Oprah Winfrey

After decades of publicly battling her weight, Oprah Winfrey revealed to PEOPLE that she now uses prescription weight-loss medication “as a tool to manage not yo-yoing,” stressing that she no longer sees it as “the easy way out” but part of treating obesity as a disease.

Oprah said the shift came after speaking to medical experts, explaining she had “released my own shame about it” and now pairs the drug with hiking and lifestyle changes.