Editor’s Note: Adrienne Bitar is the author of “Diet and the Disease of Civilization” and a lecturer in American Studies at Cornell University. The views expressed in this commentary are her own. View more opinion on CNN.
Oprah Winfrey recently disclosed that she had taken weight-loss medication, and some Americans felt betrayed. How could she, the queen of WeightWatchers and doyenne of dieting, be abandoning the equation of diet + exercise = slim? Maybe because Oprah is conceding an uncomfortable truth: Diets rarely work. It doesn’t matter how much grit or willpower you have or how hard you’re willing to work, the weight comes back; it nearly always does.
If Oprah’s army of chefs and trainers couldn’t transform her into a size 6 without drugs, then maybe it’s time to question the tired American (diet) dream that hard work = success and redefine success altogether.
Dieting is a theory and a practice. In theory, we’re desperate to believe our bodies bend to our will and health is infinitely improvable. In practice, we watch our bodies break and bend. We age. Cancer comes. Tragedy strikes. We all get sick from something. Still, diets often give people hope – if not health – to do hard things and take a first step toward something bigger. In fact, studies find that deciding to diet makes people feel stronger, just like deciding to exercise makes would-be-exercisers feel taller.
This year, let’s remember our bodies are not evidence of our human value. Taking weight-loss drugs, rejecting diet culture or choosing to diet are all valid health decisions. Oprah’s prescription for weight-loss drugs reveals nothing about her work ethic. Rejecting diet culture wholesale is powerful and empowering. And going on a diet can be fulfilling, inspiring dieters to do hard things, or at least feel stronger while they try.
But these decisions are often ridiculed. Oprah told People magazine the weight-loss medication “feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for.” People are fat-shamed and shamed for not doing anything about their weight but suffer through a diet. Memes mock those with “Ozempic face” for their gaunt expressions; with anonymity, some Reddit users call these drugs the easy way out; Jimmy Kimmel made weight loss drug users the butt of the joke at the 2023 Oscars.
These critics are clinging to an illusion: the American diet dream that hard work equals success and medication turns hardworking dieters into lazy cheats. In fact, diets have long embraced pleasure, not suffering, and many diets reject hunger altogether (case in point: the 1966 Martinis and Whipped Cream diet or the historic 1972 Atkins “no-hunger diet”). Even more, weight loss has long been a by-any-means-necessary racket, with little integrity to compromise.
Just look at the tragic history of diet drugs. Introduced in 1907, the thyroid gland extract Marmola remained a popular obesity remedy even after doctors discovered that it caused speeding heart rates and insomnia. Doctors only stopped prescribing the deadly dinitrophenol (DNP) in 1938 when the Federal Food, Drug, and Cosmetic Act labelled the drug “extremely dangerous.” (Still, dieters are dying from illegal DNP purchased over the internet).
Amphetamines and methamphetamines were touted as effortless and easy ways to lose weight for much of the mid-20th century. In the 1990s, the drug fen-phen was similarly regarded as a miracle diet cure until the FDA forced a withdrawal.
Exercise has similarly changed over time. Unlike the “no pain, no gain” mentality today, many 18th and 19th century fitness enthusiasts recommended sailing, standing, rocking, bathing, fishing, massage, shampooing, waving flags, trips to the Turkish bath and rides in horse-drawn carriages (perhaps over to the Turkish bath).
John Harvey Kellogg championed passive exercise, which was as relaxing as it sounds. He invented vibrating machines to move the body while the user remained largely still, allowing the machine to move his limbs or jiggle his fat away. Twenty minutes of vibration could stimulate the body as much as a 4-mile walk, Kellogg promised. By the 1950s, newspapers were writing about weight-loss salons, noting that their “passive exercise” provided a workout that approximated 36 holes of golf. One such salon, Slenderella, called “diet” a taboo word.
Today, our 21st century obesity medications might seem like magic bullets. But in reality, for some, weight loss on these drugs may be more modest than spectacular. Plateaus are common and can be discouraging. If the dieter stops their weekly injectable, the weight often comes right back.
It’s costly, it’s uncomfortable, and it can result in side effects: a grab bag of GI issues, some as serious as stomach paralysis or bowel obstruction. When considered in this context, semaglutide isn’t the weight loss panacea it may appear to be.
And even if taking semaglutide were just as hard as diet and exercise, diets are not a trial by fire to prove our modern mettle. Why do we praise hardship as heroic? There’s nothing noble about suffering through a diet, especially in the service of fickle beauty ideals and the pursuit of a slimmer body.
Oprah and the millions of other Americans on prescription semaglutide and similar medications should be respected — or at least not ridiculed — for ignoring the insults and choosing what’s right for them, drug or no drug, diet or no diet.
