Lizzo spoke to People about the song’s release and appearance in Someone Great:

The day I released ‘Truth Hurts’ was probably one of the darkest days I’ve had ever in my career. I remember thinking, ‘If I quit music now, nobody would notice. This is my best song ever, and nobody cares. I was like, ‘Fuck it, I’m done.’ And a lot of people rallied; my producer, my publicist and my family, they were like, ‘Just keep going because this is the darkest before the dawn.‘ […] What a moment in a movie can do for an artist is crazy. I had everything else: the hard work, the good music, touring — but then there’s that extra-special magic that nobody really knows what it is that can really change your life. Now the song that made me want to quit is the song that everyone’s falling in love with me for, which is such a testament to journeys: Your darkest day turns into your brightest triumph.

During the week ending May 18, 2019, “Truth Hurts” debuted at #50 on the Hot 100, marking Lizzo’s first song on the chart. During the week ending September 7, 2019, the song peaked at #1. During the week ending October 26, the song spent its seventh and final week at the chart’s summit. The song is Lizzo’s first to top the chart. It also passed Iggy Azalea’s “Fancy” as the longest-running #1 song by a female rapper in Hot 100 history.

As of November 10, 2020, according to RIAA, “Truth Hurts” has been certified 6x platinum (six million copies sold).