How People Treat You Differently After Weight Loss | The Oprah Podcast

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Pet injuries and additional coverage and subject to policy terms. Hi again, everybody, and thank you for listening to the Oprah podcast.
And hello to everybody who's watching us on YouTube. In the few years since GLP-1 medications were approved by the FDA for use for obesity, we have seen how these drugs can result in dramatic weight loss.
But when you lose up to 100 pounds or even more, how does that impact the self-image you had for most of your life? I wish I could say, oh my gosh, it's just been the most perfect experience ever. Do people treat you differently? People look me in the eyes now.
And everyone was so much friendlier to me. How do you see yourself in the world? My life opportunities have opened up, but it's not without its complications.
On this episode of the Oprah podcast, my conversation continues with Dr. Anya Yasterboff, an endocrinologist and associate professor at the Yale School of Medicine.
And we're going to be joined by licensed psychologist psychologist Dr. Rachel Goldman.
For this episode, our guests asked us to share their before and after weight loss pictures because they believe the photos are an important part of their journey. Welcome to part two of our conversation about weight loss medications.
I'm so glad we get another chance to open up the subject for people who are still confused. I'm here with Dr.
Anya Yastrobov, who is an endocrinologist and an associate professor at the Yale School of Medicine. And I wanted to introduce you to one of my producers, longtime producers, Brian.
So Brian, tell us why you started GLP Ones. I've seen the transformation, but when I first started talking about it a year ago, you seemed reluctant.
You were like, I'm going to wait and see. I'm going to think.
And I, you know, have my own burdens to carry and want people to do whatever is good for them. And so I stopped right there when I realized that you were not ready and it wasn't my business to tell you what to do.
What convinced you to do it? It was you, and you don't know the story, but we were right outside here. Yeah.
It was right before we taped the ABC special. We were taping something else here.
We're taping an ABC special called Shame, Blame, and the Weight Loss Revolution. Yes.
You and I had a brief conversation, and I said I was scared of the side effects, and I was scared of mourning the loss of food. Mourning the loss.
I remember you said that. And you said to me, what are you waiting for? And then of course we taped the ABC show.
And the reason I ultimately did it was that push. But you know, I have the classic symptoms and signs of the disease of obesity, which we didn't know we had.
Yes. And I love this question of what are you waiting for? Because in another conversation, we talk to people who put off everything in their life, waiting for the weight to disappear, waiting for the right diet, waiting for the moment, waiting, waiting, waiting.
And when you think about all the times in your life, you delayed, you delayed, you delayed, really the living experience, the vitality of what life is here to bring us because you were waiting on the weight. Yeah.
Waiting on the weight. I had tried every diet.
I counted. I've gained and lost the same 50 pounds six times in my life.
Getting to that point, for me, it didn't feel like I was underwater. It felt like I was empty.
Mentally and physically. And by underwater, you're meaning holding your breath underwater and you're going to eventually rise, yes? Correct.
For me, though, it felt like emptiness. So when I lost the 50 pounds and got to what I now know as my set point, I mentally and physically felt empty and thought, I'm going to eat.
I work so hard. I'm only here once.
Why am I doing this? Yes. Now, I no longer feel that way.
I've lost more weight than I ever have and don't have those feelings. And you're still in the weight losing process? Yes.
Yes. So I started at 312 pounds.
I've lost 70 in five months. So I'm losing about 15 pounds a month.
I need to lose 50 more or would like to.

But yeah, I'm still losing.

And how do you feel?

Fantastic.

I mean...

Brian.

What I didn't know was the anti-inflammatory properties

because I noticed those almost immediately.

The natural aches and pains you have,

I'm over 50, went away.

You're over 50 now.

I'm over 50 now. You were a babe when you started with me.
You've known me for a long year in my 30s. Yeah.
So yeah, I feel great. I mean, I can bend over and tie my shoes.
We were on a shoot in New York. I could run up and down those Starbucks stairs.
Like it's life changing. Okay.
You used to have three desserts, I heard. I was a sugar addict.
So it was a sugar addict. What are those going to be today? And if I don't have them, do I need to have them delivered to the office? Or if somebody put donuts out in the office, I know I'll have one.
How can I sneak the second one so I don't look crazy? And then I had to talk myself out of not eating the third one because I knew I would be sick for the day. So that was the mental gain that was happening to me.
And that was the food noise. Yeah.
I remember when we first talked about this, you were so, you were reluctant because you said about the side effects. So have you had any side effects? None.
I've had a tiny bit of constipation, but that's manageable and I learned how to manage it. And that's it.
I've had no other at all. And the day I took it, whether that's psychosomatic or not, I don't know.
But the day I took it, it all stopped. The food noise, not feeling full.
I did not wake up hungry. I mean, I would be ravenous if I didn't eat lunch until noon.
That's just gone. I look at food like many people must have always looked at food now.
Yes, and isn't it amazing when you think, oh, this is how you all have been doing all this time. It's so freeing.
It's so freeing. You know, a friend of mine shared that it's like, a friend of mine who is on the medication said, I've become ambivalent to food.
It doesn't rule everything in my life. I've become ambivalent to it.
It doesn't enjoy it. That's right.
It doesn't mean you don't enjoy it. So people who have the fear, like you had the fear of losing your enjoyment and pleasure from it, doesn't mean that at all.
You still enjoy it. You just don't want as much.
That's right. All that time you get back from not thinking about it or figuring out how to get it, like I said.
I did want to add, we talked in the first show about misconceptions.

I do want people to know that it's still hard work.

Yes.

It's not a miracle shot.

You don't take it and then eat whatever you like.

I mean, you have to lean into the diet and exercise.

But in doing that, on these medications.

That's exactly what Dr. Anya was saying about when you get blood pressure medication,

they tell you to lower the salt.

When you're getting medication for diabetes, they tell you to lower your glycemic intake. That's right.
So take, eat less sugar. So the same thing is here, leaning into proteins, leaning into healthier food.
And what I have found, it's easier to do. Everything's easier to do, right? Easier to do when you start to eat that way, you crave it even more.
That's what you crave. Yes.
And now a strawberry for me is so satisfying and I'm so grateful for that and that taste. I know.
I freeze grapes as my candy. Yeah.
It's wonderful. The other day I was satiated by a handful of blueberries and I'm like, what has happened to me? Like blueberries are like a delicacy.
Yes. Wow.
These blueberries are so delicious. Tell me, you know, I've talked about this over the years and Brian's been a producer for me for 22 years.
So you've heard me talk a lot about the way even being a known person in the world, how the world treats you differently when you're overweight. And I've always thought it's easier for men because people look and they excuse a big belly, for example, on a guy where is, you know, on a woman they would not.
Have you noticed a difference in how the world receives you? Yes. And you say my belly, but always the first thing people would look at was my belly.
Yeah. Then look me in the eye.
Really? It was huge. Well, I wasn't talking about your belly.
I was talking about guys who carry bellies. I noticed people look me in the eyes now.
We were just in New York doing a Starbucks shoot, and everyone was so much friendlier to me. Strangers in the elevator.
Someone struck up a conversation with me in the lobby. People we were working with.
I mean, I think that... Do you think they would not have struck up a conversation with you 70 pounds heavier? Nobody did.
Really? I also know I feel better and I'm more outgoing, so I probably attract people to say hello or ask me, where are you in from? You know, which is what a guy said to me in the lobby. That never would have happened.
And so... It never would have happened because, is that because you were hiding in plain sight? Yes.
Or you feel that people don't notice you

when you're wearing your obesity?

Both.

I mean, you make yourself invisible

and they don't see you either.

So you're invisible on both sides of that coin.

And it feels great.

It feels so much better.

I've always been kind,

but it allows me to be even extra kindlier.

Is that the word kindlier to people?

Because I feel like it.

Yeah.

Because I know I won't be shot down and I don't have to keep my head down.

Yes.

And I'm just so thrilled for you, Brian.

I'm just so thrilled and so happy for you and that you made the decision, really.

It's a decision to save your own life and to lengthen your life and to live more productively, period.

I'll never get off it.

I thank you for the nudge.

And, you know, I always get emotional, but I want to thank you.

I have a... to lengthen your life and to live more productively, period.
I'll never get off it. I thank you for the nudge.
And, you know, I always get emotional, but I want to thank you. I'll have the opportunity because I do thank God twice a day for it.
But to thank you because I know you've made Zetbound available to people like me. I know you've helped in that process.
So, so grateful. Well, I know you have to get back into the control room.
Yes, I do. All right.
All right. Thank you.
Thank you for sharing. Of course.
Yeah. All right.
All right. Bye.
Bye. All right.
See you in the control room after. One half of U.S.
adults are saying now that they would like to take a weight loss medication, and yet only 12% of Americans have ever taken one. I do think 12% is quite a lot in the past year because when I announced last January, I think, I was like an anomaly, an anomaly in that I was willing to say it.
And I remember Joseph, who does social media for me, said, all these haters are coming after you now. In a year, it will be normalized.
That's right. And you helped normalize it.
You absolutely did. And then you came out, again, so vulnerably, so bravely.
And you shared your story. Yeah.
And again, your voice carries so much. And so I think the fact that people are embracing this now and shifting from shaming people from taking these medicines or for seeking treatment for their obesity, you've had such an incredible impact on that.
Well, I hope to continue to have an impact and let the haters hate on because as I've shared before, my mother was an insulin taking diabetic for most of her adult life. And if this were the dawning of insulin and I had a microphone to tell people what insulin could do for diabetics, that's what I would be doing.
And I feel as strongly about that as I do about these obesity medications. And if we had those obesity medications, perhaps you would not have developed diabetes in the first place.
Absolutely. Yeah.
So researchers have found that GLP-1 medications, we talked a little bit about this,

they also develop diabetes in the first place. Absolutely.
Yeah. So researchers have found that GLP-1 medications, we talked a little bit about this, may also help treat addiction, cardiovascular disease.
We know that they help prevent strokes. They have general anti-inflammatory properties.
Brian was saying after the first week of taking it, he noticed the inflammation going down. And I think the public is confused about this because you hear that list and it seems like a miracle drugs.
What are the facts? Yeah. Well, the facts are that we have many studies now that are coming out all actually within the last year and a half or so about all these other diseases, about heart disease, about obstructive sleep apnea, about reducing knee pain.
So there are over 200 obesity-related diseases that are either caused or a major contributor is obesity. And now we're finding that treating obesity is actually impacting those diseases.
But there's two parts to this. One is that it could be the weight itself, right? So people are always like, well, is it the weight loss? Is it the weight reduction? Or is it something else that the medicines are doing? And it's actually both.
So the medicines work in the brain, and that's how they lower weight. They also work on other tissues and organs in the body.
There are receptors for these medicines on the heart, for some of them on the bone or the fat. So there are direct effects of the medicine on these disease states, these other obesity-related disease states, as well as reducing the weight.
It seems to me, which is another discussion for yet another opportunity to have a podcast, but it seems to me that the insurance companies would be running towards these drugs because if you're going to be able to have an impact on over 200 other obesity related diseases that you would want to prevent. But we're not there yet.
We're not there yet. We're not there yet for many reasons.
One, we talked about in the last podcast, which is that many people are still not understanding that obesity is a disease and it is clearly a neurometabolic disease. Insurance companies among those people.
Right. So the way that we're set up is we're treating the downstream effects of obesity.
So we're putting Band-Aids on all these other diseases rather than treating the root cause, the root cause of all these other diseases. Yes.
And honestly, this is so key because we can transform medicine. By treating this one disease, we can impact hundreds of other diseases.
There are 13, at least 13 types of cancers that are obesity related. We know this.
So colon cancer is one. Another one is postmenopausal breast cancer, endometrial cancer.
These are all cancers that are related to obesity. And one of the questions is, well, if we treat obesity, can we actually impact the development of those diseases? Can we actually prevent cancer? And we don't have the answers to those types of questions yet, but think about the impact.
Yes, I am thinking about the impact and we don't have

the answers because we're at the dawning of this. We are at the dawning.
Right. Thank you so much

for explaining that. Sure.
Thank you for being here with me. We are talking to people who've

lost a significant amount of weight with the help of GLP-1 medications. What is their life like now? More with Dr.
Anya right after this. This podcast is supported by Progressive, a leader in RV insurance.
RVs are for sharing adventures with family, friends, and even your pets. So if you bring your cats and dogs along for the ride, you'll want Progressive RV insurance.
They protect your cats and dogs like family by offering up to $1,000 in optional coverage for vet bills in case of an RV accident, making it a great companion for the responsible pet owner who loves to travel. See Progressive's other benefits and more when you quote RV insurance at Progressive.com today.
Progressive Casualty Insurance Company and affiliates pet injuries and additional coverage subject to policy terms. GLP-1 medications have been life-changing for so many people.
So what happens after you finally lose the weight? How does the world see you now? That's what we're talking about on the Oprah podcast with Dr. Anya.
And we're joined by psychologist Dr. Rachel Goldman.
I want to get back to how this is a holistic change for so many people. Michaela is joining us from Oxford, Ohio.
Hi, Michaela. Hi, thank you so much for having me today.
Thank you. You look beautiful.
Aren't you dressed up? I love that dress and the necklace, the color. So you started dieting at age eight and you were labeled the fat cheerleader.
So let's hear that story. Yeah.
So I have been absolutely struggling with my weight my entire life. I remember being eight years old and walking into the doctor's office and then telling my mom, you need to watch what she's eating, giving me a food pyramid, all of those sort of things.
And that was the moment I remember my struggle with eating started then from that entire time, all the way through high school, all the way through my adult life, even like during the time I was getting married, constantly thinking about how much I weighed, what I was eating and how I was obese. So I knew from a really young age.
And now with the help of ZepBow, I understand it, and bariatric surgery that you've lost 165 pounds. Wow.
That is another whole full person. Congratulations.
How has your life changed? Oh my gosh. So I kind of want to dive into when I was 27, I went to the doctor and I had high blood pressure, high cholesterol, deep apnea.
They were recommending me to be put on oxygen. And since I've been dealing with this, since I was eight years old, I'm like, I can lose the weight.
I can do it myself. It's my fault.
You know, I'll do it. I'll do it.
And finally, the doctor said to me, when are you going to stop blaming yourself and let somebody help you? And that was the phrase that changed my life. I love that.
Say it again. Yes.
She said to me, when are you going to stop blaming yourself and allow someone to help you? I ask you to repeat that because I know that that's going to resonate with a lot of people. When are you going to let someone else help you? And I say that to everybody who is in the struggle right now with obesity.
If you could have fixed it, you would have. That's right.
If it could have been fixed, because like Michaela and like myself, you've done every diet, you've been through every program, you have boiled the soups, you have eaten the grapefruits, you have pulled the skin off the chicken and steamed that broccoli. If you could have done it, you would have done it.
Yes. A million percent.
I tried everything just like you said. And now I'm 30.
I feel like how I probably should have felt when I was 17. All of my comorbidities are gone.
I wake up every morning and I just get to be me. I get to live my life.
I get to eat food and enjoy it and not wonder if I'm going to gain 20 pounds at the end of the week because of what I ate. I use food as fuel.
Just truly get to live my life. I feel like, Oprah, that I have been completely reborn.
Like I am a new person altogether. I am so happy for you.
I am really, truly happy for you because I see how beautiful you are and how vibrantly you are now letting yourself be seen. You would not have worn that 165 pounds ago.
You would not have even put on those earrings 165 pounds ago. I mean, I know.
And I just, I rejoice in your newfound sense of self and sense of well-being. I really do.
Because I know what the struggle is like. What's it been like for you being transitioning into this, I mean, 165 pounds over how much time? It's been about two and a half years now.
Wow. You lost another full, whole person in two and a half years.
And I know people's reactions to you. It's unbelievable, right? Yes.
So I have truly, I wish I could say, oh my gosh, it's just been the most perfect experience ever. But I've truly been funneling through these three emotions and it's been happy, sad, and mad.
And I'm happy because I'm finally who I've always wanted to be. And I finally got the help that I needed and I'm living this amazing life.
I mean, look where I am right now. I'm talking to you, Oprah.
I'm also sad. I'm very sad because no one would listen to me.
I was constantly blamed for such a long time. And I think about the life I could have lived if somebody would have helped me.
And then anger, because like you said, what is the reaction to people seeing me? I constantly get told, oh, you're so pretty. You're such this nice person.
Getting invited to certain things I would never have been invited to before.

And it's like, why now?

Why do you feel like that about me now?

Because I've always been Michaela.

I've always been this person.

But then it fumbled back into happy because I'm just happy I'm here now and happy I'm able to tell this story and advocate for other people just like me.

Well, I want to bring in Dr. Rachel Goldman now, who goes by Dr.
Rachel. There's Dr.
Anya, Dr. Rachel.
And Dr. Rachel, is high again, is zooming in from New York.
She's a licensed psychologist in private practice and a clinical assistant professor in the Department of Psychiatry at the NYU Grossman School of Medicine. So, Dr.
Rachel, you see what Michaela is talking about, right? I do, all the time, unfortunately.

It's completely normal, you know, to be experiencing all of those different emotions because there's so much going on, right?

So if we think about taking the medication, losing this amount of weight, it doesn't just end there, right, as Anya has been talking about.

But there's so many changes going on and emotional changes that people don't really anticipate or expect, unfortunately. And I like to explain it in a way that there's a lot of changes that people don't expect.
And they end up saying like, oh, that's not going to happen to me. And they don't really understand until it does happen to them.
And there's so much because individuals are learning to navigate life in a different body. And that's difficult for many reasons.
Any change can be really overwhelming, a good change or a bad change, right? It can be overwhelming and a lot of emotions. And then when like what Michaela just expressed, you know, people are treating her differently.
People are, you know, or what Brian said before, that people are opening the door for him and being kinder. There's that realization of like, wow, the world in our society is really viewing appearance as, you know, putting so much weight on that appearance.
That's right. Yeah.
I like what Michaela said. The reason why it's so

angering is because you've always been this person. It's not like you became another person.
Michaela, you say not everyone in your life has also been supportive, right? As you expected. How so? So I think when you say you're going to lose all this weight, people automatically assume it's because you hated yourself.
And that's not the case for me. I love myself so much that I wanted to make this change and make this transition.
So when I said I'm going to... I think that's huge.
Underscore that. I loved myself so much.
I wanted to make this change. That's powerful.
I want to live life like that. That's why I did it.
But when you say I'm having bariatric surgery or after having bariatric surgery, I also got on set down because I still needed help. I asked for help a second time.
People are like, well, are you sure you need to? Why don't you try dieting? Why don't you try exercising? Have you tried this? Have you tried that? When like we've talked about, I've done all of those things my entire life. And I think the reason I got that pushback is they thought I was going to fail, like how I failed with everything else.
So I didn't. I've lost the 165 pounds.
And what I've noticed is a lot of the people that would invite me to things and that would show up for me stopped. And I'm not sure if they enjoyed me more as the background friend or like you said, I would have never worn this top or this dress.
I would have never put on these earrings. I would have probably been dressed in all black trying to mute myself out and for no one to see me.
And now I love to be seen. I love to talk.
I be the center of attention in these type of situations. And I have to ask myself, did they prefer me the way that I once was before? I think a lot of people who have friends like us who were overweight, you get accustomed to them being a certain way.
And there is no question about it that the culture feels that people who are overweight are inferior. There's no question that that is the case.
And I don't see how some of that, even if you have the best of friends, some of that doesn't also get interpreted in relationships. Not your most intimate relationships, but in other relationships.
And so being the fat friend serves a lot of people because you're right. The attention isn't on you.
It's always on them. That's what I think.
But let's ask Dr. Rachel.
She has a degree in it. Yes.
And I actually was just going to say that every relationship serves a purpose, right? Yes. Every single one.
And at the time when Mikayla was in a larger body, the relationship that she had with those friends and that dynamic was very different. And now the dynamic is changing, which is, again, unfortunate because she's still Mikayla.
But I am going to add, though, she now has this newfound self-confidence. She has this newfound self-esteem.
She feels better about herself. And that shows.
And everybody around her that isn't, so to say, like catching up so quickly, isn't familiar to that. Right? That's not comfortable.
This isn't the Mikayla we know. Yes, exactly, because we like what's familiar.
We like what's comfortable as humans. So in a way, we're like shaking that dynamic up.
We're changing things. And that can be scary to other people, which is unfortunate for us or for Michaela, because again, she's still Michaela.
Is this a a typical reaction though from some friends? There are friends who are just genuinely, genuinely happy for you. And then there are other friends who are like, oh, you think now you must think you're, you're celebrity, or now you must think you're cute.
Or now you must think, you know what I'm talking about, Mikayla, right? Yes. A million percent, a million percent.
And even like something like this, like, oh, I'm going to be on Oprah's podcast. I know when I say that there will be some people who will be so supportive of me and watch, and then there will be people that won't just because it's me and because I lost the weight.
But they would have been there before when I was 350 plus pounds and living my worst life. But now that I'm living my best life, it's like they've disappeared.
So it's been very hard. So anger and sadness and happiness, are those all normal feelings to be feeling, Dr.
Rachel? Absolutely. And it's important to remember that we can have conflicting feelings and emotions at the same time, right? So we can be feeling happy about aspects of this.
I got my life back. I'm happier and all of these things.
And we can be angry and upset and sad about the other aspects, like the relationships and people treating us differently in the way that the society is. So it's completely normal.
And I think it's important that people remind themselves of that. We can have conflicting emotions and feelings at the same time.
We're human. There's a wide range of emotions that we all have, and we're never just one single emotion.
Got it. Thank you so much, Michaela.
Thank you for joining us. You know, Oprah, if I could say one thing to you, I remember being a little girl, and I heard you talking earlier, and I would see the magazines in the aisle when I was at the grocery store with my mom.
And I remember seeing when you would have a great weight loss success story and how you did it. And then there would be another one like years later, something like, oh, she gained it back, like something so controversial.
And you said earlier, you've been shamed and blamed your entire career. And I just wanted to say, I'm so sorry because I totally understand that.
And thank you so much for what you're doing and using your entire career. And I just wanted to say I'm so sorry because I totally understand that.

And thank you so much for what you're doing

and using your platform to advocate for girls like me

because I have been watching and I've seen it.

I understand.

So just thank you.

Thank you for that.

Thank you for that.

That means so much to me.

Thank you.

I appreciate you.

More with Dr. Anya and Dr.
Rachel. We're talking about the new world of weight loss medications after these messages.
Hi there. Thank you for being here.
What happens in the aftermath of losing a significant amount of weight? Dr. Anya and Dr.
Rachel are taking more questions from viewers and listeners. Anna is a recent college graduate who says that after losing 80 pounds, she finds that guys treat her differently, too.

Anna joins us from Willimantic, Connecticut.

Hi, Anna.

What have you noticed?

I'm still getting over Michaela, looking at the magazines all those years.

Okay.

So what's going on with you?

Hi, Oprah.

Hi, Dr. Anya.
Dr. Anya is actually my mom's doctor.
Um, so good to see you. Great to see you too.
You look just like your mom, just like your mom. Beautiful.
Shout out my mom. So, um, yeah, a few years ago, I kind of started getting into the dating scene.
And you know, when you don't like the way you look, and when you're overweight, it's already so difficult to set up a profile. Just for yourself, you're just like looking at what pictures are kind of the most strategic and not even in a way that you want to hide how you look, because I never wanted to hide the way I looked.
But it was also just like, I just didn't like any pictures of myself. I just never took any pictures of myself because I didn't like the way I looked.
So just starting off,

it's already difficult. And then I remember I would start talking to guys and before I would

go on a date with them, I would always ask them, well, just letting you know, like, I'm bigger or

I'm curvier. Is that okay with you? Like as if the way I look needed to be okay with them, well, just letting you know, like, I'm bigger or I'm curvier.
Is that okay with you? Like as if the way I look needed to be okay with them, which is just so strange. Because thinking about it now, it's like, well, if they didn't like me, then why would they even go on a date with me? And also, like, they've seen how I look.
So it was just, it's very strange that I felt the need to do that. But I do think that that's the way that a lot of people feel dating and a lot of women especially.
Because in dating culture today and in dating app culture, everything is about first impressions and about the way you look. Do you have a question you wanted to ask Dr.
Anya or Dr. Rachel? Yeah.
So I think there's like a misconception that obesity isn't related to mental health. And I guess my question is like, why do people think that and how are they really related? Rachel, you want to take that? Yes.
So great question. And obesity is related to so much as Dr.
Anya had mentioned before, it's, you know, multifactorial. It involves so many different illnesses and diseases.
And we all have mental health and actually everything impacts our mental health. And if we think of just obesity for a moment, you know, we're talking about not just weight, as we've been saying, but we're talking about the emotional aspect, the emotional piece even related to food and eating.
We're talking about body image, self-esteem, self-confidence, self-worth. All of that is being impacted by, again, our weight, our appearance, but also the disease of obesity.
So everything is tied to our mental health and that's going to impact how we act. It's going to impact the way that we think and how we think about ourselves, the words that we use when we talk to ourselves, and that impacts our emotions as well.
So it's absolutely all related. And I really thank you for that question because mental health is so important, and we can't be having this conversation without talking about mental health.
And do you have a lot of patients who share similar concerns when they first start dating, like Anna's sharing? Yes, absolutely. A lot of people come to me saying, you know, I have one client in particular that's like, oh my gosh, I'm flirting.
Like people are flirting with me and I've never experienced this, right? So there's that also that there's a lot of newness to this. And people are, again, like we said before, are going to treat you differently, unfortunately, but it's how we learn to navigate that.
And that's where the emotional piece comes in because this is different. It's something that you're not used to.
It's something that could have caught you off guard, which is why what Dr. Anya said before, I want to just highlight that, for instance, with bariatric surgery, most bariatric surgery programs require individuals to see a mental health provider like myself before having surgery.
And we talk about the changes to expect after surgery. Unfortunately, with these medications, that is not the standard.
And I really wish it was.

I do have a few clients that have come to me saying, I want to start these medications. I know there's going to be changes and I want to talk about it and get ahead of it, which is amazing.
Unfortunately, mental health services, just like certain health care, is not accessible to everybody. And I would think so.
You know, you all are aware that there are a lot of physicians

and, you know, providers who aren't even very familiar with the drugs themselves. You know, they were just handed the drugs through the drug companies or whatever, and they don't even understand themselves how the drugs work or what to expect.
And I just think there needs to be more education for the physicians themselves. And I know a lot of people in, you know, that are not in Los Angeles and not in New York, but are in, you know, rural areas and so forth.
And their doctors don't know anything about it. And their doctors are still telling them to go on a diet.
I mean, and in terms of the education, none of us learned about this in medical school. You know, I was in medical school nearly three decades ago.
We didn't have any education about obesity. I don't even think we had, maybe we had one lecture about nutrition or what food was.
So there really wasn't any of that. And the thing is, is we didn't have highly effective tools beyond bariatric surgery,

which, of course, is a very highly effective tool.

But we didn't have medications.

And so, in essence, there wasn't the education around it because we didn't have a medical way of treating.

We had a surgical way, but not a medical way.

And the medications, these highly effective medications, they come out and now we're playing catch up.

We're trying to make sure there's enough education in medical schools and residencies and fellowships. We're trying to make sure that that happens, but it's playing catch up.
And in terms of psychological support, super critical. Thank you so much.
Thank you, Dr. Rachel.
Thank you. Thank you, Anna.
Thank you so much. Thank you so much.
Keep on shining. Keep shining shining keep your light shining keep going and enjoy the flirting flirt back flirt back okay okay 27 year old jewel uh is joining us from new york city and her mother marissa from st louis the last time we spoke on the abc special shame blame Blame, and the Weight Loss Revolution, Jewel, I remember you telling us, look at you! Girl! I remember you telling us your highest weight was around 390, and now what has happened? So I weighed myself this morning because I wanted to be super accurate for you.
Today we are 284, which is 26 pounds since the last time I saw you and 107 pounds total, which is crazy. Wow.
And how has your life changed? Honestly, it has been so much more complicated than I anticipated. I think that I had always growing up in a bigger body expected that once I finally got the weight off, it would be I'm happy and this is it.
That was my only thing standing in my way. Um, so I am, I have so many more options available to me.
My life opportunities have opened up in a way that like make me feel so proud, but it's not without its complications. Like, like Dr.
Rachel was talking, my mental health has been, you know, we're doing roller coasters. We're doing jumping jacks, cartwheels, and somersaults.
Like it's up and down. And I think that I wasn't anticipating that, but the way that I have fought my way through it, I think has given me a level of confidence that I could not have had if I didn't go through everything that I went through.
I mean, even the tone of your voice is different than when I first spoke to you and the state of weight. Marissa, what changes have you seen in your daughter since she started on these medications? What have you noticed? I bet it's been a roller coaster for you two, too.
It's been great for the most part. Her confidence is up.
Her sense of self is way up. We talk about weight a lot less.
Like our conversations are much more mother-daughter fun. She's thriving as a young adult now and living her best life, right? She's focusing on other goals besides just about weight.
You know, she's taking up hobbies and American Sign Language and just, you know, she focuses on non-scale victories and, you know, airplane seats and going to the theater comfortably. And so it's just refreshing to watch her live.
And to be honest, I feel like she kind of takes it for granted a little bit. Like she forgets where she's come from.
Like she takes it for granted a little bit. But she has come such a long way.
She's like, oh, it's just a lifestyle now. No big deal.
I'm like, girl, what? Girl, what? So, Jewel, do you have a question for either Dr. Anya or Dr.
Rachel? Yeah, I do. For Dr.
Anya, I, so I kept up with Amy, who was also on the ABC special. And we're both content creators, so we keep up together online.
And part of my journey was getting over the discouragement. I felt she lost 160 pounds in 14 months.
My weight loss has been a little bit slower, So it kind of feels like the tortoise in the hare. And my question would just be like, why is that? Why is it possible for someone to lose so much weight so quickly, whereas other people just don't? Yeah, that's a wonderful question and one that we hear a lot.
And the crux of the answer is that there are different types of obesity. So your obesity is likely different than Amy's and your response to a medicine and Amy had bariatric surgery and took a medicine is also different.
And, and that's, that's not a bad thing. That's a, that's a good thing, right? Your body is doing it at its pace, given the treatment that you are taking.
And again, it's not a race, right? So the thing is, is the weight did not come on overnight. And maybe it's a good thing that it's not coming off overnight, right? We want to do this safely.
We want to do this slowly. It gives you the opportunity to make sure that you're getting enough nutrients that you can exercise and do all the things that you love to do.
So it's not a negative thing. We just gotta be patient, right? And then just know that over your lifetime, you may need different therapies, right? And right now, this is working for you and keep going.
Once you reach a plateau, if you're in a healthy place in terms of your health and how you're doing and how you're feeling, keep going with it. If you need additional treatment, just like Amy, reach out for additional treatment and grab it.
With 107 pounds, have you plateaued? Did you plateau? I kind of for the past three to four months have been in a little bit. I like I'm like in the same five ish pounds.
But like, honestly, I have been really trying to make peace with that. I'm just, like my mom said, this is my lifestyle now.
I'm not, this is not a crash diet. This is not a thing that I'm trying to do hard and fast.
I really want to make this stick. And so it's not even a thing for me, the fact that I've plateaued.
You know, I want to just, if my body feels good, if I'm moving my body, if I'm fueling my body and it decides it wants to be 284, we're going to chill at 284. And I'm not going to make a big thing about it.
And then that is such a wonderful approach, right? Like you have such a wonderful, healthy approach. And to your mom's point about saying like, well, this is just how it is now and that you're starting to take things for granted.
I actually want that for everybody within my lifetime. And I'm almost 50, so we got to hurry up.
When I first talked to them, they were debating whether to even use, and Marissa at the time was like, I don't want my daughter on drugs. I don't want that happening.
I'm not sure. But in that audience, I saw Marissa's face.
She had the same light bulb moment I did when we heard obesity is a disease. Yes.
Your body's going to always take you back to that point. That was the revelation, right, Marissa? Absolutely.
It really has been a game changer. And I've been kind of like a champion for, you know, other parents, you know, who question and have those same questions.
I'm just like, you know, check your resistance, like check the root of your resistance to your child and understand their experience. I've never thought about going to the theater and worrying about the seat in the theater or that, you know, you can't sit in the exit row.
We have we're tall and have long legs. We prefer the exit row.
That wasn't an option for her. I didn't know that there were policies for extra seats.
I did not understand her experience. And we have a very close relationship.
Like I really had to educate my ignorance and thanks to you, I was able to do that. And, you know, I, one of the things that I also love about her that I didn't mention, she has become such a fierce advocate for her health overall.
She actually went to try an obesity doctor and they weren't great. They put her on a crash diet.
She did it for about a week and she was like, you know what? She did it because they were supposed to be obesity specialists. But she was like, this isn't right.
I don't want to go back to this. And she stopped going.
And I was just like, excellent for you. Yeah.
That would be a question is sort of how do you find good doctors. What are the questions to ask? Since there is a shortage, how do you find good doctors that are versed in this space? Or at least what questions should you ask? Yeah.
And, you know, right now we're in this place where we're trying to educate as many providers as we can. And there are different specialists that can prescribe this.
In fact, most of obesity care is going to come from primary care providers because they're on the front lines. They're seeing the most patients and they are going to provide the most of obesity care long term.
That's what happens with diabetes, too. Most people with diabetes are not treated by an endocrinologist like me.
They're treated by their primary care. What I would say to you, Joel, is you did this amazing job because you said, uh-uh, this does not feel right.
This is not right. And you listen to yourself, you talk to your mom about it, and you went forward and you actually found the help that you needed, which is so amazing.
Right? And I think right now that's what we need to do. I think long-term we'll still need to do that, right? You got to find the right doctor.
You have to bond with them. You have to trust them.
You have to know that they truly believe and know that obesity is a disease and that they're going to help you through that process. And it's lifelong.
It's a lifelong relationship with that provider. Great to see you all again.
Thank you, Jewel. Thank you.
Thank you, Marissa. I thank you for joining me on the Oprah podcast.
We're going to get back to more of my conversation with Dr. Anya when we come back.
Thank you for taking time to listen to what life is like after a dramatic weight loss. We're back with Dr.
Anya and Dr. Rachel.
Maggie and her mom, Erica, are joining us from Marceline, Missouri, and they appeared on the ABC Weight Loss special too. Erica told us about the decision for Maggie to take...
Hi, y'all. You look so great.
Hi. Oh, wow.
Maggie to take GLP-1 medications when she was just 12 years old because Maggie was nearing 300 pounds when she was 12 years old. And now she's lost 155 pounds and had excess skin removed, I hear.
How are you doing, Maggie? I'm doing great. Thanks for asking.
I saw the pictures of you from the prom. How was that? It was so much fun.
But there was a tornado, so we had to go to the basement of the school. Oh, my.
It was fun. We still got the new stuff afterwards.
Oh, great. So how has your life changed now? Well, let's see.
I got a part-time job at the nursing home, and right now I don't have any cheer, because we don't do basketball cheer. Yeah, the last time we talked, you had made the cheerleading team.
That was so cool. And now you have a job working at the nursing home, and I heard you really like that job.
It takes a special kind of person to work at a nursing home and feel comfortable and be able to give up service there. I'm sure they love having you there.
Oh, my gosh, I love them. Yes.
Erica, what advice do you have for other parents who have teenagers who are struggling with their weight? I would say my biggest piece of advice is just keep looking. It is hard to find a good provider.
And I think that people are obese for different reasons and finding treatment that fits you is a hard process. Yes.
Yes. But you can't, I could never give up.
I could give up for myself, but I could never give up for my daughter. And I know your daughter's glad you didn't give up.
I am so glad. Yeah.
Yeah. And I, and you know,'s got to be so hard, Erica, because you knew for a long time.

I remember you telling me that you all were sitting at the dinner table.

And was it some kind of pork something she was eating before she even had teeth?

Maggie was always a really good eater, even as a baby.

We would eat dinner a lot with Papa and Nanny.

And my father-in-law at one point giggled and said,

look at that. She doesn't have a tooth in her head and she's already eaten a whole pork steak.
And I remember thinking as a mother that something wasn't right with that. That was too much food for a child of her age.
I really honestly think that Maggie had one of the most extreme cases of obesity that I have ever seen.

In that, I mean, my mother struggled with her weight. I've struggled with my weight.
But I've never seen someone who just couldn't stop themselves from eating. And that's what Maggie experienced.
and you, the day we found out that obesity was a disease was life changing for us. And to work with a team of doctors who were willing to try everything to fix that for her was the best thing that ever could have happened to us.
I mean, they were willing to try combinations of medicines and meeting with psychologists. We've met with psychologists and psychiatrists and exercise specialists.
And she's had this multi-pronged approach where every tool in the toolbox was implemented to help her out. And it wasn't just one thing that helped her.
It was a combination of many things. But I feel like we have finally found a place with GLP-1 medications that she can maintain her weight loss.
She can maintain her mental health for the rest of her life. Yeah.
And one of the things that was the big aha for me on the last podcast that I did with Dr. Anya was recognizing that just because you've lost the weight, you haven't solved the problem of obesity, that you still carry the obesity with you.
And it's just like managing your blood pressure. When you're taking blood pressure medication, if you stop taking blood pressure medication, your blood pressure goes back up.
And the same thing is true with these obesity management medications, and that you will always have the obesity and having the courage, as you have done, to be the kind of mother who did not give up on your child. You did not give up.
You have fought the fight and dealt with the doctors who didn't believe, who didn't know, who said, you know, you should watch your own weight and you should watch what she's eating and all everybody just needs to steam some more broccoli, you know, and keep moving. So I applaud you for that.
I applaud you for that. And I just hope you have the most wondrous, best life possible for yourself, Maggie.
Thank you. Yes.
Good to see you both again. Thank you, Erica and Maggie.
Good to see you. Thank you.
Thank you. Bye, guys.
Before we go, Dr. Rachel, any final thoughts? Yes.
So I think, you know, I just want to add the piece that there's a lot of changes that are going to happen. So if somebody decides to go on an anti-obesity medication, it's not just about doing an injection once a week.
There's a lot that's going to happen. And I think it's important that people acknowledge that, that

there's amazing changes that are going to happen. There's going to be a roller coaster of emotions.

There's going to be changes that you didn't expect and changes that you maybe heard from

other people and didn't think would happen to you. And the most important thing that you can do

is to find not just the right doctors, but to find a supportive community. And I understand that not everybody can have a mental health provider in their back pocket or afford therapy, but having that supportive community, figuring out who your go-to people are, who can lift you up, who can help you navigate this.
If that's, you know, parents, like some of the moms that have been here or other people. Or Amy from our show last week who started her own online community with people who are going through the same thing.
I think that's huge. Exactly.
Yes. Right.
Because there's going to be comments, unfortunately. There's going to be different emotions, different comments about food and body, shape, size.
And people need to know how to be prepared for that. And eventually, I think you get to the place where you can own it.
Because I noticed, you know, when we started out with Brian, he gave us the, you know, how much weight he'd lost and what his number was before. And I know that for myself and everybody I've ever talked to about this, that there's so much shame around the number.
There's so much shame around the number. Even going to the doctor, you're standing on one foot on the scale to take off five pounds, you know, because there's just so much shame around the number.
And being able to reduce that shame and just to be able to call it what it is, is so liberating. Yeah, I'm so glad you said that because similar to what Dr.
Anya said before, if somebody was like, oh, what are you doing for your blood pressure? Somebody would say, oh, I'm not eating as many salty foods and I'm taking medicine, right? So I think that just feeds into the whole idea that we're trying to change the way that we're thinking about this because obesity is a disease. So if you own it, that would be amazing because then we're helping other people understand.
But it takes time. It takes time.
It takes time. Yeah.
Everybody should do it in their own time, in their own way. Absolutely.
And I think, you know, there's a difference in terms of obesity that it's external, right? So you could take that antihypertensive, that blood pressure medicine, and it's in your pocket. Nobody knows.
But with obesity, it's external.

Right. So it's experienced in a very different way.
So everybody knows when you're losing weight. That's right.
That's right. Well, I think my biggest takeaway from today is that the medical community needs to be made aware that it is not a, you don't fix the problem just because you give somebody the medication, that there needs to be an overall psychosocial mental approach to taking these medications, especially if you have a lot of weight to lose.
Because you shift the way you see yourself and other people certainly shift the way that they see you. And that takes adjustment.
And I agree with that. And I agree with the psychosocial, I think, has been talked about the least, right? So we've talked about the diet and the exercise, the physical activity, but the psychosocial has not.
And, you know, to Dr. Rachel's point, it affects so many things all at once.
And it's because it's change and it's external change that we experience. Well, that's why I wanted to do this show.

That's right. The reason why I wanted to do this show is because exactly what Dr.
Rachel said. Everybody who goes through a great weight loss is going to experience some kind of psychosocial change.
And you need to be prepared for it. That's right.
And they've been doing it for years with bariatric surgery. They just are not doing it with these medications.
Yeah. and all of the psychosocial things that we're seeing now with the medications, we've been seeing for years with bariatric surgery, the relationship changes, the body dysmorphia, all of that we've known about.
I mean, I've been talking about it for years to my bariatric surgery patients, but now it's becoming something new because it's now with the medications as well, but it's not new to us. And that's why we need to be having these conversations.
Well, thank you for being a part of this one. Thank you.
Thank you so much for having me. Every time I talk about this topic, I think that we are barely scratching the surface of the impact of these medications.
Dr. Rachel and Dr.
Anya, I thank you so much for your valuable insights here today.

And thank you to all of our guests.

Thanks, everybody, for listening and for watching us here on YouTube.

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We'll see you next week.