It was written by Lizzo alongside Jesse Saint John and producers Steven "Tele" Cheung and Ricky Reed.

Though it did not chart upon release, it became a viral sleeper hit in 2019 after gaining popularity on the TikTok video sharing app and being used in the Netflix movie Someone Great.

[2][3][4] It spent seven weeks at number one, becoming the longest-running number-one for a solo song by a female rapper, earning her a Guinness World Record.

Its high debut was due to a Billboard rule that affects songs older than one year from entering the Hot 100 unless obtaining a substantial number of chart points.

[4][12][13] "Truth Hurts" became the third solo song by a female rapper to top the Hot 100, following Lauryn Hill's "Doo Wop (That Thing)" and Cardi B's "Bodak Yellow".

[14] It spent seven non-consecutive weeks at number one, tying Iggy Azalea's "Fancy", featuring Charli XCX, for the longest-leading rap song by a female artist on the chart.

[21] In Belgium, the song entered the top 10 of the Belgian Singles Chart, at number two, becoming Lizzo's first and highest-charting entry in the country.

Ashley Monaé, writing for Pitchfork, stated the song contains "sobering moments of truth where Lizzo's charisma wins us over and sets her apart.

"[26] * denotes an unordered list A music video was released to accompany "Truth Hurts", styled by Brooke Candy.

She opened the VMAs performance wearing a cowgirl attire surrounded by dancers in front of an "inflatable ass" bouncing to the beat.

[41] Writing for Esquire, Matt Miller said that, "If there was a star-making performance of the night it was this one, an unforgettable moment that I'm hoping we'll see at more award shows".

For the intro, her guitarist Celisse Henderson paid homage to Sister Rosetta Tharpe by playing an altered version of the song's lead melody on a cream-colored Gibson SG Custom.

[46][47] The Washington Post editors considered it "a classic Lizzo number, as she also dazzled the crowd by breaking out her flute for a solo".

[49] Rolling Stone editors opined that she "topped the whole thing off with five words that made the performance a mic-drop for the ages: "Welcome to the Grammys, bitch!"".

[50] Lizzo performed the song on the season 45 episode of Saturday Night Live hosted by former cast member Eddie Murphy.

[72] On October 15, producers Justin and Jeremiah Raisen posted on Instagram that the opening line was lifted from an unreleased demo, "Healthy", that they co-wrote with Lizzo and other songwriters.

"[75] Lioness posted a Tweet on October 23, 2019, saying "I just took a DNA test, turns out I'm a credited writer for the number one song on Billboard.