What's the best way to lose weight? 'It's everything,' Oprah says - including medication

By Charles Passy

Oprah revealed she's using weight-loss medication as part of her diet plan. Obesity experts also recommend combining diet, exercise and behavioral changes, possibly in tandem with drugs or surgery.

If you want to follow Oprah Winfrey's latest plan for losing weight, be prepared to do, well, everything - such as possibly taking medication.

At least that's how Winfrey, who has been showing off a noticeably trimmer figure of late, described what she's been doing. When asked about her new weight-loss approach at "The Color Purple" movie musical premiere last week, the 69-year-old media mogul told "Entertainment Tonight" that, "It's not one thing. It's everything." And on Wednesday, she revealed to People that she is using weight-loss medication, although she didn't disclose which one.

"I now use it as I feel I need it, as a tool to manage not yo-yoing," she said.

Winfrey, who is a board member of WW International (WW) (formerly Weight Watchers) and has long championed the company, said she sees access to weight-loss drugs as a "gift." And she doesn't want anyone to feel shame for using medication to manage their weight.

"The fact that there's a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for," she said. "I'm absolutely done with the shaming from other people and particularly myself."

'The fact that there's a medically approved prescription for managing weight and staying healthier, in my lifetime, feels ... like a giftOprah

Indeed, experts agree that her "everything" approach to slimming down could include taking some of the popular medications now used for weight loss, such as Ozempic, Wegovy and the newly-approved Zepbound.

For that matter, weight-loss surgery, such as gastric bypass or banding, is also still an option for those who are struggling with obesity.

But regardless of what Winfrey or anyone else is doing, a multifaceted approach to weight loss - again, "It's everything" - is one that's being heavily recommended by physicians and other specialists who work in this area.

"Weight-loss success is always based on the entire lifestyle, and not just certain components," said Cesar Sauza, a registered dietitian and nutritionist with EHProject, a company that provides information about weight loss through its website.

That idea is seconded by Dr. Amy Lee, chief medical officer for PEAR Health Labs, a company that sells fitness products and solutions.

"You have to eat appropriately, incorporate movement and follow a lower-stress lifestyle, along with surgery and/or medication," Lee said.

Of course, this isn't an entirely new idea, since we've long heard of the importance of diet and exercise as a key combo to shedding some pounds. And plans like WW have long included behavior modification as a critical element, along with group support.

But at a time when weight-loss medications are gaining such acceptance - Goldman Sachs recently predicted the annual market for these drugs could grow to $100 billion by 2030 - the concern is that some people will see the drugs as a "magic pill" of sorts, and the only solution they need to tip the scales in their favor.

Ultimately, you want lots of tools in your weight-loss tool kit, experts advise. And just as important: There's no single combination of methods that works best for everyone.

"Different people need different things," said Dr. Holly Lofton, director of NYU Langone's medical weight-management program in New York City.

Even then, the combination approach takes some personalized parsing. For example, which diet plan should you follow? And if you're taking Ozempic or any of the other weight-loss medications, then is one diet better than the rest?

Ultimately, you want lots of tools in your weight-loss tool kit, experts advise.

Like many in the weight-loss world, Lofton isn't a fan of fad diets, and emphasizes sensible eating plans to her patients. "If you've lost 30 pounds in a month and you're eating cabbage soup, that's the wrong way," she said.

At the same time, Lofton also said it comes down to simple math - that is, you need to take in fewer calories a day, no matter which diet you choose. But one caveat: If you're on weight-loss medications, then Lofton advises against consuming high-fat foods and drinking too much alcohol, because she says those things will interact with the drugs in such a way to cause an upset stomach.

Of course, for those who combine these many approaches to losing weight, the cost of "everything" is going to add up.

The weight-loss industry is a $75 billion behemoth, according to research firm Marketdata - and the parts of it each equate to sizable chunks.

Weight-loss drugs can run from $936 a month for Ozempic to $1,349 a month for Wegovy, according to health-policy researcher KFF - at least for those who don't have insurance that covers the medications. Gym memberships average anywhere from around $40 to $75 monthly, depending on which state you call home, according to one survey.

And if you opt for bariatric surgery and have to go the self-pay route, your costs can top $30,000, according to the GoodRx Health site.

We can only guess what exactly is in Winfrey's "everything" tool kit, though we suspect she can afford whatever approach she has taken. Winfrey's representatives didn't respond to a request for comment.

Meanwhile, WW International also seems to be promoting an "everything" approach that includes medication by virtue of the fact that it recently acquired Sequence, a company that provides weight-loss solutions incorporating drugs like Ozempic and Wegovy. A spokesperson for WW International had no immediate comment for this story.

-Charles Passy

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12-13-23 1438ET

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