Oprah Winfrey just made an admission that should concern anyone considering GLP-1 medications for weight loss.
After stopping her weight loss injections “cold turkey” in January 2024, she regained 20 pounds over 12 months. Despite continuing to exercise. Despite maintaining a structured diet. Despite having access to personal trainers, nutritionists, and every resource money can buy.
Her conclusion? GLP-1 medication will be “a lifetime thing.”
She’s not wrong about the science. She’s just wrong about there being no alternative.
What Oprah’s Experience Confirms
Oprah’s year-long experiment perfectly illustrates what the research already shows.
A January 2026 study in the British Medical Journal reviewed 37 studies involving over 9,300 people who used weight loss medications. The findings:
People who stop GLP-1 medications regain their lost weight within approximately 18 months. Those taking semaglutide or tirzepatide (Wegovy, Ozempic, Zepbound) lost an average of 33 pounds while on treatment but gained back about 22 pounds within a year of stopping.
The STEP 1 trial extension showed similar results: participants regained two-thirds of their prior weight loss within one year of stopping semaglutide.
Oprah didn’t fail. She did exactly what the science predicted.
And now she accepts that without the medication, her body will work against her efforts indefinitely. As she put it: “I’m on high blood pressure medication, and if I go off the high blood pressure medication, my blood pressure is going to go up. The same thing is true now, I realize, with these medications.”
The Math Oprah Doesn’t Have to Do
Here’s what Oprah can afford to ignore:
GLP-1 medications cost between $900 and $1,500 per month without insurance. Even with coverage, copays often run $300-500 monthly.
Over 10 years, that’s $108,000 to $180,000 in medication costs alone.
Over 20 years? Over 30 years?
Oprah can pay out of pocket for acquaintances who can’t afford the medication. She can absorb lifetime costs without blinking.
Most people cannot.
And even for those who can afford it, there are other considerations:
- Supply shortages have left patients scrambling for medication
- Side effects including nausea, vomiting, and gastrointestinal issues affect many users
- Long-term effects remain unknown since these medications are relatively new
- Insurance changes or job loss could suddenly cut access
- Dependency on a weekly injection that must continue indefinitely
There’s a reason 50% of GLP-1 users stop within the first year. Cost, side effects, and access issues force people off medications they’ve come to depend on.
The Option Oprah Doesn’t Mention
I’m a bariatric surgeon. I’ve performed over 7,800 weight loss surgeries. And I want to tell you something that Oprah’s new book probably won’t cover:
Gastric sleeve surgery addresses the same biological mechanisms as GLP-1 medications, but permanently.
Here’s why that matters:
GLP-1 medications work primarily by mimicking hormones that suppress appetite and slow gastric emptying. When you stop taking them, those effects disappear, and your body returns to its previous state.
The Enhanced Gastric Sleeve works differently. During the procedure, approximately 75-80% of the stomach is permanently removed, including the fundus where the majority of ghrelin (the “hunger hormone”) is produced.
The result:
- Permanent reduction in hunger hormone production. Unlike GLP-1 medications, this effect doesn’t stop when you “go off” treatment, because there’s no treatment to stop.
- Permanent reduction in stomach capacity. Physical restriction that doesn’t require daily willpower or weekly injections.
- One-time procedure. Not a lifetime commitment to medication, pharmacy visits, and insurance negotiations.
The Numbers Comparison
Let me show you what the research says about long-term outcomes:
| Factor | GLP-1 Medications | Enhanced Gastric Sleeve |
|---|---|---|
| How it works | Mimics hormones temporarily | Permanently removes hormone-producing tissue |
| Duration | Must continue indefinitely | One-time procedure |
| Weight loss | 15-20% while on medication | 60-70% excess weight loss long-term |
| If you stop | Regain 2/3 of lost weight within 1 year | No “stopping” involved |
| 10-year cost | $108,000-$180,000+ | One-time surgical cost |
| Ghrelin effect | Suppressed while taking medication | Permanently reduced by 80%+ |
GLP-1 medications are remarkable tools. But they’re tools you must use forever.
Gastric sleeve surgery is a permanent change to your anatomy that continues working whether you think about it or not.
Why Oprah’s Framing Matters
Oprah now describes obesity as a chronic condition requiring lifelong medication, similar to high blood pressure.
She’s right that obesity has biological components. She’s right that willpower alone often isn’t enough. She’s right that shame is counterproductive.
But her framing conveniently omits that permanent surgical solutions exist.
Medications require pharmaceutical companies. Medications generate recurring revenue. Medications create dependent customers.
Surgery happens once.
I’m not suggesting conspiracy. Oprah genuinely believes what she’s saying. But the narrative that “medication forever” is the only answer serves certain interests more than others.
Who Should Consider Surgery vs. Medication?
Both options are valid medical treatments. The right choice depends on your situation.
GLP-1 medications may be better if:
- You have BMI under 35 with no obesity-related conditions
- You prefer non-surgical approaches and can afford lifetime costs
- You respond well to medication with minimal side effects
- You have reliable, long-term insurance coverage
Enhanced Gastric Sleeve may be better if:
- You have BMI of 35+ (or 30+ with obesity-related conditions)
- You want a permanent solution without ongoing medication
- You’re concerned about lifetime medication costs
- You’ve tried medications and experienced side effects or regain
- You want to address the root hormonal issues permanently
What Oprah Got Right
Let me be clear: Oprah’s message about shame is important.
“If you have obesity in your gene pool, I want people to know it’s not your fault,” she said. “Don’t say, ‘Why don’t you just work out more and eat less?’ That is not the answer.”
She’s absolutely right. Obesity has biological drivers. Willpower is not a treatment plan.
Where she stops short is presenting all the treatment options. GLP-1 medications are one path. They’re not the only path.
The Question to Ask Yourself
If you’re considering GLP-1 medications, ask yourself:
Am I prepared to take this medication every week for the rest of my life?
If the answer is yes, and you can afford it, and you tolerate it well, that’s a valid choice.
But if the idea of lifetime medication dependency concerns you, if the costs are prohibitive, if you want a permanent solution that doesn’t require ongoing intervention, you should know that option exists.
Learn More About Permanent Weight Loss
I offer the Enhanced Gastric Sleeve at my QUAD A accredited facility in Tijuana, just 20 minutes from San Diego. My PhD in molecular biology informs my understanding of the hormonal mechanisms driving weight gain, and my 7,800+ surgeries include the most advanced techniques for permanent results.
To find out if the Enhanced Gastric Sleeve is right for you:
Check your eligibility for a free virtual consultation.
You deserve to know all your options, not just the ones that require lifetime prescriptions.
Frequently Asked Questions
Q: Is gastric sleeve surgery safer than taking Ozempic forever?
A: Both have risks. Gastric sleeve surgery has a one-time surgical risk (complication rate under 1% in experienced hands), while GLP-1 medications have ongoing risks including gastrointestinal side effects and unknown long-term effects since these are relatively new medications. The key difference: surgical risks are one-time, medication risks are ongoing.
Q: How does gastric sleeve reduce hunger like Ozempic does?
A: The gastric sleeve removes approximately 80% of the stomach, including the fundus where ghrelin (the hunger hormone) is primarily produced. GLP-1 medications suppress appetite through hormone mimicry that stops when you stop the medication. The sleeve creates permanent hormonal change.
Q: What if I’ve already tried Ozempic and regained weight after stopping?
A: You may be an excellent candidate for gastric sleeve surgery. Many patients come to me after experiencing exactly what Oprah described: weight loss on medication followed by regain after stopping. Surgery can provide the permanent solution that medication couldn’t.
Q: Can I take Ozempic after gastric sleeve if needed?
A: In some cases, yes. Some patients use low-dose GLP-1 medications after sleeve surgery to optimize results. However, most sleeve patients don’t need additional medication because the surgery itself addresses the hormonal mechanisms.
Q: How much does gastric sleeve cost compared to years of Ozempic?
A: Gastric sleeve surgery in Tijuana costs a fraction of US prices and represents a one-time expense. At $1,000+ monthly for GLP-1 medications, most patients reach the surgical cost equivalent within the first year of medication use, with surgery then “paying for itself” every subsequent year.
Q: Did Oprah ever consider weight loss surgery?
A: Oprah has publicly discussed various weight loss approaches over decades but has focused on medication and lifestyle rather than surgery. Her choice is valid for her circumstances, but may not represent the best option for everyone, particularly those without her financial resources for lifetime medication.
Dr. Gabriela Rodríguez Ruiz is a double board-certified bariatric surgeon with a PhD in molecular biology. She has performed over 7,800 bariatric surgeries at her QUAD A accredited facility in Tijuana, Mexico.
