The holiday season is synonymous with abundant food, from work functions to social gatherings.
“For my patients, it’s less the ‘most wonderful time of the year,’ and more the ‘most challenging,’” explains Dr. Andres Acosta, a Mayo Clinic gastroenterologist and hepatologist.
This is particularly true for individuals using GLP-1 and/or GIP hormone-targeting weight-loss medications (like Ozempic, Wegovy, Mounjaro, and Zepbound) to manage appetite or diabetes.
“We’ve seen patients delay, rather than skip, injections,” notes Michelle Cardel, WeightWatchers’ chief nutrition officer. “For instance, someone might move their Wednesday injection to Friday to allow for greater holiday indulgence and minimize potential side effects.” Some patients even discontinue medication for extended holiday periods, according to physicians.
However, doctors generally advise against altering injection schedules. Unlike earlier anti-obesity drugs, Wegovy and Zepbound, for example, work partly by suppressing hunger signals in the brain. To achieve this with minimal side effects, the weekly dose must gradually increase over 16 weeks to the maximum, which is then maintained. Each injection typically controls hunger for about a week; subsequent injections are timed to coincide with waning efficacy.
Altering injection timing creates a ripple effect. Shifting from Wednesday to Friday, for example, permanently changes the injection day. Skipping doses can also trigger a recurrence of initial side effects like nausea, vomiting, diarrhea, and other gastrointestinal issues upon restarting.
“I discourage my patients from stopping their medication, as we’re managing chronic obesity,” Acosta emphasizes. Changes to the established schedule can have further consequences. Interruptions exceeding one week necessitate returning to lower doses and gradually rebuilding to the previous level, hindering weight-loss progress.
Dr. Andre Teixeira, medical director of the Orlando Health Weight Loss and Bariatric Surgery Institute, has observed significant repercussions. “Some patients struggle to regain their prior dosage,” he explains. The hormonal nature of these medications, he notes, mirrors the experiences of some women with certain birth control pills, where severe side effects can render them unusable.
Moreover, discontinuing Wegovy or Zepbound inevitably leads to weight regain. “I emphasize to patients the importance of avoiding undoing a year’s worth of progress during the six-week holiday season,” says Acosta.
Acosta recommends proactive dietary and fitness adjustments instead of medication alterations. On holidays like Thanksgiving or Christmas, he suggests avoiding large meals earlier in the day. “Skip the big breakfast and lunch,” Acosta advises. “Go for a morning walk or hike. Plan shared physical activity; a stroll in the park or a mall trip, depending on the weather, can burn calories.”
He also stresses the importance of mindful eating while on medication, even amidst social pressure. Sharing your weight-loss journey, which is increasingly common on social media, can make it easier to express your needs to loved ones.
Managing alcohol intake is another key consideration. Many experience nausea, vomiting, and GI distress while on these medications. WeightWatchers research revealed that 45% to 51% of GLP-1 and GIP drug users reduced alcohol consumption. While the reasons – side effect avoidance versus general healthier choices – aren’t fully clear, Cardel suggests, “It’s likely a combination of both.”
Ultimately, thoughtful planning allows those using these medications to fully enjoy holiday traditions while maintaining their treatment regimen.
“`
