The talk-show host – out in New York Monday for the Rosie's Theater Kids gala, benefiting her namesake nonprofit – spoke candidly on The View about the stressful side of watching her own body change so drastically. But she also shared with PEOPLE the upside of her weight loss.
"In my opinion, [this surgery is] something that needs a little more attention for people who have suffered with morbid obesity their whole lives," she said of the vertical gastric sleeve surgery she had in July 2013. "This has really, really helped [me]."
While acknowledging some people think surgery is a shortcut to weight loss, or an easy way out, O'Donnell, 52, said the experience is far from a breeze.
"Everyone has to approach it in a way that feels right with them, [but] once you have the surgery, it's not a magic pill," she said. "It's still hard. You have to risk your life, and you're in severe discomfort for a couple of months, and it forces you to modify your behavior when you haven't been able to before."
After suffering a heart attack in 2012, she now says the operation is helping to save her life.
"I think, for me, always having a weight issue and struggling with weight my whole life, to the point I had a heart attack that almost killed me and [until] the doctor said, 'You have to do this,' I don't think I would have done it ever," she said.
Another benefit, hopefully: less bullying, something she says she fell victim to a few years ago when she and Donald Trump verbally sparred in the media.
"Probably the Trump stuff was the most bullying I ever experienced in my life, including as a child," she said. "It was national, and it was sanctioned societally. Whether I deserved it is up to your own interpretation."
One project that helps keep her grounded and on track is Rosie's Theater Kids, which offers low-income children more opportunities in the arts, school and life.
O'Donnell recalled one teacher she had when she was young, "who loved me back to life, who told me I was worthy and important and good" after her mother had died two years earlier.
"When I got to a point where I knew I could do that for other kids, that's what I did," she said.