For decades, the world has watched Oprah Winfrey’s very public battle with her weight, as she yo-yoed between sizes, inspiring admiration with every pound she lost and ridicule when she gained it back. Winfrey, who has always spoken candidly about her weight and health struggles, says it wasn’t until recently that she felt liberated from toxic diet culture.
Part of her transformation was going on a GLP-1. But the other part was gaining insight into the science of obesity, in part, thanks to meeting Ania M. Jastreboff, MD, PhD, a physician-scientist and founding director of the Yale Obesity Research Center. The result is their new book, Enough: Your Health, Your Weight, and What It’s Like To Be Free, in which the two teamed up to provide some much-needed insight on how to reframe the conversation around obesity and the ever-expanding roster of drugs that can effectively treat the disease.
The book is at once an evidence-based guide and a poignant account of the heartbreak of navigating life in a world that views excess weight as moral failing and weakness. SELF spoke with Dr. Jastreboff about what science still needs to understand about obesity and GLP-1s and her powerful collaboration and friendship with Oprah. “I don’t know anybody else who has that much conviction and grit,” Dr. Jastreboff tells SELF.
SELF: In your book, you write that a person’s weight is determined by their “enough point.” What does that mean?
Dr. Jastreboff: Eons ago, our bodies figured out that in order to survive, they had to store fuel. And the way that they store that fuel is as fat. So how does our body do this? How does it know how much fat to store? There are nutrient-stimulated hormones in the body, and they inform our brain, I’m hungry, I’m full, I’m storing this much energy, I’m storing this much fat. And then our brain sets the enough point.
So if that’s our beautiful biology, then why do nearly half of Americans have obesity? It’s because of the obesogenic environment, which has ultraprocessed food, lack of sleep, lack of physical activity, lots of stress, and medications that cause weight gain as a side effect. And all of these different things push up the enough point on a population level, meaning that most people are carrying or storing more fat than is healthy or needed. How we think [GLP-1s] work is that they recalibrate and lower the enough point. As your enough point is lowered, the weight follows.
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