TRESSIE McMILLAN COTTOM: Oprah, Ozempic and us
Thursday, March 21, 2024 -- Oprah Winfrey is back and she wants to talk about losing weight. ... Viewed at a distance and as a whole, the one-hour program was a harbinger of how the weight-loss industry is rebranding: Obesity is a disease and -- for the first time -- it's not your fault.
Posted — UpdatedThat’s Oprah’s trademark: turning big political questions into a personal narrative of freedom and triumph. And it is this special’s raison d’être. Over and over again, deft production turns the thorny issue of weight-loss medicalization into (admittedly compelling) personal stories. But personal stories about prom dresses and self-esteem distract viewers from the inequality of obesity treatments that risk becoming luxury cosmeceuticals.
There is a war brewing between insurers and providers over who can get these drugs, and not even Oprah Winfrey will be able to broker a resolution. True to her brand, she did not try.
What Oprah did try to do is finally write the ending to a story about bodies that she has been writing for almost 40 years. “The Oprah Winfrey Show” went into national syndication in 1986. I was 10 years old. That means I have been in a psychosocial relationship with Oprah’s weight-loss struggles for longer than I have been an adult.
In the 1980s, most of the Black women on television were either fair-skinned beauty queens such as Vanessa Williams or darker-complexioned mother figures like Nell Carter. Oprah was not a thin beauty queen, but she also wasn’t the help. Engaging, articulate, and utterly in control, Oprah embodied possibilities. Along the way, she also introduced a new language about bodies. They could be sites of struggle and changing them could become a public ritual. The show’s 25-year run became a cultural textbook for remaking one’s self as Oprah lost weight, gained weight, pivoted from “skinny” to “fit” and took us along for every part of the ride.
This special reminded audiences that Oprah is remarkably, almost preternaturally, good at making compelling television for a broadcast audience. It was her narrative storytelling that turned “The Oprah Winfrey Show,” a talk show, into something more like long-form narrative. Each episode had a topic. The topics had range: the best vacations, how to know if your husband had cheated on you, reconciling with your racist mother-in-law after you have a biracial baby.
But Oprah also created a meta-narrative in the ongoing story of her weight. Would this be the day, the week, the show, the year that Oprah loves or hates her body?
When Oprah ended her talk show in 2011, she had settled into her body. But settling is not love. In that way, she was, as she had become during her career, a stand-in for millions of Americans. Chained to our bodies, destined to be wed to them, but never falling in love. We are at turns fat, not “fit,” overweight and obese. The acceptable terminology changes. It accommodates new fad diets — Atkins, Mediterranean, low-glycemic — and new morals around bodies. What has not changed is that weight loss is a booming business that seems to have no ceiling. Being fat can be hell. Selling to fat people is profitable.
Then the new drugs came. They work on multiple physiological levels to help some people lose a moderate to a significant amount of weight. Expensive, hard to ignore, these new drugs promise us that weight loss can be more than a new diet. They promise to solve obesity.
Even so, it is hard to overstate how much this has turned the fitness and weight-loss industries upside down. Self-help fitness gurus have long styled themselves priests in America’s Church of Fitness. They preach self-control, calorie deficits, supplements, cardio and strength training. But the truth is that the lithe, ultrafit bodies of people such as Tracy Anderson, Jillian Michaels and Bob Harper have always not so tacitly been selling thinness. The structured programs based on discipline and shame become far less salable when clinical trials disprove their underlying thesis — diet and exercise alone do not work for everybody.
Oprah also used the “it’s not your fault” language to release individuals from the shame of fat bias. But it also does something else. It positions these GLP-1s as management drugs, such as insulin for diabetics or medication for those with high blood pressure. Those are the kinds of drugs that insurance companies are compelled to subsidize.
It is hard to imagine a weight-loss revolution if Medicare continues to limit coverage. Currently the two brands of GLP-1 approved by the Food and Drug Administration for only weight loss are underinsured. Two pharma reps who appeared on the special indicted insurance providers for denying drug coverage. Insurance providers will tell you that demand for the drugs plus the price that the pharma companies charge for them are unsustainable. The obesity crisis is a health financing crisis, just as much as anything else. We can’t solve one without solving the other.
But above all of this, the new weight-loss drugs offered something else to Oprah’s metanarrative. They offered the nation’s dieter in chief a chance to fulfill her show’s destiny — to finally create a body she can love. It was a payoff that some of her audience has perhaps waited 30 years to see. For others, it could be a letdown. A woman so successful that she redefined the term, not just for women, but specifically for Black women born to unglamorous means and expectations. If she cannot fall in love with her body at any size or shape, what hope is there for the rest of us?
In a way, it feels unfair to ask this of Oprah. She gave enough of herself in ushering us through our own national schizophrenia about good bodies and bad bodies. It is unfair to blame her for popularizing diet culture. The Richard Simmonses, Suzanne Somerses, Jane Fondas and Susan Powters of the world deserve some credit. So, too, does the idea of a thin body as a moral body. It is an idea far older than Oprah. And it is an idea with a nasty racist and classist history. In some ways, it is a triumph of its own kind that a Black woman took a foundational idea of white supremacist thinking about aesthetic virtue and turned it into her own private fortune. I’m pretty sure there would have been a dieter in chief even if Oprah had never existed.
The ABC special doesn’t solve the pressing political issues of the weight-loss revolution. But, watching Oprah stand onstage, towering above the audience, wearing the kind of figure-hugging monochromatic jumpsuits she now favors, I realize that this may not be about us. This is about Oprah. You may find inspiration in her final weight-loss chapter. Even if you don’t, she clearly has found a way to love her body. It is hard to judge that.
Related Topics
Copyright 2024 New York Times News Service. All rights reserved.