfrey, who hosted a prime-time TV special on ABC titled “Shame, Blame and the Weight Loss Revolution.” Winfrey was an especially fitting host for the topic, as she’s spent decades waging a very public weight loss battle, culminating late last year in the announcement that she’d begun taking a GLP-1 to help manage her weight.
Throughout the hourlong special, Winfrey discussed her own successes with the drug—which she has yet to identify by name, referring to it only as “the medication”—and brought out a handful of fellow patients, doctors and pharma executives to corroborate her support for GLP-1s.
Their testimonials suggested that the growing prevalence of the medications as a weight loss tool marks the early stages of a sea change in how society views obesity: as a disease influenced by biology rather than evidence of a lack of willpower. Winfrey also repeatedly called for an end to “the stigma and the shame and the judgment” around obesity.
In keeping with that positive outlook, the segment largely glossed over the less-sunny aspects of the drugs, including their documented side effects and often high out-of-pocket costs.
Among the fellow GLP-1 users spotlighted in the special were Erika and Maggie Ervie, a mother and her teenage daughter, both of whom are currently taking Novo Nordisk’s Victoza for weight loss. Maggie, now a sophomore in high school, began taking the drug at age 13 and has since lost more than 100 pounds; a recent profile of the teen in The Cut made her a poster child for the controversial decision to make GLP-1s available to adolescents, especially since research suggests that the drugs must be used for life to maintain results.
Though Maggie raved about the positive impact that those results have had on her social life and self-confidence, both mother and daughter said they’d prefer to be on a different GLP-1—Erika cited Wegovy and Eli Lilly’s Zepbound in particular—but noted that they’re unable to afford it because of insurance coverage limitations.
When Winfrey asked why coverage of the drugs for weight loss is still limited, W. Scott Butsch, M.D., director of obesity medicine within the Cleveland Clinic’s Bariatric and Metabolic Institute, suggested that insurers are still reluctant to see obesity as a disease and to cover treatments for it as such.
Later, Winfrey brought out executives from Novo Nordisk and Eli Lilly—appearing together “for the first time in 100 years,” she claimed—both of whom agreed that coverage is lacking, though they stopped short of offering any tangible suggestions for lowering patients’ out-of-pocket costs, let alone lowering their own list prices for the drugs.
“Access is complex, just like the disease itself is complex,” said Negelle Morris, Novo’s senior VP of cardiometabolic sales, while Rhonda Pacheco, Lilly’s group VP of diabetes and obesity, added, “When you look at obesity, it’s nowhere near the coverage that we need.”
Both Novo and Lilly confirmed to Fierce Pharma that they had no financial involvement in Monday night’s special. Novo added in a statement that it didn’t have any control over the program’s production, content or guests, nor did it provide background information or “any funding or sponsorship” to ABC to support the broadcast.
The portion of the broadcast dedicated to discussing side effects associated with GLP-1s began with Winfrey citing the results of a study showing that nearly 17% of people stop taking semaglutide because of side effects, the majority of which are gastrointestinal. She also spoke to a woman who was only able to take the medication for about four months before excessive nausea and vomiting sent her to the emergency room and drove her to quit that unnamed GLP-1.
Despite those reports, however, the doctors interviewed by Winfrey all but brushed aside the concerns.
“I think that they’ve gotten overhyped. Medicines have side effects, but the important part is that they’re mild to moderate in the research studies,” said Amanda Velazquez, M.D., director of obesity medicine at Cedars-Sinai.
“There’s been a lot of hype around pancreatitis, gallbladder complications, concerns for thyroid cancer—so, this has really not been shown in human studies, that this is a downstream complication. And, really, the risk is less than 1%,” she continued, describing some of those complications as merely the result of improperly prescribing GLP-1s to patients with contraindications like medullary thyroid cancer.
Both Velazquez and Butsch have served as paid consultants to makers of GLP-1 drugs.
Jennifer Ashton, M.D., ABC’s chief medical correspondent, echoed Velazquez’s claim that reports of side effects have been overblown. She noted that a rare incident will look less rare as the patient pool increases, shifting attention instead to the “significant” health risks that are tied to not treating obesity at all.
Elsewhere during the segment, Winfrey spoke to WeightWatchers CEO Sima Sistani; Winfrey had previously served as an ambassador for the weight loss program and been on its board of directors since 2015, but she said Monday night that she stepped down from the board and donated her shares in the company to the National Museum of African American History and Culture so that she could speak freely on the TV special.
“Why do we need WeightWatchers when we’ve got Zepbound and Wegovy?” Winfrey asked.
Sistani replied that the company offers more of a holistic, community-focused approach to weight management, adding that WeightWatchers has recently added the missing “biology” component to its approach—which previously focused primarily on lifestyle changes—by acquiring Sequence, a telehealth prescriber of weight-loss drugs.
Ultimately, Winfrey ended the broadcast by offering a “bless you” to viewers of all beliefs: those who don’t feel the need to undergo intensive treatments for obesity, those who believe that diet, exercise and willpower are all that’s needed for weight management and those who find “relief and support and freedom” through GLP-1 drugs.
“The most vital thing is to get trusted information, and also: Let’s stop the shaming and blaming,” she said.