Serena Williams and Oprah on Deciding to Take GLP-1 Medications

26:57There are some people who respond really, really strongly to it and other people don't. And that's because there's different types of obesity. There's not one type of obesity. There's different types of obesity. We just haven't figured out. I had the tough type. You have the tough type. You have the tough type. But you responded, which is really wonderful. And likely what happened with you is you probably needed a higher dose. You got to start at the low dose. We'll talk about side effects later, but we got to start at the lowest dose and go up. If you don't start at the low dose, everybody, we will talk about side effects later.

27:25But 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. So it's really good because it sounds like you started at the appropriate low dose. Go by the books. You go by the books. Go by the books. the book. And then you go up and you probably just needed to get to that higher dose. It just takes time. 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.

28:00We want to do it well. We want to maintain all that wonderful muscle mass. Right. We don't want to lose it all at once. So this is very good. This is very good. So you've been now taking the medications for nearly a year. What's changed for you? So my life, I feel happier. I mean, I feel like I have more energy for my kids. I have a, 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. Would you like to see me? Yes, I would. I would. I would love to see. Okay. Yeah!

28:40Wow. Wow.

28:49That's so great. No, but seriously, it affects my joints. And 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 done this while I was still playing. Like, it would have made such a big difference for me in my career. Well, you could come back. I could. But yeah, so it's just, as I skip over that. Okay. 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.

29:27And I can go to the clubs now. We saw you. We saw you. Listen, during the Super Bowl, during the thing we did. I hear 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 truly biological. Yeah, and it's so relatable because so many people, as we see, are dealing with this.

30:14Obesity is a real thing. And the more I read about it, the more how it's just going to help so many things. Yes. Like you were talking about heart disease, which is the number one killer. Killer of Americans. Of Americans. And it's just... 13 types of cancer, diabetes, all these different things. I love the way, I love the Roe ad where you said, I don't take shortcuts. Yes, I don't. You don't. And so I thought that was another thing. And I loved how Roe 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.

30:49And 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? It really wasn't. It's just, if anything, it's just a shortcut to better health. And that's just the way to look at it. 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 got to do all these things. We wouldn't say, let me try to do without the insulin as long as I can. 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.

31:24Why 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. But I think that we weren't looking at it as a disease. You're absolutely right. 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... I told you we was going to talk about it. We have to do something. Yeah, we weren't talking about it.

31:49And so it's about having these types of conversations and educating people that this is a disease now treat it. Yes, and you're a huge part of that. Yeah. And obviously so is Oprah. Yeah. Sade, what did you want to say? Oh, my gosh, Sharina. I was on the subway, on my way to work, when I read the 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. Wow. And as a psychologist by trade, I've always appreciated how you've just showed emotional strength and vulnerability throughout your career.

32:31It's really helped women like myself and my clients be able to understand that, like, resilience is not about, you know, not meeting challenges, but really meeting yourself with self-compassion and grace. And while being with Ro on these JLP1s, I've just had so much compassion for myself. I mean, I was working out four times a week doing HIIT workouts. Oh, me too. I love HIIT workouts, though. Yes, I love it. And you know I messed up the soap 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 ones, I'm still doing the HIIT workouts four times a week.

33:07I still have energy to show up and do that. So it's just been, thank you so much. Doesn't it make the workouts that much better? That's what I've noticed. My workouts have improved, like, exponentially. Absolutely, and my knees, like, I'm not going to drop. Well, just in case you want to. But even with the running, I'm noticing my joints and knees are not, you know, feeling as tight and heavy and sore. 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.

33:46So 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. Yeah. Thank you. And don't you feel freer? Don't you feel freer? I feel freer. I feel I feel better. I 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. It's heightened. And that 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 try.

34:24You said you would do four workouts a day. Yeah. And like how you weren't losing the weight. I can totally relate. You look great, by the way. Thank you. Yeah. Well, we know you have a busy schedule. So thank you for stopping by. Thank you. Thanks for having me. Thank you so much. Serena, what is the greatest of all times? So nice to meet you. The greatest of all times. Thank you. Wow. Thank you so much. See you later. See you. Thank you. Take care. Bye, everyone. Thank you. Bye, Serena. So I want to bring in this audience who have questions. Elizabeth. Hi, Oprah. Hi, Dr. Anya. Thank you so much for including me in this important conversation.

35:04I'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... Which makes you even more prone to heart disease, does it not? Yes, yes. Women who carry weight, who carry the weight in the middle, makes you more prone to heart disease. 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.

35:40And 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 got to give this a try. The alternative is what? So I went on Z-Bound. It's been eight months. I've lost 52 pounds. Whoa. 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. That's right. That to me is like gold. Yes. My cholesterol has 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 your blood pressure life life changing and blood pressure i've 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 yeah 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 yes And the food noise, after the first day of trying it, I was like, wow.

36:50I didn't know what food noise was until that voice was gone. And so my question is, back to food noise, why do some people have food noise and some people, like my husband, does not have the food noise? 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.

37:30So 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. 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.

38:07It's like, uh-uh, you got to eat more. You got to 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. Thank you. So Carolyn, Carolyn's in our audience. Carolyn, tell us your story and your question. 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.

38:45When 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. Yeah. And I wasn't losing any more weight, even though I wanted to lose more. Yeah. 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. Yeah. And then I found these GLP-1 medications, heard about them on social media. and I've been on Z-Bound for three years.

39:34It'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 going to have for lunch? What am I going to have for dinner? What am I going to have for a snack? Am I still hungry? Do I need to eat this? Just so much time and energy was spent on what I was going to eat. And then why am I not enough? Why am I not doing enough to change my weight? The title works no matter what you're saying. Absolutely. Very good title.

40:17I see it works for everyone, yes. And so I understand that with the weight, with your mind and your body, it sort of settles on this certain weight. Yes. And why would it do that in the sense that, like, why would it settle on a weight that's not healthy for you? And is there a way to ever change it? Yeah, that is such a great question. So thank you. Your story is incredible. 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.

41:03So I don't know, you know, obviously your history and your medical history and everything, but likely there's a stronger genetic component for you than for other people. There are many patients who require bariatric surgery and then medications afterwards. So around 12 to 18 months after bariatric surgery, we can start to see some weight regain. and it might be disease progression, meaning your body would have continued to gain weight. And 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.

41:42That'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? 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.

42:25But 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. 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. That's right. It's not your fault. I heard another doctor recently in Australia say that genes load the gun and the environment pulls the trigger.

43:14Yes. And I got, you get that, right? genes load the gun and the environment pulls the trigger. 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. And so I think to actually understand that, that was Dr. Georgia Regas 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. This episode is brought to you by Redfin. You're listening to a podcast, which means you're probably multitasking, maybe even scrolling home listings on Redfin, saving homes without expecting to get them.

43:59But Redfin isn't just built for endless browsing. It's built to help you find and own a home. With agents who close twice as many deals, when you find the one, you've got a real shot at getting it. Get started at redfin.com. Own the dream. 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.

44:40He'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've said that many years, food was your best friend. Explain why. Well, I used 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. Hiding food under the bed. Can I tell this story? Yes. So Julius lived with us for a while. Julius lived in Chicago with Seben and I for a while. And one day we were in the kitchen talking.

45:19Remember this? Yes. We were talking. 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? honestly he takes me to his bedroom and under the bed are oreos fig newtons true story i mean cheetos red hot cheetos ruffles every i mean it's like a store under there and i went yeah but i was just like what is going on in here julius oh no yeah so i realized as i got older that I was actually addicted to food.

46:07I 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. Okay, she wants me to cry. No, I don't want you to cry.

46:52I want you to tell the story because I thought this was a seminal moment for you. Yeah. So for a long time in my life, I had been hiding and felt invisible. and so my grandmother I got a call that she wasn't going to make it my grandmother raised me from a from a baby and I got the call that she wasn't going to 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.

47:41I didn't want anybody to see me. I was embarrassed. I grew up with all the weight, the weight issues. And I 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 going to 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... 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.

48:30So I've never forgiven myself for that. I was too late.

48:40And 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. 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 but as you're sharing that story Julius I could 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.

49:30Lots 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. Yes. 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.

50:11But 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? 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 46 hours in the gym as well.

50:50And 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 going to do it? How am I going to do it? I didn't stand a chance, so that clicked for me. But it took a while. It took a long time. And so what has happened now that you've been on the medications? What has it been like for you? 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.

51:29Everything in my life is just exponentially better. 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. Yeah. 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.

52:15We do, too. Yeah. Yeah. Yeah. So that you didn't have to. I'm kind of ticked off since 2013, y 'all have known. We haven't. It's 2023 when I catch on. And 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. Thank you. Thank you, Julius. Thank you. You know I love you. Thank you. Thank you. You know I love you. We have been through it. We have been through it.

53:01We 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? Hi, thanks for having me. I appreciate it being part of this conversation. So my number was like 220. I was carrying 220 for years, which was overweight for me. That's your enough point? Yeah, my enough point. At 5 '8 and a half, even that was a bigger number than ever liked. So several years ago, I had about a six-month window of pretty heavy family stress. My mother had a stroke. My brother had major heart surgery, and my other brother was diagnosed with stage 4 colon cancer.

53:39So 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 I 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, 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.

54:18Great. You know, do I have to stay on it forever? Can I even lower the dose more without going back up? Yeah. And if I do have to stay on it, you know, what are some long-term effects, you know, from that as well? Great question. That's the question we want. That's the question. 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.

54:56And 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 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 wanna do? We wanna maintain, we wanna maintain that new enough point so we wanna maintain that new weight. What would happen if we would stop it? Well, the enough point, your enough point would go back up.

55:33And what happens when the enough point goes back up? Guess what? but 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.

56:04In terms of the dose, you know, we're working all these things out. 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. Yeah. I tried, I tried to beat this. Remember? Cause 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. Uh, I took myself off the medications for a year last year and I gained 15 pounds. And then I said, My enough point went back up?

56:33My enough point went back up. 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 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 walk. I'm going to add to five miles a day. Then I'm going to add to six miles a day. Grit, grit. Now I'm going to not eat just one meal a day. I'm going to eat one smaller meal a day. It doesn't matter. Your biology is like, uh-uh, I'm not listening to that. I'm going to go right back up. And I stopped myself before I said, I see where you're going.

57:08Girl, I see where you're going. You're heading back to 211. You're heading back there. You can't willpower that biology away. You just can't. It's just so powerful. It's just so powerful. 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'd check in and say, how are you doing? How are you doing? 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. Yeah. And I put myself back on in August. And then to your second point, the long-term side effects.

57:40So these medications, GLP-1 receptor agonists 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.

58:19So nausea, diarrhea, constipation, 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. Yeah. We have to start at the lowest dose. So for you, hopefully. So that your body gets used to it. Your body gets used to it. And that also means that let's say you are going to pause, right, for any reason or stop them for any reason because of shortage or cost or anything else. if you pause or stop them for any reason at any time, you have to start back at the lower dose again.

58:57For more than two weeks, right? And it depends on the medicine, but yes, two to three weeks because of the - Because I stopped for a year and then - You got to start at the lowest dose. You got to start back at the lowest dose again. 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 patients can do to help mitigate those side effects. So they're fairly simple. So it's not eating past the point of fullness, watching out for which foods may exacerbate your symptoms.

59:33So 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. 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.

1:00:06Maybe 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. 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. And what I'll say is, you know, when I went to medical school, it was the late 1990s.

1:00:41We 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 we have to - Obesity and the 200 other - Other obesity-related diseases, absolutely. Absolutely. All right, Patricia, you had a question.

1:01:15Yes. 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. Yeah. And then I heard Miss Winfrey was taking them and they were working and I thought, okay, well, maybe I could be brave.

1:01:54You can call me Oprah, actually. Thank you, Oprah. So when I heard Oprah was taking them, I thought, okay, 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. 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?

1:02:41Yeah. That is an amazing and incredibly forward-thinking question. We are not there yet. We're not there yet. Hopefully within our lifetime. I'm 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.

1:03:19And this actually brings up a really important point. These are medicines. 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.

1:03:55All 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. Great question. Great question. So the reason why I'm doing this, even though I know I'm going to get a lot of hateration for it, is because I just believe that these medications should be accessible to everybody. I agree. I see how much they've 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.

1:04:37And I just want everybody else to be released from that and to be released as young as possible. I think of all the years and time I wasted. I wasted feeling embarrassed, feeling ashamed, I'm feeling like 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 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, feeling like you don't belong in this store because you know that there's not one single thing in here that's going to fit you. So no amount of money, no amount of success, no amount of fame can change that.

1:05:29So I am grateful that the medications have arrived in my lifetime. And I think about all the people who I've known who could have benefited from them. You know, 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, wow, Luther, if you just hung in there, you would have been able to be around when this came. And I know that he would have benefited so much from it. So what do you hope people take away from Enough? Yeah.

1:06:03I 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, one patient at a time, we can transform the health and lives of millions of people.

1:06:55We can transform the health of our nation and of the world. And I do think that that's enough. Oh, that is good. Good button there.

1:07:13Thank 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, from showing up the way you needed to show up. Thank you so much for being open enough to do that. And I want to thank Oprah. Yes. 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.

1:08:03So I thank you. I thank you. 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.

1:08:45I'll be telling everybody. So I'm now telling everybody, telling everybody about enough. Thank you, Dr. Anya Yastroff. 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 and all of our guests see you next week go well everybody

1:09:16you 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

1:09:35We'll see you next time.

1:09:55or Santa Fe Hybrid. Now, during the Hyundai Getaway Sales Event. Hurry, offer ends March 31st. Call 562-314-4603 for details.