I don't mean Goopy Gwyneth Paltrow and her utterly ridiculous vaginal jade eggs or her vagina-scented candles. The health of Ms Paltrow's vagina worries me not.

I mean Oprah.

Oprah Winfrey. Sharing with us the struggles of weight loss. Explaining how hard it was to shed weight in the international spotlight. Encouraging us to stop the stigma and therefore an ambassador for body positivity.

On Oprah Daily earlier this year, she said: "This is a world that has shamed people for being overweight forever and all of us who've lived it know that people treat you differently - they just do. I get treated differently if I'm 200-plus pounds versus under 200 pounds."

Now she's lost a truckload of weight using weight loss medication. We don't know which one (she's had the good sense not to name the product) but it's worked.

Every single person I know who is obese or obese-adjacent has had a similar experience with weight-loss drugs. Significant success with losing weight through medication. Awesome.

I come from a family of fat people. And in 2009, my GP read me the riot act.

Basically she said that if I didn't lose weight, I'd cark it early, just as my parents and my sister did.

She got me good and at my most vulnerable - my sister had died a year or so before this hard conversation.

She wasn't interested in fat shaming me. She wanted to scare me to life.

There's no doubt shaming just makes us feel worse about ourselves. But I am sick to death of fat positivity. There is nothing about being obese which is positive. And I say that as a person who has struggled with weight her entire life.

Lost over 50kgs. Put 10kgs back on. Still not slender. It's bloody annoying because I live among the slender in my own house.

I force myself to walk kilometres every day. Do weights. Manage what I eat. I don't even mind the walking because I can multitask (also known as listening to the ABC).

But the managing what I eat is really infuriating because what causes me to put on weight troubles Mr Skinny not one iota. He could eat chocolate, fried food, ice cream every day and still not chunk up.

And I absolutely adore all the things which are bad for me.

As Emily Banks, ANU professor and a public health physician and epidemiologist says: "It is hard to lose weight. You want no stigma but you want the best possible to support to lose weight."

So we need to create environments where the easiest thing is to be a healthy weight, where we aren't drowning in a sea of excess. We need health promoting and not fat shaming - but I fear body positivity. It somehow erases the urgent need we have to think about losing weight because weighing less is better for us.

Our blood pressure improves. Our cholesterol improves. Our knees and hips experience less stress. And we are far less likely to develop diabetes.

I can proudly say I have avoided it so far. Fingers crossed because my inheritance sucks.

I ended up losing weight only because my GP enrolled me in a clinical trial with on-tap dieticians, nutritionists, exercise physiologists and cheer squad. If I'd been able to take drugs to help me lose weight, I would have signed up on the spot.

There are a bunch of drugs which work this way available in Australia.

The most well-known is Ozempic (semaglutide), also used to treat diabetes, but there are many others.

According to the Royal Australian College of General Practitioners there is a critical shortage of semaglutide and a growing demand for weight loss medication.

There are four drugs registered with the Therapeutic Goods Administration (TGA): dulaglutide (sold as Trulicity), semaglutide (sold as Ozempic), liraglutide (sold as Saxenda) and tiezepatide (sold as Mounjaro).

Not all are approved for weight loss or listed on the Pharmaceutical Benefits Scheme which makes them ridiculously expensive and out of the reach of most of us.

And there are some side effects. It can make you lose muscle mass, it can give you endless runs. But it can also help you lose weight which is a wonderful thing.

Instead of fat shaming, we should be looking at what society does to encourage fatness.

Ultra-processing of foods which inevitably means high salt, high sugar and high fat content. Portion sizes. Ridiculous junk food advertising. Near incomprehensible information on packets. What we call the obesogenic environment which encourages high calorie intake and sedentary behaviour.

READ MORE:

And all those weight-loss drugs, once tested and safe, should be available at the cheapest costs possible to whoever needs them.

It's not about being smart enough to lose weight or having the best willpower in the world. It's about being health positive.

And, yes, it is true that not every overweight person will suffer from any of the multiple things I mentioned - but as The Food for Health Alliance's executive manager, Jane Martin told Caitlin Fitzsimmons, body weight is a risk factor for many chronic diseases including type 2 diabetes; cardiovascular disease; 13 different cancers including bowel and breast cancer; dementia; depression and anxiety; and skeletal problems.

Winfrey is lucky. She's loaded. She has access to all the best healthcare. And she succeeded in losing weight.

Plus she's nearly 70, an age neither my parents nor my sister ever saw.

I'm hoping to get to 70 myself. If it takes drugs to get me there so be it.

There is nothing wrong with being fat except it might kill us.