Barbra Streisand asks Melissa McCarthy about Ozempic, sparking debate on weight

A comment Barbra Streisand left on an Instagram post shared by Melissa McCarthy has sparked a conversation about weight, shaming and the increasingly widespread use of drugs for weight loss.

McCarthy, 53, shared two photos on her Instagram page Sunday of herself with director Adam Shankman attending a gala in Los Angeles over the weekend.

In the comments section, Streisand, 82, responded to McCarthy's photos, writing, "Give him my regards," referring to Shankman, before adding, "did you take Ozempic?"

Streisand's comment, which has since been deleted, was captured by the Instagram account Comments by Celebs, which posted a screengrab of the comment on its own Instagram page, writing, "Babs!!"

In a follow-up post on her Instagram story hours later, Streisand addressed the comment publicly, writing, "OMG - I went on Instagram to see the photos we'd posted of the beautiful flowers I'd received for my birthday! Below them was a photo of my friend Melissa McCarthy who I sang with on my Encore album. She looked fantastic! I just wanted to pay her a compliment. I forgot the world is reading!"

McCarthy and Streisand have worked together in the past, including performing a duet in 2016.

ABC News has reached out to McCarthy's representative for comment.

Streisand's comment, which was left from her verified Instagram account, quickly led to a debate on social media about the shaming around drugs used for weight loss, including Ozempic.

"Why is it that people that haven't had obesity care so much - what does it matter Barbara? If she has or hasn't it's not your concern," wrote one commenter, adding, "and even if it was meant to be a DM - still rude!"

"Ozempic admit or keep silent!!" wrote another commenter. "Not one celebrity has admitted to losing over the magic number of 40 pounds in every article written around the world. No one wants to admit they have been on the med for a year and have dropped 6 sizes and trying to explain away only 40 pounds. Total nonsense."

Over the past two years, medications that can lead to weight loss, including Ozempic as well as Zepbound, Wegovy and Mounjaro, have become more widely available and have skyrocketed in popularity.

Both Ozempic and Mounjaro are approved by the U.S. Food and Drug Administration to treat Type 2 diabetes, but some doctors prescribe the medication "off-label" for weight loss, as is permissible by the FDA.

Wegovy and Zepbound, which contain the same active ingredients as Ozempic and Mounjaro, respectively, are each FDA-approved as a weight loss management treatment for people with obesity, or those who are overweight with at least one related underlying condition, such as high blood pressure.

As the landscape of obesity medicine has changed over the past two years, the public perception of obesity as a chronic medical condition has seemingly struggled to keep pace.

People who take medications for weight loss, including Oprah Winfrey, have spoken publicly about feeling shamed for taking what some have labeled "the easy way out" for weight loss.

"The fact that there's a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for," Winfrey said when she first publicly confirmed she was using a medication to help maintain her weight.

While McCarthy has spoken publicly in the past about her weight journey and her experiences with body shaming, she has not spoken publicly about Ozempic or other medications for weight loss.

In a 2016 interview, the "Bridesmaids" actress said she never wants weight to be "the most interesting thing" about herself.

"I'll be up, I'll be down, probably for the rest of my life," she told Refinery29 of her weight. "The thing is, if that is the most interesting thing about me, I need to go have a lavender farm in Minnesota and give this up."

McCarthy continued, "There has to be something more. There are so many more intriguing things about women than their butt or their this or their that. It can't be the first question every time, or a question at all."

What doctors say about weight and shaming

That the topic of weight continues to hold such a grip on society likely stems from the fact that it is both so universal and so visible, in that people can see weight loss or weight gain, obesity medicine specialists say.

Obesity is a medical condition that affects nearly 42% of people in the U.S., according to the U.S. Centers for Disease Control and Prevention. Obesity has been associated with conditions like stroke and heart attack, hypertension, breathing difficulties, sleep apnea and an increased risk of early death.

"The reality is that, yes, obesity is a disease, but unlike other diseases, you can see it. That's part of the issue," Dr. Caroline Apovian, an endocrinologist and co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital in Boston, told ABC News. "And its not a disease that affects 1 in a million. It affects 42% of adult Americans."

Apovian said the fact that obesity affects so many people can make it seem more approachable to talk about, even though it is a medical condition that affords privacy.

"There are many people who are famous who talk about their battles with breast cancer or ovarian cancer or heart disease and obesity," she said. "But in this instance, there is a nuance here, because you would never have thought to comment on a photo of somebody and say, 'Hey, I see you don't have breast cancer. Did you take chemo?'"

Dr. Fatima Cody Stanford, an obesity medicine physician scientist and educator at Massachusetts General Hospital and Harvard Medical School, echoed Apovian's comments on obesity being a "visible" medical condition.

Stanford argues it is not "fair" for people to ask questions or make judgment calls on how an individual treats their medical condition, even if it is one the public can see.

"We shouldn't be able to make a judgment call on how a person has chosen to address this disease, whether they've chosen lifestyle or behavioral modifications, whether they've chosen medicines or whether they've chosen metabolic or bariatric surgery or, for many of my patients, all of the above," Stanford told ABC News. "Individuals that have chosen these strategies don't owe anyone an explanation on how or why or when they've chosen to use the strategies to address their chronic disease of obesity."

Stanford said some of society's acceptance with talking about people's weight may have to do with misconceptions about the condition of obesity, which she describes as a chronic, relapse-remitting disease that is a result of a person's genetic makeup.

In the same way, medications used for weight loss are often mischaracterized as the "easy way out" because they may be misunderstood, according to Stanford.

The medications work by mimicking a hormone, glucagon-like peptide-1, known as GLP-1, that is made by the small intestine and helps deliver satiety signals in the body.

The active ingredient in Mounjaro and Zepbound, tirzepatide, works by activating two hormone receptors: GLP-1 and glucose-dependent insulinotropic polypeptide, or GIP.

In Ozempic and Wegovy, the active ingredient, semaglutide, works by activating only the GLP-1 receptor.

"I think a lot of people don't know that every single human who was ever born and lived has GLP-1s in their body," Stanford said. "Those of us that happen to have a leaner body as a baseline just happen to have more GLP-1 at baseline. Those of us who just weren't born with that privilege happen to need more of this, and maybe get it through the form of a medication."

Stanford said it is wrong to criticize or question people who use medications for weight loss because that is blaming them for their "physiology having some dysfunction."

"I don't care if you're a celebrity or an average patient without a celebrity status, I don't think we should judge people for what they are or are not taking," Stanford said. "Some of us don't have the same privilege as others to have a fully functioning body, so let's give the others a fair shot."