It was originally released on September 19, , by Nice Life Recording Company and Atlantic Records , but then re-released as a radio single in Though it did not chart at the time of its release, it later became a viral sleeper hit in after gaining popularity on the TikTok video sharing app and being used on the Netflix movie Someone Great.
The song was included as a bonus track on the deluxe version of Lizzo's third studio album Cuz I Love You and reached number one on the Billboard Hot , becoming Lizzo's first song to do so. Musically, it is led by a "glittering" piano loop. During a concert in her native Detroit, Lizzo revealed that "the person I wrote that song about is from Detroit. In the United States, "Truth Hurts" became a sleeper hit two years after its release; the song was originally released in September and eventually charted in the spring of Its high debut was due to a Billboard rule that affects songs older than one year from entering the Hot unless obtaining a substantial amount of chart points.
The song also hit number one on the US Rhythmic chart, where it became Lizzo's first Billboard chart topper; and one of five songs to reach number one with a jump on that chart since its October inception. In the United Kingdom, "Truth Hurts" has debuted at number 67 on the UK Singles Chart on the week ending May 9, ,  later peaking at number 29 on the week ending September 19, The song also entered the top 10 of the Belgium Urban Singles Chart, at number nine, also becoming her first and highest-charting entry on the chart, respectively.
Lizzo performed the song on the season 45 episode of Saturday Night Live hosted by former cast member Eddie Murphy. Atlantic allowed the station to make changes to the song and was ultimately "cool with it" when it came to the adjustment. In a episode of the American game show Jeopardy! Two official remixes of "Truth Hurts" were released by Lizzo. The other features Charlotte rapper DaBaby and was released on August 23, The release of the remixes were an effort to get "Truth Hurts" to reach number one on the Billboard Hot A music video was released to accompany "Truth Hurts", styled by Brooke Candy.
February 24, . 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. They attributed the lyric to Lioness's tweet. In response, Lizzo's lawyer stated that the Raisens did not co-write "Truth Hurts" and that the Raisens "expressly renounced any claim to the work, in writing, months ago".
Lioness was credited as a co-writer of the song on October 23, In an Instagram post, Lizzo wrote "The creator of the tweet is the person I am sharing my success with Digital download .
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