Pod Insights The Oprah Podcast Serena Williams and Oprah on Deciding to Take GLP-1 Medications About this episode For her most of her adult life, Oprah has struggled with her weight. She never dreamed in her lifetime, there would be medications that could help her as well as millions of others. On this episode of The Oprah Podcast, Oprah is joined by Dr. Ania Jastreboff, leading endocrinologist and associate professor at Yale School of Medicine in front of a live audience in New York City.
They discuss Dr. Ania’s new book, Enough: Your Health, Your Weight, and What It's Like To Be Free which delivers a deeply transformational message: there is a path to healing from the blame and shame of obesity to lead the life you have always wanted. Dr. Jastreboff shares the science behind why obesity is a disease and not a question of willpower and why the new medications have been so effective for tens of millions of people. Oprah shares her decades-long public struggle with her weight and reveals how her experience with a GLP-1 medication has given her a freedom and energy she never thought possible. Plus, 23-time grand slam tennis champion Serena Williams joins the conversation and opens up about her own battle with weight calling it “the one opponent she couldn't defeat.” Serena also reveals why - after her initial skepticism - she decided to start a GLP-1 medication. Finally, we hear from guests in the audience about how the GLP-1 medications have changed their lives. One of those guests is Stedman Graham’s nephew Julius who shares with heartbreaking honesty how his weight held him back for decades. He says that after losing 64 pounds on a GLP-1 medication he is now “fully alive.”
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00:00:00 - Welcome Dr. Ania Jastreboff, author of “Enough”
00:01:30 - 74% of americans are overweight
00:04:30 - Obesity is a disease
00:07:30 - We live in an obesogenic environment
00:09:10 - Genetic link to obesity
00:10:50 - You can’t willpower away obesity
00:13:30 - Defining food noise
00:18:30 - Recalibrating your “enough point”
00:22:30 - Some people have food noise, others don’t
00:23:40 - Welcome Serena Williams
00:27:00 - Why Serena tried GLP-1s
00:29:30 - Everyone responds to GLP-1s differently
00:31:00 - How Serena feels on GLP-1s
00:40:00 - Why your body settles on an unhealthy “enough point”
00:42:00 - Welcome Julius, Stedman’s nephew
00:50:00 - How GLP-1s changed Julius
00:54:00 - Do you stay on GLP-1s forever?
01:02:00 - Can GLP-1s prevent obesity?
01:04:00 - Oprah wants GLP-1s available to all
01:05:40 - Dr. Ania wants people to understand obesity
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Transcript 12,455 words · 14 speakers
Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
0:01 Speaker 00 This episode is brought to you by HBO Max. For your awards consideration, HBO Max presents Rooster. Starring Steve Carell, this new comedy series focuses on the complicated relationship between a successful author and his daughter. Don't miss the series IGN called hilarious and brilliant. Rooster is streaming on HBO Max. Watch now.
0:21 Oprah Winfrey? But I love to dance. I can drop it. I got knees like Megan now.
0:27 Oprah Winfrey? Would you like to see?
0:28 Speaker 02 Yeah.
0:30 Oprah Winfrey? I would love to see. Okay.
0:32 Speaker 02 Okay, happy legs.
0:43 Oprah Winfrey? Hi, everybody. Thank you for joining me on the Oprah Podcast. So great to be here with you who are watching and those of you who are listening and great to be with this fantastic audience in New York City.
0:59 Oprah Winfrey? So I am really, really, really excited for this episode because I have been waiting to share with you all the details of how my life has just opened up in ways that I could never have imagined, okay? I feel strong. I feel vibrant and I feel more connected and alive than I have in decades, in decades. And I can honestly say I feel liberated. I feel a sense of freedom. And the reason I'm so excited to share this is because, just like me, I know that 74%
1:42 Oprah Winfrey? of Americans, that's almost three quarters of us in this country, share the same struggle, being overweight or living with obesity. And besides cancer, did you know this, that besides cancer and heart disease, this is the defining health crisis of the modern age. And for the first time, there actually is real hope. So if you're one of those hundreds of millions of people, or you love somebody who is one of the hundreds of millions of people struggling with their weight because of obesity, maybe this rings true for you. I can say that almost for as long as I can remember...
2:24 Oprah Winfrey? Weight has been a source of shame and embarrassment for me. In fact, I can remember the very first time I was embarrassed by the idea of weight. I'd gotten a scale at the Kmart and I was in the hallway, standing on the scale. And my father passed by and he says, "No need you weighing yourself because you know, you're going to be big. You're going to be big. And no matter what you do, you're always going to be big." He says, "Have you seen your mother? Have you seen your mother and your mother's sisters?" And he tells the story, he says, "I had your mother and your mother's sisters in
3:05 Oprah Winfrey? the back of my Buick and I could hardly drive off with my Buick because they were so big." And I remember that moment and I carry that with me throughout my life. You're going to be big, you're going to be big. Remember your mother, remember your aunts. And about three years ago, that core belief that I was destined to be big started to shift in the most profound way when I learned that for so many of us, obesity is a disease. The science is now clear. Obesity is not a choice. It is not caused by a lack of willpower or inherent laziness or you not doing enough. It is a disease.
3:48 Oprah Winfrey? And this is one of the most astonishing revelations of my lifetime, I have to say. So I want to introduce you to Dr. Anya Yastrov. She is an endocrinologist and professor at the Yale School of Medicine. And hi, Anya.
4:02 Speaker 03 Hi, hi Oprah.
4:03 Oprah Winfrey? For 15 years, Dr. Anya has been at the forefront of the research on the new GLP-1 based medications. And now she has written a book. And I tell my weight loss story in the book. And the book is called Enough. Enough.
4:21 Oprah Winfrey? Your health and weight and what it's like to be free. So my hope is that this book will help all of you who are on your own weight journey, whether you are taking the new GLP-1 medications or not. It is the book that I wish I had when I'd started and wish I'd had long ago when I didn't even know that obesity was a disease. So, welcome back to the podcast, Dr. Anya.
4:47 Speaker 03 Thank you so much for having me.
4:49 Oprah Winfrey? You have been studying this now for decades. And this is the thing that struck me, that you all who've been studying this have known that obesity was a disease, at least for the past 10 years.
5:03 Speaker 03 Yes, yes, yes, we have, actually longer than that.
5:06 Oprah Winfrey? Okay, longer than that, okay, okay. And how did we all miss the memo?
5:14 Speaker 03 Well, it's one thing for a medical association to declare obesity as a disease, right? So the AMA declared obesity as a disease in 2013. The WHO declared it as a disease in 1948. And actually, we already knew that obesity was a disease back in Egyptian times. It's another thing to say that it's because of biology and to understand that there's a biology that is driving that obesity. And it wasn't really until the mid 1990s with the discovery of leptin, which is a hormone made by our fat, that we started to understand that hormones communicate with the brain and that can lead to obesity biology. The other part of it is the new medicines.
5:56 Speaker 03 The new medicines actually opened up an entire new world in terms of helping us to understand the biology of obesity. So until we had effective treatments, there wasn't necessarily a way to treat that obesity. And so they were key in helping us to understand the biology, which is why obesity is a disease, not because an association declares it to be.
6:16 Oprah Winfrey? Yeah, I get that part. So what we all want to know, and for you to explain in as layman's terms as possible...
6:26 Oprah Winfrey? Um, why it is a disease? Now, the very first time I heard this, I likened it into, because I know there are a whole lot of naysayers and a lot of people who want to believe that it isn't, even though the science is saying it is. But, you know, I've been through this. I've lived long enough and done conversations long enough that I remember in the very early days of doing the Oprah Show, like in, like in 1986, 1987, the very first time we did a show on alcoholism. And doctors were saying alcoholism is a disease. The audience, all the people, although we did not have social media at the time, were like, "Oh, no, just put down the bottle. Why can't you just stop drinking?" People did not understand
7:09 Speaker 03 Yeah.
7:09 Oprah Winfrey? that there are some people who are genetically prone
7:13 Speaker 03 Yeah.
7:14 Oprah Winfrey? for it being a disease. And that everybody who drinks is not an alcoholic. But there are many people who drink. And because of what alcohol does to their bodies, because of their genes, is very different than people who just... So is it the same thing? Lots of people are eating in the world. Not everybody is carrying the propensity for obesity.
7:34 Speaker 03 Yes, not everybody is carrying the propensity. Although, as you pointed out, uh, two-thirds or three-fourths of us actually are. So if we had been born 100 years ago, all of us would likely weigh less. So somebody born 100... Well, because of our obesogenic environment. So an environment that is filled with ultra-processed food, lack of physical activity, lots of stress, lack of sleep. All these things lead to the development of obesity. They confuse our biology. And our biology is doing the best that it can to adjust. Um, but if we had been born, let's say somebody was supposed to be normal weight 100 years ago. Fast forward to right now, they may actually have overweight or be overweight.
8:17 Speaker 03 If somebody was supposed to be overweight 100 years ago, if they were born now, they may actually have obesity. And that's because our environment changed much more quickly than our biology. Because our biology evolved thousands of years ago, hundreds of thousands of years ago.
8:33 Oprah Winfrey? Okay, so is it a gene? Is it a hormone? Is it a something within my body that's not in Reese Witherspoon's body?
8:44 Speaker 03 So.
8:45 Oprah Winfrey? I love Reese and I go to Reese because the first time you told me this and you were saying, "Well, it's our environment." I said, "Reese Witherspoon lives in the same environment."
8:53 Speaker 03 Yeah, yeah. She does.
8:55 Oprah Winfrey? She actually lives in the same neighborhood.
8:57 Speaker 03 She does, she does.
8:59 Oprah Winfrey? And Reese does not have this problem.
9:02 Speaker 03 Yeah, and you may walk your dogs together. So genetically, she may have genetic thinness, and I don't know. I don't know the details of Reese Witherspoon. But she may be more likely to be resistant to that environment. But most of us, most of us are not. Most of us end up gaining weight. Now, in terms of the genetics of it, for most people, it's not just one gene. There are people who have monogenic, so single-gene, forms of obesity. But for most of us, it's polygenic. It has to do with our family. So as your dad had pointed out. So if our parents have obesity, we are more likely to have obesity. So there's many genes that are involved. But it's true, some people are more resistant to that environment than others.
9:46 Oprah Winfrey? Time for a quick break. When we come back, Dr. Anya will explain why our bodies are actually physically designed to make it difficult to lose and to keep off weight.
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10:27 Oprah Winfrey? Hi, we're back on the Oprah Podcast. I'm with Dr. Anya talking about her groundbreaking new book, Enough: Your Health, Your Weight, and What It's Like to Be Free. If there's someone you love who is struggling with being overweight or with obesity, I hope you share this episode with them. Okay, over the years, I think I've gained and lost and gained and lost probably, you know, hundreds of pounds. Yeah, everybody has seen me pull out the wagon of fat and I thought that was the end of it. And then I ran a marathon and then I've done Weight Watchers. I've done hundreds of diets, just like many of you have done, hundreds of diets. And I know so many of you feel, as I felt, like your body is fighting against you.
11:08 Speaker 03 Yes.
11:09 Oprah Winfrey? And in the book Enough,
11:11 Speaker 03 Yeah.
11:11 Oprah Winfrey? you talk about us all having an internal thermostat.
11:15 Speaker 03 Yes.
11:16 Oprah Winfrey? And mine, I think, is set at 211 pounds.
11:19 Speaker 03 Yes.
11:20 Oprah Winfrey? And I say that because my body is always, when I first went on, did the fast, back in 1988 and pulled out the wagon of fat, I started out at 211 pounds. After I ran the marathon, put the weight back on, I went back to 211 pounds. 211 seems to be the set point for me, between 211 and 218. My body is fighting to get to 211.
11:43 Speaker 03 Yes.
11:43 Oprah Winfrey? Why is that?
11:44 Speaker 03 Your body's biology is extremely strong, extremely strong.
11:48 Oprah Winfrey? I see that she is.
11:49 Speaker 03 Yes, yes, she is, yes, she is.
11:52 Oprah Winfrey? She's a tough old girl.
11:53 Speaker 03 And
11:54 Oprah Winfrey? She's a tough old girl who wants to be 211.
11:57 Speaker 03 Yes. And I don't know anybody else who has more grit than you do. I mean, you have more grit than someone who has scaled Mount Everest. You have tried everything. You have dieted, you have run marathons, it's just like you said, you have so much grit and yet you cannot overcome this. And that's because we cannot, we'll power away the biology of obesity.
12:16 Oprah Winfrey? Okay, so this is the most important thing to know for everybody who, they saying and doesn't really get it yet. Your body is always fighting to get back to a certain internal thermostat.
12:28 Speaker 03 Yeah.
12:29 Oprah Winfrey? And for all of us, that thermostat is different. As I just said, mine seems to be between 211 and 218. You all are all thinking about what your number is, right? Because you always, no matter what, end up back in that, in that range.
12:44 Speaker 03 And I can explain it with an analogy. So, we can think about a house and a house has a thermostat. We don't really think about it, it's just set to a certain temperature. Let's say 70 degrees Fahrenheit. And when it is hot outside, what happens? The AC turns on. We don't think about it, right? When it's cold outside, what happens? The furnace turns on. And ultimately, that temperature is 70 degrees Fahrenheit. It's just there. Your body does this with so many different things. It does this with body temperature. So for example, body temperature 98.6. Are any of us sitting here thinking to ourselves, "I must keep my body temperature 98.6"? No, we're not. If we're cold, like we are right now, we shiver.
13:24 Oprah Winfrey? Yeah.
13:24 Speaker 03 If we are hot, then we will sweat, right? So we keep it there. It turns out our body does the exact same thing with fat. It has this amount of fat in mind. And for Oprah, that amount of fat somehow equates to about 211 pounds. So what does that mean? When Oprah diets, when she exercises, when she does all the things, all the things, what happens is her appetite increases. Her appetite increases and her body says, "Eat more and burn less. Be more efficient with the energy that you have." In the same way, what our body does is actually when we gain weight, it does the opposite. It turns down our appetite and it helps us burn more.
14:06 Speaker 03 But the way that we are built is to actually always want more. And the reason why we always want more and why our body doesn't think that it has enough is because we are built for survival. And so we don't want to starve. So every time Oprah tried to lose weight, her body was like, "You're starving. You better go eat something else. You better conserve your energy. Do not lose that weight. I do not want you to die."
14:33 Oprah Winfrey? Is that what the food noise is?
14:34 Speaker 03 That's what the food noise is.
14:35 Oprah Winfrey? Yeah.
14:36 Speaker 03 That's exactly what the food noise is.
14:37 Oprah Winfrey? And for those of you who have never experienced food noise because you live in a thinner body and you don't have obesity as a disease or as an issue for you, please explain what food noise is. Because I remember talking to somebody and they were like, "What do you mean? What do you mean food noise?"
14:53 Speaker 03 What are you talking about, food noise?
14:54 Oprah Winfrey? And I go, "Oh."
14:54 Speaker 03 I know.
14:54 Oprah Winfrey? "Oh, you don't know what it is." Okay.
14:58 Speaker 03 So food noise is a manifestation of that biology, of that striving to survive. So basically, what happens is if we are living below our set point, or our enough point. So, again, in Oprah's case, 211 pounds. What happens is, her body's like, "Well, we gotta find a way to eat more. You gotta eat more. If you don't eat more, we're gonna die." So constantly, she may walk by the kitchen and be like, "Hmm, is there something for me to snack on? Is there something..."
15:27 Oprah Winfrey? I call that grazing thing, where you're just standing in the pantry, you're standing with the refrigerator door open.
15:31 Speaker 03 And you don't notice. You just, you, and... So, food noise is a manifestation of that biology. It is persistent. It is disruptive. It is intrusive. It really takes our attention away from all these other things that we could be doing. And anytime that somebody is living below their enough point, they may experience food noise.
15:51 Oprah Winfrey? But here's the thing!
15:52 Speaker 03 Yeah.
15:52 Oprah Winfrey? Here's the thing. The moment I took the first GLP-1, I mean, like, the next day, the food noise subsided. And I thought, "What the living hell is going on here?" Because, all these years, I always thought that those of you who do not suffer from this, have not had obesity, or the experience of it, I always thought you all were just stronger, that your willpower was greater, that you, that in spite of all the things I've been able to do in my life, that some, many of you have that thing that allows you to not to think about food.
16:31 Speaker 03 And that is...
16:32 Oprah Winfrey? Then I realized, you weren't even thinking about it.
16:34 Speaker 03 That's right. That's right.
16:35 Oprah Winfrey? You weren't even thinking about it.
16:37 Speaker 03 Yeah.
16:37 Oprah Winfrey? You describe in "Enough" that the discovery of the GLP-1 medications is similar to the discovery of penicillin and insulin.
16:49 Speaker 03 Yes.
16:49 Oprah Winfrey? Why are these medications different than anything we've ever experienced before?
16:55 Speaker 03 Yeah, yeah. Well, there are these moments in medicine, like the discovery of insulin or penicillin. These medicines taught us about the diseases. They taught us about the biology. And they saved millions of people's lives. And that's exactly what these medicines are doing. They're teaching us about the biology, just as we talked about. And they're gonna save millions of people's lives, and they already are. And here's why. Because obesity, in and of itself, is a disease that affects so many of us. But obesity is also associated with over 200 other diseases. 200. So diseases like diabetes, like heart disease, certain types of cancer, hypertension, high cholesterol, all these things. And what is the number one killer of Americans today?
17:40 Speaker 03 It is heart disease. It is heart disease. And if you are a woman and you have obesity, your risk for developing heart disease is 50% higher. And if you are a man, it's 70% higher. And if you already develop type 2 diabetes, it is 90% higher. So if we can effectively treat obesity, we can treat 200 other obesity-related diseases and literally save lives.
18:07 Oprah Winfrey? Well, I think there is that's really. I think there's still. I think there's still a lot of confusion around how and why the GLP-1 medicines work. This book goes into great detail that I know is going to help a lot of you on the journey be able to wrap your brains around this. Can you explain it briefly? How it works?
18:31 Speaker 03 Yeah, sure.
18:31 Oprah Winfrey? Because you think it's working on your stomach. It's not. It's working on your brain.
18:34 Speaker 03 Yeah, yeah. So what happens is that our body wants to survive. And so it sets this, in Oprah's case and in many, many people's case, it sets a higher enough point. Our body doesn't think it has enough. So it's always striving for more, for more fuel, for more fat, for more energy to store, store, store.
18:52 Oprah Winfrey? That's why you called the book that?
18:54 Speaker 03 Yes, that's exactly why I called the book that. I woke up with the idea for the title shortly after the idea for the book came up. And it, you know, really perfectly captured the essence. And that's because our body doesn't think it has enough. Oprah's body doesn't think it has enough. And the medicines recalibrate. They lower the enough point. So that your body knows it has enough, enough food, doesn't need anymore. You just, you just are, you've had enough. The other reason why it's called enough is because we have so unfairly and tragically blamed people for having a disease that is not their fault and that is not their choice. This is about biology, this is about having a disease. And so we've had enough shame and blame.
19:39 Oprah Winfrey? Yeah, that's what the enough meant to me. Enough, enough.
19:42 Speaker 03 Enough, enough. We've had enough.
19:44 Oprah Winfrey? Yeah. We will be back in a moment with the legendary Serena Williams, who gets real about her struggle to lose weight after having children.
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20:21 Oprah Winfrey? We're back on the Oprah Podcast. Dr. Anya and I are joined by Serena Williams, the greatest female tennis player in the history of the world, who opens up about the one opponent she could not defeat. So, this is what I know for sure, that some people, no matter what you do, you can't lose the excess weight. We've watched Serena Williams win championships after championships. You all know she is the GOAT, the greatest of all times. She is an elite world-class athlete, working out every single day, eating healthy food. Even she could not win the battle until now. Come on out here, Serena Williams.
21:16 Oprah Winfrey? 23-time Grand Slam champion, The Goat Serena Williams, says her struggle with weight began after giving birth to her two daughters. In August 2025, Serena announced that she lost 31 pounds on a GLP-1 medication and is now partnering with the telehealth company, Ro, to share her story. Well, this is the thing, when you came out for Ro,
21:40 Speaker 06 Yeah.
21:41 Oprah Winfrey? I went, "Holy Lord Jesus and all your disciples." I felt that that was a seminal moment and I was like so proud of you because I knew that you were gonna get a whole lot of, "Oh, how dare you?" And "What do you mean?" and na, na, na, na, na.
21:58 Speaker 06 Yeah.
21:59 Oprah Winfrey? And what was that like for you, the day that you came out for Ro?
22:02 Speaker 06 Um, I just felt good, you know. First of all, you know me, I don't listen to the noise. I'm like, "Get in line, there's a very long line." Go all the way to the back and you're gonna be a long time before I hear that complaint. But it made so much sense because as you were saying, I'm an elite athlete and I loved hearing what you were talking about because all that stuff makes so much sense. And I think everyone's personal body is different.
22:27 Oprah Winfrey? Yes.
22:27 Speaker 06 And like the food noise, like all the benefits that the GLP-1s can have. I just feel like, for me, I just felt totally different. And I'm literally, like my last, my last match of the Open, I literally was working eight hours a day in the gym, training, and I never could lose an ounce. In fact, I feel like I may have even gained weight.
22:48 Oprah Winfrey? Wow.
22:49 Speaker 06 And it was incredible how my body looked even though I was putting in hours. And I'm talking, we're in the summer in Florida, putting in hours and hours and hours of training. And I was eating life.
23:01 Oprah Winfrey? Well, that's why I said, "Lord Jesus, you know."
23:04 Oprah Winfrey? That if Serena Williams, who's working out eight hours a day.
23:08 Speaker 06 Literally.
23:09 Oprah Winfrey? Cannot lose weight.
23:11 Speaker 06 No.
23:12 Oprah Winfrey? Something's up. It's the biology.
23:14 Speaker 06 I think it's the biology. And I think also when you have kids, maybe that biology changes. You would have to tell me. But I feel like a little of that changed. And also, as you age, a little of it changes. And then you just learn so much about the GLP-1s and how much they're affecting your body with the different proteins that it's doing.
23:30 Speaker 03 Yeah.
23:31 Speaker 06 And it's just.
23:32 Oprah Winfrey? So it did change for you after having your first child?
23:35 Speaker 06 Yeah, absolutely. It did change for me. Yeah, I couldn't lose weight the way I used to.
23:40 Oprah Winfrey? Yeah.
23:40 Speaker 06 And it was actually virtually impossible.
23:43 Speaker 03 Yeah.
23:43 Oprah Winfrey? Yeah, with eight hours. I mean, I can't even imagine. And your workouts, we've seen your workouts.
23:49 Speaker 06 Yes, my workouts are insane. A professional athlete. I was actually playing a professional sport.
23:53 Speaker 03 Yes.
23:54 Speaker 06 So I felt it so important.
23:55 Oprah Winfrey? Drop the mic, y'all, that's it.
23:57 Speaker 06 I felt it so important to tell my story because I felt like a lot of people could relate to that.
24:02 Speaker 03 And I loved when you shared your story because for the very reason, you are the most amazing athlete.
24:09 Speaker 06 Of all times.
24:10 Speaker 03 Of all time.
24:12 Speaker 06 Of all times. But I couldn't beat that weight.
24:15 Speaker 03 Yes.
24:16 Speaker 06 Couldn't beat the weight. The one opponent I could not defeat.
24:20 Oprah Winfrey? Is the weight.
24:21 Speaker 06 Yes. So it was so exciting to work with Row. And then they really wanted, with them, they really wanted to tell a story. They didn't just want to just single out like me. They really wanted to tell a story about so many people were dealing with what I was dealing with.
24:35 Oprah Winfrey? I read that you were initially skeptical of the GLP-1s.
24:39 Speaker 06 Absolutely.
24:39 Oprah Winfrey? Yes.
24:40 Speaker 06 Because it's like the skinny shot. And like, it's a shortcut. And so for years, I didn't, well, not for years, but for a long time, I didn't do it. And I didn't want to do it.
24:47 Oprah Winfrey? Yeah.
24:47 Speaker 06 And I thought like, I'm not going to take the shortcut. You know, I'm going to work harder. But then eventually, I was like, I've tried everything. I've tried every diet. I've tried every workout. I've tried walking for hours. I would go to Europe and Paris, and I would just walk for hours. And the 20,000 steps a day, like every single thing, you know? And nothing was working. Or I would, so this was killing me backstage. I would lose the weight, but my body liked to be. At a certain weight. That was so eye opening for me. I was like, I didn't know that.
25:18 Speaker 03 The enough point.
25:19 Speaker 06 Yes.
25:19 Speaker 03 It wants to be there.
25:20 Speaker 06 And it's so weird because like whenever I lose weight, it's like all of a sudden I'll get even hungrier.
25:25 Speaker 03 Yes.
25:25 Speaker 06 And I'm like.
25:26 Speaker 03 Exactly.
25:27 Speaker 06 And when I reach a certain weight, it wants to go back to the other weight. And I'm like, no.
25:31 Oprah Winfrey? That's your biology. That's your biology.
25:34 Speaker 03 You get hungrier and guess what? When you're playing those amazing tennis matches, your body's burning less. It's more efficient. So it's making you eat more and burn less. Because it wants to keep you at that enough point.
25:46 Speaker 06 Listen, and I had enough of that enough point.
25:48 Speaker 03 That's right.
25:50 Oprah Winfrey? So what made you change your mind about trying the medications?
25:54 Speaker 06 Well, honestly, I've heard a lot about this medication, about the GLP-1s, not only for weight loss. So that's the original reason I got on it because I was like, listen, first of all, I do want to lose weight, but there's also other benefits. I don't know if you can share those benefits, but anyway, I thought there was, I saw, I read there was lots of other benefits. I'm so excited to read your book. Because there's so many more benefits from GLP-1s.
26:15 Speaker 03 Yes.
26:16 Speaker 06 But I was like, let me at least try those benefits and maybe I can lose weight with it. But I would like to say again, everyone's body is different. So I don't know how you guys all feel. I didn't lose, you lost weight, the food noise stopped for you, you said instantly?
26:29 Oprah Winfrey? Yeah, it stopped like the next day.
26:31 Speaker 06 A month or two for me.
26:33 Oprah Winfrey? Really?
26:33 Speaker 06 Yeah, and I don't know if anyone else had that, you know, experience, but a couple of my friends are like, oh, I've been on it for a month and I've only lost like three pounds. I'm like, that's okay, I actually probably lost one pound. So I think everyone's personal body, it talk like, I'm like, talk to me about that.
26:48 Oprah Winfrey? Everybody loses differently. I know somebody who just started, they lost, a female who lost on the lowest, no, lowest dose, lost 13 pounds in one month. That is highly unusual. I hear that there are super responders to this medication.
27:04 Speaker 03 That's right.
27:04 Oprah Winfrey? And there are low responders. There are some people who respond really, really strongly to it and other people don't.
27:11 Speaker 03 And that's because there's different types of obesities. There's not one type of obesity, there's different types of obesities. We just haven't figured.
27:17 Speaker 06 I had the tough time.
27:20 Speaker 03 But you responded, which is really wonderful. And likely what. What happened with you is you probably needed a higher dose. You gotta start at the low dose. We'll talk about side effects later, but we gotta start at the lowest dose and go up.
27:31 Oprah Winfrey? If you don't start at the low dose, everybody, we will talk about side effects later, but if you don't start at the low dose, that's why a lot of people were having major side effects in the beginning, growing up, all of the gastrointestinal issues. Come when you take too high of a dose and you don't gradually move into higher doses.
27:50 Speaker 03 So it's really good because it sounds like you started at the appropriate low dose.
27:55 Oprah Winfrey? I go by the books.
27:56 Speaker 03 You go by the books. Gotta go by the book. Gotta go by the book. And then you go up and you probably just needed to get to that higher dose. It just takes time.
28:03 Oprah Winfrey? Yes.
28:03 Speaker 03 But that's a good thing. The weight did not come on overnight. We don't want it to come off overnight. We want to do it slowly. We want to do it well. We want to maintain all that wonderful muscle mass.
28:13 Oprah Winfrey? Yes.
28:13 Speaker 03 Right? We don't want to lose it all at once. So this is very good. This is very good. Yeah.
28:17 Oprah Winfrey? So you've been now taking the medications for nearly a year. What's changed for you?
28:23 Speaker 06 So my life, I feel happier. I mean, I feel like I have more energy for my kids. I have, I just feel like I can do more. Don't laugh, but I love to dance. I can drop it. I got knees like Megan now.
28:38 Speaker 06 Would you like to see?
28:39 Speaker 02 Yes, I would.
28:40 Speaker 06 I would. I would love to see. Okay.
28:45 Speaker 06 Yeah.
28:49 Speaker 02 Wow.
28:58 Speaker 06 That's so great. No, but seriously, it affects my joints in a, like, my joints are so much lighter and so much better. And I can, I'm like, oh, my goodness, I just wish I had have done this while I was still playing. Like, it would have made such a big difference for me in my career.
29:12 Speaker 02 Well, you could come back.
29:15 Speaker 06 I could, but yeah, so it's just, as I skip over that, okay? It was, it's just like, it's affected me, like, I feel physically so much better. I feel more alert. And it's just, to be able to do things that I could never do, like, even when I was playing, I could never do that at my highest because I realized it was extra weight that my joints were carrying. And I, I can go to the clubs now.
29:41 Oprah Winfrey? We saw you, we saw you, listen, during the Super Bowl, during the thing we did.
29:47 Speaker 06 True, true.
29:48 Oprah Winfrey? I hear, I hear you, you, you really want people to understand, and I think this is so important, that the medications are not a shortcut. I mean, first of all, I think that's why I was so proud of you, because for you, Serena Williams, the greatest of all times, to say you were having problems, and now you understand that it was because of your biology and your enough point for you to not to be able to conquer the weight, means it's, it's, it's, it's truly biological.
30:18 Speaker 06 Yeah, and it's so relatable, because so many people, as we see, are dealing with this. Obesity is a real thing, and the more I read about it, the more how it's just gonna help so many things.
30:29 Speaker 03 Yes.
30:30 Speaker 06 Like, you were talking about heart disease, which is the number one killer.
30:33 Speaker 03 Killer of Americans.
30:34 Speaker 06 Of Americans, and it's just...
30:36 Speaker 03 Thirteen types of cancer, diabetes, all these different things.
30:39 Oprah Winfrey? Well, but, yeah, yeah, I love the way, the way, I love, I love the Ro ad where you said, "I don't take shortcuts."
30:44 Speaker 06 Yes, I don't.
30:45 Oprah Winfrey? You don't.
30:46 Speaker 06 And so I thought that was another thing, and I loved how Ro wanted to put this together, because I've never taken a shortcut in my life. In fact, I would go the longer way to make sure I was the best, to make sure I did the extra work, to make sure I did the most. And so for me, and that's why it took me a little bit to want to start on the GLP one, because I thought, well... Is this a shortcut? And it really wasn't. It's just, if anything, it's just a shortcut to better health.
31:09 Speaker 03 Yeah.
31:09 Speaker 06 And that's just the way to look at it.
31:10 Speaker 03 And it's a way to get healthy. If you had diabetes, we wouldn't say, "Well, I'm sorry, you can't have any insulin. You gotta do all these things."
31:18 Oprah Winfrey? You wouldn't say, "Let me try to do without the insulin as long as I can."
31:21 Speaker 03 Exactly. "Let me concentrate really, really hard and make my blood sugars normal." We would never say that to a patient. Why do we say, "Okay, for the rest of your life, control every morsel of food that you're eating. Control every movement that you're doing for the rest of your life." Why would we ever do that? Let's treat the biology. Let's treat the biology just like we treat it for any other disease. So this is absolutely not a shortcut. This is a way to treat your disease.
31:43 Speaker 06 But I think that we weren't looking at it as a disease.
31:46 Speaker 03 You're absolutely right.
31:47 Speaker 06 I think we were looking at it in a different way. But if you do change how you look at it and change the conversation. This is why this conversation is so important. I'm so glad we talked about this, because I'm like, we have to...
31:55 Oprah Winfrey? I told you we was gonna talk about it.
31:57 Speaker 06 We have to do something.
31:58 Oprah Winfrey? Yeah, we were gonna talk about it.
31:59 Speaker 06 And so it's about having these types of conversations and educating people that this is a disease, now treat it.
32:05 Speaker 03 Yes, and you're a huge part of that.
32:06 Speaker 06 Yeah.
32:07 Speaker 03 And obviously, so is Oprah.
32:08 Speaker 06 Yes.
32:08 Oprah Winfrey? Sade, what did you want to say?
32:10 Speaker 07 Oh, my gosh, Serena. I was on the subway on my way to work when I read that article about you being on the GLP-1s. And I immediately signed up with Ro while on the train. Because given that you are the GOAT and your career is evidence of that, I just knew I could see myself in you and just know that it's been working. I mean, since August, I've lost over 20 pounds.
32:31 Speaker 06 Wow.
32:32 Speaker 07 And as a psychologist by trade, I've always appreciated how you've just showed emotional strength and vulnerability throughout your career. It's really helped women like myself and my clients.
32:43 Speaker 06 Thank you.
32:44 Speaker 07 Be able to understand that resilience is not about not meeting challenges, but really meeting yourself with self-compassion and grace. And while being with Ro on these GLP-1s, I've just had so much compassion for myself. I mean, I was working out four times a week doing HIIT workouts.
33:02 Speaker 06 Me too. I love a HIIT workout, though.
33:04 Speaker 07 Yes, I love it. And you know, I messed it up to so press, but I love it. But, you know, I wasn't seeing any results, and I still had cravings. And then, once I started the GLP-1s... I'm still doing the HIIT workouts four times a week. I still have energy to show up and do that. So it's just been, thank you so much.
33:22 Oprah Winfrey? Doesn't it make the workouts that much better? That's what I've noticed. My workouts have improved exponentially.
33:28 Speaker 07 Absolutely, and my knees, like, I'm not going to drop.
33:32 Oprah Winfrey? Just in case you want to.
33:35 Speaker 07 But even with the running, I'm noticing my joints and knees are not, you know, feeling as tight and heavy and sore.
33:42 Speaker 03 Yeah, and there are, you know, we think there are anti-inflammatory effects. So it's carrying less and it's the anti-inflammatory. And that's, you know, that's where a lot of the research is now because patients are sharing with us what they're experiencing. So already two examples right here. Food noise, the joints, the anti-inflammatory effects. So we're learning from all of you. We're literally learning from all of you.
34:04 Speaker 07 Yeah.
34:05 Oprah Winfrey? Well, and don't you feel freer? Don't you feel freer?
34:07 Speaker 06 I feel freer. I feel better, have more confidence. Not that I, the thing is, it's not that I didn't have confidence before, because I did, but it's just, it's just different. You know what I mean? It just heightened.
34:20 Oprah Winfrey? It tightened.
34:21 Speaker 06 And it's like that self-love. It's like you have it, but then it just comes out in a different type of way. And it takes away things that you didn't know that you were feeling or you were subconsciously feeling because of the extra weight that you had on you. That you tried, you said you would do four workouts a day.
34:35 Speaker 07 Yeah.
34:36 Speaker 06 And like how you weren't losing the weight, I can totally relate. You look great, by the way.
34:39 Speaker 07 Thank you.
34:41 Oprah Winfrey? Well, we know you have a busy schedule, so thank you for stopping by.
34:44 Speaker 06 Thank you, thank you for having me.
34:46 Oprah Winfrey? Thank you so much.
34:47 Speaker 06 Serena, welcome, the greatest of all time. The greatest of all time.
34:51 Speaker 07 Thank you.
34:54 Speaker 06 Thank you so much. See you later.
34:55 Oprah Winfrey? See you.
34:57 Speaker 07 Take care.
34:58 Speaker 06 Bye, everyone, thank you.
35:00 Oprah Winfrey? Bye, Serena.
35:03 Oprah Winfrey? So I want to bring in this audience who have questions. Elizabeth?
35:07 Speaker 08 Hi, Oprah, hi, Dr. Anya. Thank you so much for including me in this important conversation. I've struggled with my weight throughout my whole life. And then I entered the realm of perimenopause, where my body just continued to expand, especially my midsection. And no matter what I did, I could not contain it. It just kept stretching and stretching and stretching. And so...
35:32 Oprah Winfrey? Which makes you even more prone to heart disease, does it not?
35:34 Speaker 03 Yes, yes.
35:35 Oprah Winfrey? Women who carry weight, who carry, carry the weight in the middle. Makes you more prone to heart disease.
35:39 Speaker 08 And I carried it there, and it kept on going with a mind of its own. So, like I said, anything I did just wasn't working. And I've heard of GLP-1s. And when Oprah, you shared your experience and success with GLP-1, and a dear friend and coworker of mine had a profound effect on her life. I said, "I gotta give this a try." The alternative is what? So, I went on Zepbound. It's been eight months. I've lost 52 pounds.
36:11 Oprah Winfrey? Whoa.
36:11 Speaker 08 What's even more exciting, when someone sees me and they're like, "Wow, you've lost so much weight." I was like, "I don't have high cholesterol anymore."
36:18 Speaker 03 That's right.
36:19 Speaker 08 That, to me, is like gold. My cholesterol's been high for so long. It's finally normal for the first time. My A1C is normal. Inflammation, what inflammation? It's, it really has been...
36:32 Oprah Winfrey? How's your blood pressure?
36:33 Speaker 08 Life-changing.
36:35 Oprah Winfrey? And blood pressure?
36:35 Speaker 08 That's good, too. I mean, just everything has been, when I got my labs, which now labs, to me, that's like a rock star. My labs are great. I wear it with a badge of honor, because I have three daughters, and I want to lead by example and show that things are possible.
36:53 Speaker 03 Yes.
36:53 Speaker 08 So, and the food noise. When, after the first day of trying it, I was like, "Wow." I didn't know what food noise was till that voice was gone. And so, my question is, back to food noise. Like, why do some people have food noise? And some people, like my husband, does not have the food noise?
37:14 Speaker 03 Yes, yes. So, first, thank you for sharing your story. It is one that we hear so much. Perimenopause is a time where people gain weight and where women start to carry more fat around their bellies, just like you said, and that can cause diabetes. It can cause all these different things that you're talking about. So, I'm so glad that you are getting healthier, that you are feeling healthier, and that you're feeling great. In terms of the food noise, so it really depends. So some people just don't have it. But people who live away from their set point, from their enough point. So your husband may not be living away from his enough point. He may be living exactly where his brain wants him to be. His brain wants him to carry a certain amount of fat.
37:58 Speaker 03 That's where he is, and that's where he stays. For you, you were working at trying to decrease your weight, to lose some of that fat. And so let's say you were 15 pounds away from wherever you were going to be. Your brain was trying to pull you back up. And a great way that your brain, your brain's super smart. It's like, uh-uh, you gotta eat more, you gotta eat more. So it was manifesting that biology of not having enough to bring you back up to where it wanted you to be. So the farther away you are from your enough point, the more food noise you are likely to have.
38:31 Oprah Winfrey? Thank you. So Carolyn, Carolyn's in our audience. Carolyn, tell us your story and your question.
38:37 Speaker 09 Yes, I have struggled with obesity my whole life. I was three years old when a doctor told my mom that I should go on a diet because I was on the high end of the weight scale. So it's just something that has always been with me. Struggled with the binge restrict cycle throughout my teenage years. When I was 25, I hit 401.6 pounds and decided that I was going to have gastric bypass surgery. So I did at 25 years old in 2020. And in that first year, I lost 180 pounds. Incredible, and I felt amazing. And then for the next year, I felt like that food noise was coming back.
39:19 Speaker 03 Yeah.
39:19 Speaker 09 And I wasn't losing any more weight, even though I wanted to lose more.
39:24 Speaker 03 Yeah.
39:25 Speaker 09 I just felt like I was fighting my own body on a day-to-day basis, just to even stay where I was, not even to lose more weight.
39:32 Speaker 03 Yeah.
39:33 Speaker 09 And then I found these GLP-1 medications, heard about them on social media. And I've been on Zepbound for three years. It's changed my life. I've lost an additional 60 pounds. I feel so much better in myself and have so much more freedom. Like, I didn't realize how much time was spent thinking about food. And now I can... Go about my day and not think about, what am I gonna have for lunch? What am I gonna have for dinner? What am I gonna have for a snack? Am I still hungry? Do I need to eat this?
40:08 Speaker 03 Yeah.
40:09 Speaker 09 Just so much time and energy was spent on what I was going to eat. And then, why am I not enough? Um, why am I not doing enough to, to change my weight?
40:20 Speaker 03 Yeah.
40:21 Speaker 09 And... The title works, no matter... Absolutely. Very good title. I see it works for everyone, yes. And so, I understand that with the weight, with your mind and your body, it sort of, you know, settles on this certain weight.
40:36 Speaker 03 Yes.
40:36 Speaker 09 And why would it do that? In the sense that like, why would it settle on a weight that's not healthy?
40:46 Speaker 03 Yeah.
40:46 Speaker 09 For you? And is there a way to ever change it?
40:48 Speaker 03 Yeah. That is such a great question. So, thank you. Your story is incredible. Um, you have persevered. You've tried all sorts of different treatments for your obesity throughout your entire life. You developed obesity at a very young age. For people who develop obesity at a very young age, so less than five years old, there's likely more of a genetic component. So, I don't know, you know, obviously, your, your history and your medical history and everything, but likely, there's a stronger genetic component for you than for other people. Um, there are many patients who require bariatric surgery and then medications afterwards. So, uh, around 12 to 18 months after bariatric surgery, we can start to see some weight regain.
41:34 Speaker 03 Um, and, and it might be disease progression, meaning your, your body would have had, continued to gain weight. And the, the medications really help with that, just as they have helped you. They, again, they recalibrate. They lower that enough point even more. And that is why you have more freedom from that food noise. That's why you're not thinking about food all the time. The question of why our body allows this, I think that the desire to survive is so strong that our body, our brain specifically, has to make this decision. It makes the decision, well, do I store more fat so that I don't starve, so that I survive no matter what? No matter what, I survive, I survive, I survive. Or do I decrease that enough point and potentially risk not surviving?
42:19 Speaker 03 There is an upper limit, meaning that if there wasn't, because all of us eat enough that we would actually all weigh over 1,000 pounds, right? There is an upper limit. But that upper limit, it's not clear why it's set so much higher than for other things in our body. But it's a great question. I'm so glad that you're persevering and I'm so glad that all these things have helped you. You seem like you're doing great.
42:41 Oprah Winfrey? Yeah, I think the most important thing for everyone to know who suffers from obesity, and it was always a hard word for me to even use because it's been so stigmatized that we didn't even want to use the word obesity or obese to describe ourselves. But anybody who suffered from it, I think the most important thing to understand, and particularly this book that you've written, Enough, is that it's not your fault.
43:11 Speaker 03 That's right.
43:12 Oprah Winfrey? It's not your fault. I heard another doctor recently in Australia say that genes load the gun and the environment pulls the trigger.
43:24 Speaker 03 Yes.
43:25 Oprah Winfrey? And I got, you get that, right? Genes load the gun and the environment pulls the trigger.
43:32 Speaker 03 Yes.
43:32 Oprah Winfrey? And depending on how your genes are loaded into the gun that is you and the environment that you're in, you get the body that you have.
43:40 Speaker 03 Yeah.
43:41 Oprah Winfrey? And so I think to actually understand that, that was Dr. Georgia Regus who says that. After this quick break, we'll hear from one of my family members, Stedman's nephew Julius Graham, about how taking a GLP-1 medication truly saved his life.
43:57 Speaker 10 This episode is brought to you by State Farm. You know those friends who support your preference for podcasts over music on road trips? That's the energy State Farm brings to insurance. With over 19,000 local agents, they help you find the coverage that fits your needs. So you can spend less time worrying about insurance and more time enjoying the ride. Download the State Farm app or go online at statefarm.com. Like a good neighbor, State Farm is there.
44:22 Oprah Winfrey? I welcome you back for more of my conversation with Dr. Anya about the revolutionary GLP-1 medications that have changed the game on obesity and the struggle to lose excess weight. So I want you all to meet now Julius Graham. Julius is a family member. He is Stedman's nephew, so I've known him for many, many, many, many, many years and have been through many, many, many, many weight loss programs with him. He's now lost 64 pounds on a GLP-1 medication. His story is also featured in Dr. Anya's book Called Enough. And Julius, you said that many years, food was your best friend. Explain why.
45:02 Speaker 11 Well, I use food to cope. I didn't know how to survive without it. I just, from an early age, when I was stealing cookies from a relative, from the cookie jar where they had to hide the cookie jar, hiding food under the bed.
45:15 Oprah Winfrey? Hiding food under the bed. Can I tell this story?
45:17 Speaker 11 Yes.
45:19 Oprah Winfrey? Julius lived with us for a while. Julius lived in Chicago with Stedman and I for a while. And one day, we were in the kitchen talking. Remember this?
45:27 Speaker 11 Yes.
45:28 Oprah Winfrey? And we were talking about great snacks. And I said, you know what I loved? I used to love that Fig Newton commercial where they say, darn tootin', I like Fig Newtons. And I said, boy, would I love a Fig Newton right now. And Julius said, you want some Fig Newtons?
45:46 Oprah Winfrey? Honestly, he takes me to his bedroom and under the bed are Oreos Fig Newtons.
45:55 Speaker 11 True story.
45:57 Oprah Winfrey? I mean, Cheetos, Red Hot Cheetos, Ruffles, every, I mean, it's like a store under there and I went.
46:04 Speaker 11 Yeah.
46:05 Oprah Winfrey? But I was just like, what is going on in here?
46:08 Speaker 11 Oh, no.
46:09 Oprah Winfrey? Yeah.
46:10 Speaker 11 So I realized, as I got older, that I was actually addicted to food. I tried every diet, went to rehab for food addiction, did OA, Overeaters Anonymous, did diet weight loss centers. From as early as my freshman year in college, I tried everything. I tried all the diets and the problem with all that was I started to take on the identity of, like, something's wrong with me, I'm not enough, I'm broken, I'm wounded. And that affected every area of my life. And so I'm so grateful for these GLP-1s because it saved my life. Saved my life, gave me a life. Tell them about the story about your grandmother. My grandmother.
46:57 Speaker 11 Okay, she wants me to cry.
46:58 Oprah Winfrey? No, I don't want you to cry. I want you to tell the story because I thought this was a seminal moment for you.
47:03 Speaker 11 Yeah.
47:06 Speaker 11 So for a long time in my life, I had been hiding and felt invisible.
47:12 Speaker 11 And so my grandmother, I got a call that she wasn't gonna make it. My grandmother raised me from a baby and I got the call that she wasn't gonna make it. And I told myself, in my disease mind, in my biology mind, my addict mind, that I just need to lose five pounds, you know, before I go, to see her before she passes away. And how heavy were you in that moment? I was probably in the 300s. And I had so much shame and so much self-torture and, you know, just so, I didn't want to go home. I didn't want anybody to see me, I was embarrassed, I grew up with all the weight,
47:53 Speaker 11 the weight issues and felt like I would be teased and they would still say, "Look at him, he's still not enough, enough." And so anyway, I said, "Let me book my flight." So I booked the flight, I said, "I'm gonna need five days because I can lose a pound a day." And as if five pounds mattered when you weigh 300 pounds, nobody would have cared. So the night before I left, I got a call and the call...
48:26 Speaker 11 You know the call? The call was your grandmother. You know, she's gone. That morning, I was leaving, supposed to leave. You know, that morning, that very morning. So, I've never forgiven myself for that. I was too late. And I just, I've carried that. I've carried that for many years. And it's good to hear, and it's nice to hear, that it wasn't my fault. Because I felt so, I tortured myself about that. The woman who raised me from a baby, who took me in and raised me, I didn't see her before she passed away.
49:08 Speaker 11 And I made that, I also included that into my identity of, "Oh, now you're just not a good person. You didn't even see your grandmother before she passed away." And so, I've lived with that, and...
49:21 Oprah Winfrey? But as you're sharing that story, Julius, I can hear other people sniffling. And I could hear other people thinking about how you've allowed weight in your own life to hold you back from something that was really important. Lots of us have not shown up in the way that we needed to show up in our lives because, for one reason or another, you wanted to lose 10 pounds or 15 pounds, or you didn't feel like you were enough to be there in that moment. So, I really do, you know, you and I have talked about this a lot, hope that you come to some peace about it.
49:57 Speaker 11 Yes.
49:58 Oprah Winfrey? Understanding, number one, the weight wasn't your fault. And also, I was sharing with Julius, I said, "It reminds me of how many times I've gone to the doctor." Anybody else done that? And you, like, take one foot off the scale when you're being weighed. And if you're 211 pounds, like, 208 is not going to make a difference in what the number really is. But you think that it is, in your mind, if you're three or five pounds less, that it's going to make a difference. You think if you're 300 pounds and I lose five pounds, it's going to make a difference to somebody, and it doesn't? And I think it's really appropriate that you said, "In my diseased mind, I was thinking that way." And you were, at first, reluctant. You shared with me, you were reluctant for the GLP-1s too, because...
50:43 Speaker 11 Well, I thought it was the shortcut, like Serena said. I was taught to grind it out. And willpower it out and discipline it out. And I was the guy who spent forty-six hours in the gym as well. And so I could never work out enough. And then, something really struck me. This woman here, who is the hardest working person I know, the most disciplined, who has all the willpower, who has all the grit, as you said. If she can't do it, how am I gonna do it? How am I gonna do it? I didn't stand a chance, so that clicked for me. But it took a while.
51:22 Oprah Winfrey? And so what has happened now that you've been on the medications? What has it been like for you?
51:27 Speaker 11 I mean, my life is just opened up in a way that has never opened up. I'm fully alive, fully engaged. My relationships are better. Everything in my life is just exponentially better.
51:40 Oprah Winfrey? You're right, and this is enough, that self-blame is one of the most pernicious effects of this whole disease, and shame is it.
51:49 Speaker 11 Yep.
51:50 Speaker 03 Yeah, but your story is, I mean, when I heard it the first time, it's heartbreaking. And so many of our patients, so many people with obesity, that's exactly what they experience. And it's so unfair. It is so tragic. Why have we blamed people for this long? It's about biology. And now you know that. And, you know, I hear in your words now, the freedom that you feel. And I wish we had these medicines hundreds of years ago, or decades ago.
52:23 Oprah Winfrey? We do too.
52:26 Oprah Winfrey? Yeah.
52:26 Speaker 03 So that you didn't have to...
52:27 Oprah Winfrey? I'm kind of ticked off that since 2013, y'all have known.
52:33 Speaker 03 We haven't...
52:36 Oprah Winfrey? It's 2023 when I catch on.
52:39 Speaker 03 We did have medications, and we still have them. They're not as effective as the ones that you're taking now. We still use them, but we didn't have as effective medications yet. So, I'm grateful that we have them now. I'm grateful that we can help patients, we can help Julius. We can help our patients.
52:57 Oprah Winfrey? Thank you. Thank you, Julius.
52:59 Speaker 11 Thank you.
52:59 Oprah Winfrey? You know I love you. Thank you.
53:01 Speaker 11 Thank you.
53:02 Oprah Winfrey? You know I love you. We have been through it. We have been through it. We have been through it. Tim? Tim is a high school teacher and lacrosse coach. Bravo to you. I know we need so many more male teachers right now. What is your question for Dr. Anya?
53:20 Speaker 12 Hi, thanks for having me. Appreciate to be part of this conversation. So my number was like 220. I was carrying 220 for years, which was overweight for me.
53:29 Oprah Winfrey? That's your enough point?
53:30 Speaker 12 That was my enough point. At 5'8 1/2", even that was a bigger number ever liked. So several years ago, I had about a six-month window of pretty heavy family stress. My mother had a stroke. Brother had major heart surgery. And my other brother was diagnosed with stage IV colon cancer. So I kind of ate all that on and got up to 246. So that was about a little over a year ago. So a friend of ours had real good success with the program. And I knew my father died of a heart attack years ago and had four previous heart attacks and a stroke as well. So I knew the heart thing was a real threat. So went on Zepbound, lost. I'd say I was a super responder. I dropped in a hurry. I dropped 60 probably in five months. Hit 70 by six months.
54:15 Speaker 12 Tapered the dose, got to where I am now, which is 185. So my question is, now that I'm at a good weight, my blood level's been good. Blood pressure's really good.
54:26 Speaker 03 Great.
54:27 Speaker 12 You know, do I have to stay on it forever? Can I even lower the dose more without going back up? And if I do have to stay on it, you know, what are some long-term effects? You know, from that as well?
54:39 Speaker 03 Great question.
54:41 Oprah Winfrey? That's the question we want. That's the question.
54:46 Speaker 03 And this is probably one of the most common questions, if not the most common question that we get, both from patients and from healthcare providers. And at the crux of it, the baseline is obesity is a chronic disease. It's a chronic disease. It's a lifelong disease. So we need to treat it chronically. We need to treat it lifelong. And this is also why we don't call the medicines weight loss medicines, right? It's not about weight loss per se. It's about maintenance. And what the medicines do is not weight loss. They recalibrate, they lower the enough point so that you, your body wants to carry less weight, wants to carry less fat. So that's exactly what happened to you when you lost all that weight. Your enough point came down and the weight followed. Now, what do we want to do?
55:29 Speaker 03 We want to maintain, we want to maintain that new enough point, so we want to maintain that new weight. What would happen if we would stop it? Well, the enough point, your enough point, would go back up. And what happens when the enough point goes back up? Guess what? You chase it, you go right back up. So you regain the weight. So for most people, on average, they regain the weight. You mentioned blood pressure. Okay, so let's say you were taking a blood pressure medication and your blood pressure came down beautifully, wonderful. What would happen if you stopped taking the blood pressure medicine? Blood pressure would go back up and we're not surprised. It's the same thing with these medications. So right now, what we're finding is in order to maintain that weight reduction, in order to maintain that weight, you have to keep taking the medicine. In terms of the dose, you know, we're working all these things out.
56:14 Speaker 03 We're trying to figure out what the best thing is in terms of maintaining. Right now, just like for other diseases, the medicine that worked for you, the dose that worked for you is likely to maintain, but there could be some variability.
56:24 Oprah Winfrey? Yeah, I tried, I tried to beat this, remember? Because I said, no, I'm going to beat it. I'm going to prove to you that I can do it without it. And so I went for like a year. I took myself off the medications for a year, last year. And I gained 15 pounds. And then I said-
56:40 Speaker 03 Your enough point went back up.
56:41 Oprah Winfrey? My enough point, and I was doing all the things. I was still trying to maintain the same amount because I was like, I'm going to prove her wrong. I'm gonna, I was doing all the same things. I was working out and I was like, okay, so I'm walking 3.5 miles a day. Now I just need to, I'm going to add to five miles a day. Then I'm going to add to six miles a day.
57:02 Speaker 03 Grit, grit.
57:03 Oprah Winfrey? Now I'm going to not eat, eat just one meal a day. I'm going to eat one smaller meal a day and- And I
57:09 Speaker 03 It doesn't matter. Your biology is like, uh-uh. I'm not listening to that.
57:12 Oprah Winfrey? And I stopped myself before. I said, I see where you're going.
57:15 Speaker 03 That's right.
57:15 Oprah Winfrey? Girl, I see where you're going. You heading back to 211.
57:18 Speaker 03 That's right.
57:19 Oprah Winfrey? You heading back there.
57:19 Speaker 03 You can't willpower that biology away. You just can't. It's just, it's just so powerful. It's just so powerful.
57:25 Oprah Winfrey? Yeah, and I was able to keep the weight for like a few months. I was like, no, Dr. Anya, I'm doing really good. And she checked in and said, how are you doing? How you doing? I go, I'm doing really good. And I was like, well, I gained three pounds this week. And then now I gained two pounds this week. So I tried. I tried.
57:41 Speaker 03 Yeah.
57:41 Oprah Winfrey? And I put myself back on in August.
57:43 Speaker 03 And then to, to, to your second point, the long-term side effects. So these medications, GLP-1 receptor agonists and, and GLP-1 GIP receptor. GLP-1 receptor agonists have been used for the treatment of diabetes for 20 years. So we've been monitoring for side effects, for long-term side effects for 20 years. Can I say we know what's going to happen after 30, 40, 50 years? No. With millions of people taking medicines, will everything always be good? No. There's nothing in life that is all good. So we have to keep on monitoring and looking for things. But right now, we're not seeing any long-term detrimental side effects. Now, there are things that come up. In terms of the most common side effects of these medications, they are gastrointestinal.
58:27 Speaker 03 So nausea, diarrhea, constipation, and, and sometimes vomiting. Those are the most common. But the best way that we can not have those side effects, or at least mitigate those side effects, lessen them, we mentioned before, which is to start at the lowest dose and go up very, very slowly.
58:44 Oprah Winfrey? Yeah.
58:44 Speaker 03 We have to start at the lowest dose. So for you, hopefully
58:47 Oprah Winfrey? So that your body gets used to it.
58:49 Speaker 03 Gets used to it. And that also means that, let's say you were going to pause, right? For any reason, or stop them for any reason, because of shortage, or cost, or anything else. If you, if you pause or stop them for any reason at any time, you have to start back at the lower dose again.
59:04 Oprah Winfrey? For more than two weeks, right?
59:05 Speaker 03 And it depends on the medicine. But yes, two to three weeks, because, because of the
59:10 Oprah Winfrey? Because I stopped for a year and then
59:12 Speaker 03 You gotta start at the lowest dose.
59:14 Oprah Winfrey? You had to start back at the lowest dose again.
59:16 Speaker 03 Because otherwise, if you go up too quickly, you're more likely to have nausea, vomiting, diarrhea, constipation. So start low and go slow is really the best way to go. And that takes communication with your provider, and your provider should know that. There are also things that, that, that patients can do to help mitigate those side effects. So they're, they're fairly simple. So it's not eating past the point of fullness. Watching out for which foods may exacerbate your symptoms. So for a lot of people, it's fatty foods. And then the last one is eating smaller but more frequent meals. So those three things really help in terms of mitigating side effects like nausea. Additionally, drinking enough water really helps. If we're dehydrated, one, our kidneys are not happy. And two, it can actually make nausea worse.
1:00:00 Speaker 03 And then the fifth thing that I think is so, so, so, so critical is if you're having side effects, tell your provider. They're there to help you. They're there to work with you and they're going to figure it out. They're going to say, maybe you need a lower dose for a little bit longer and then we'll go up. Maybe we can try this, you know, another way of eating for a little while and that will help you. So they're there to help you with those side effects.
1:00:20 Oprah Winfrey? I'd say if you're on the medications, and listen, I'm not just trying to promote your book, but if you're on the medications, this book is really going to help you. If you're thinking about the medications, this book is really going to help you because I have found that a lot of the providers, they're just getting used to the medications themselves. They really don't know how to advise people. That's what I've discovered.
1:00:43 Speaker 03 And, and what I'll say is, you know, when I went to medical school, it was the late 1990s, we didn't have one lecture about obesity. These medicines didn't exist and we didn't know about the biology of obesity. Leptin had just been discovered, the hormone that your fat makes that communicates with the brain. So we didn't have that education. So in a way, we're playing catch up. We're playing catch up to educate ourselves to then be able to help our patients. And again, these highly effective medications have brought this on. Right now, we have an effective, safe way to treat obesity and, and we have to.
1:01:16 Oprah Winfrey? Obesity and the 200 other.
1:01:17 Speaker 03 Other obesity-related diseases, absolutely.
1:01:20 Oprah Winfrey? Absolutely. All right, Patricia, you had a question? Yes?
1:01:24 Speaker 13 So when I saw you hold up that book called Enough, I immediately thought of you saying to all of us all these years, you are enough. So thank you for that. I'm going to be 48 this month and I've spent 30 of those years on a diet. I started on Weight Watchers when I was 16 and I got to the point where I just didn't think anything was going to help, perimenopause, COVID, et cetera, et cetera. And to be very honest, I was aware of these medications, but I was afraid to take them, very skeptical. I really didn't think they would work.
1:01:56 Speaker 03 Yeah.
1:01:57 Speaker 13 And then I heard Ms. Winfrey was taking them and they were working and I thought, okay, well, maybe I could be brave.
1:02:01 Oprah Winfrey? You can call me Oprah, actually.
1:02:05 Speaker 13 Thank you, Oprah.
1:02:07 Speaker 13 So when I heard Oprah was taking them, I thought, OK, I can be brave and I can try this. And much like Elizabeth, I had terrific success. I've lost 60 pounds. And more importantly, my cholesterol also went down by 60 pounds. And being a person who was diagnosed with high cholesterol at the age of 11, that was remarkable. Wow. More importantly to me, I am built with the genetics of obesity, diabetes, heart disease, high blood pressure. They're all loaded in my genetics.
1:02:39 Speaker 03 Yes.
1:02:39 Speaker 13 And so I've been fighting that my whole life. So what I'm most curious to ask you is, do you think that these medications can prevent obesity?
1:02:49 Speaker 03 Yeah. That is an amazing and incredibly forward-thinking question. We are not there yet. We're not there yet. Hopefully, within our lifetime of about your age. So hopefully, within our lifetime, that will happen. Right now, we have tested the medications in people who have obesity and who have overweight with all of these different things that you're mentioning. High blood pressure, high cholesterol, all those things that you're predisposed to genetically. We don't know whether they're safe yet in people to prevent that obesity. I think, you know, going forward, we may look at that. But right now, we don't know. And this actually brings up a really important point. These are medicines.
1:03:31 Speaker 03 So there's a risk versus benefit ratio that we have to think about. There are side effects, like we talked about. And so these are not weight loss drugs. They're not quick fixes. These are medications. And so we always have to think about the risk versus benefit. We know right now, the benefit of treating patients with obesity to prevent all of these obesity-related diseases is clear. There are many studies coming out about heart disease, about preventing diabetes, about treating knee osteoarthritis, about obstructive sleep apnea. All these things are coming out. We do not yet have studies to look at obesity prevention. But in people who have a genetic, a high genetic predisposition, like we've heard from you, from Elizabeth, those are things that I think we'll look at in the future.
1:04:16 Speaker 03 Great question.
1:04:18 Oprah Winfrey? Great question.
1:04:19 Speaker 03 Yeah.
1:04:19 Oprah Winfrey? So, the reason why I'm doing this, even though I know I'm gonna get a lot of haters for it, is because I just believe that these medications should be accessible to everybody.
1:04:28 Speaker 03 I agree.
1:04:29 Oprah Winfrey? I see how much they have changed my life. I have been in the struggle for a very long time. All of you who've watched me over the years know what that struggle has looked like, up and down, and yo-yoing, and yo-yoing, and yo-yoing, feeling bad about myself, feeling shame, all that. And I just want everybody else to be released from that.
1:04:48 Speaker 03 Yes.
1:04:49 Oprah Winfrey? And to be released as young as possible. I think of all the years and time
1:04:54 Speaker 03 Yes.
1:04:54 Oprah Winfrey? I wasted.
1:04:55 Speaker 03 Yes.
1:04:55 Oprah Winfrey? I wasted, feeling embarrassed, feeling ashamed, feeling like, um, even though I am Oprah and all that that means, and it's a pretty good thing, I will say that. But walking into a store
1:05:11 Speaker 03 Yeah.
1:05:11 Oprah Winfrey? And sensing that thing, when the people just say, "May I show you the handbags? May I show you the gloves? May I show you the shoes?", you know? Uh, feeling like you don't belong in this store, because you know that there's not one single thing in here that's gonna, gonna fit you. So, no amount of money, no amount of success, no amount of fame can, can, can change that. So, I am grateful that the medications have arrived in my lifetime, and I think about all the people who I, I've known, who could have benefited from them. You know what I think about a lot? I actually think a lot about Luther Vandross. And those of you who know Luther know that he had the same struggle, up and down, up and down, up and down. And the other day, I was listening to Luther, and I was thinking,
1:05:56 Oprah Winfrey? "Wow, Luther, if you, you just hung in there, you would've, you would've been able to be around when this came." And I know that he would've benefited so much from it. So, what do you, what do you hope people take away from Enough, the book?
1:06:10 Speaker 03 Yeah, I mean, this book is about compassion. It is about hope. It is about biology, understanding, and freedom. And bottom line is, obesity is not your fault. It is not a choice. It is not about willpower. It is about biology. And it is a disease. And it's a treatable disease. And now we have effective. It's now treatable. And now we have these highly effective, safe medications that can treat obesity. And in so doing, treat over 200 obesity-related diseases. So what that means is that by treating this one disease,
1:06:54 Speaker 03 one patient at a time, we can transform the health and lives of millions of people. We can transform the health of our nation and of the world. And I do think that that's enough.
1:07:11 Oprah Winfrey? Oh, that is good. Good button there.
1:07:20 Oprah Winfrey? Thank you all for sharing your stories. Julius, thank you for being so open, so vulnerable. I think a lot of people are going to remember that story. And think about how you have used weight in your life to hold you back from being the most that you could be, from serving the best you could serve, or showing up the way you needed to show up. Thank you so much for being open enough to do that.
1:07:49 Speaker 03 And I want to thank Oprah.
1:07:50 Speaker 11 Yes.
1:07:52 Speaker 03 Because she's been the most vulnerable. She's been the most shamed, the most blamed for something that has never been her fault. And she has turned her pain, her silent pain, into something so wonderful for all of us. So I thank you. I thank you.
1:08:14 Oprah Winfrey? Well, this is what's amazing to me. Thank you for saying that. But I live with the philosophy that everything is better when you share it. Everything is better when you share it. And I've had that philosophy since I was living on a dirt road in Mississippi, and we only got candy once a year. I would hold on to my candy till my cousins came, because it's a lot better to say, "Ain't this good?" Than to eat it all by yourself. And so, once I discovered this, and I remember doing a show many years ago, talking about weight and gaining weight, losing weight. And I said, "Y'all, if they ever invent a pill, if there's ever a cure, I'll be shouting from the mountaintops. I'll be telling everybody." So, I'm now telling everybody,
1:08:57 Oprah Winfrey? telling everybody about enough. Thank you, Dr. Anya Yashirov. Thank you. Her book, Enough: Your Health, Your Weight, and What It's Like to Be Free, is available now wherever books are sold. A big thank you again to Serena Williams
1:09:15 Oprah Winfrey? and all of our guests. See you next week. Go well, everybody.
1:09:24 Oprah Winfrey? You can subscribe to the Oprah Podcast on YouTube and follow us on Spotify, Apple Podcasts, or wherever you listen. I'll see you next week. Thanks, everybody.
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