Thanksgiving is upon us. The annual gathering of family to watch parades and football while celebrating the harvest traditionally comes with an unhealthy dose of gastric overload, namely culinary delicacies high in fat and sugar from sweet potato casserole to apple pie.
For Atlantans who take medications such as Ozempic and Wegovy to control their appetites, Thanksgiving can either be a cause of anxiety or a saving grace from wayward eating habits.
A pair of Atlanta medical professionals whose patients take weight loss drugs shared tips for choosing healthier options on Thanksgiving, savoring favorite dishes and avoiding confrontation with those who like to weigh in on others’ lives and choices.
When they haven’t seen family in a while, patients taking the drugs may have to explain a dramatic weight loss or why they can’t eat as much, said Dr. Alicia Shelly, who works in obesity medicine at Wellstar Douglasville Medical Center.
One of Shelly’s patients said she dreads Thanksgiving because her mother-in-law always comments on her weight. “It can be so stressful for her not having lost as much weight as she wanted,” Shelly said. “Others may have stressors because they are going to be tempted by all the food, more food than they eat on a regular basis.”
Debbie Isbitts is among those worried about navigating all the food choices at Thanksgiving. This is her first Thanksgiving post-Ozempic after two years on the medicine.
“When I was on the medicine, it made me stop eating. … Even if I made bad food choices it did not affect me. I was still losing and losing,” said Isbitts, a Marietta resident who lost some 65 pounds and discontinued the drug this summer. “Now I think about food and my food choices all the time. I’m eating better now than when I was on Ozempic. I am much more aware of what I put in my body. To that extent, I’m worried about overindulging.”
There are multiple drugs on the market that are approved by the U.S. Food and Drug Administration for diabetes treatment and weight loss. Among them: Wegovy, which is approved for weight loss and contains the same main ingredient — semaglutide — as Ozempic, which is approved to treat diabetes. Known as GLP-1 drugs, they slow down digestion, curb hunger and help manage blood sugar levels.
The drugs can result in weight loss of up to 20% or more of body weight. But the drugs also make a holiday centered around multiple courses of food challenging for those trying to lose or maintain their weight.
Finding healthy foods at Thanksgiving can be frustrating when you are a guest and don’t have control over the menu, Shelly noted. In those cases, she suggests bringing your own food to stay healthy and on track. “What if there’s food you do not eat any more? If you try to stick to a healthier diet, it makes it more difficult. You may not be able to have as much, but it doesn’t have to sabotage you.”
Those on weight loss drugs can still eat until they feel full, but the feeling of fullness may come sooner for them than for others. “The medication does what it’s supposed to do; it (encourages) portion control. You can still stick to your goal of losing weight while allowing yourself to eat foods you don’t eat on a regular basis.”
Still, with family and friends continuing to eat, some may question why they aren’t doing the same, which can be frustrating and overwhelming, Shelly said.
She suggests those taking the medication set boundaries and discuss the issue beforehand to avoid confrontation. “You don’t have to engage. You can change the subject or go to another room. If they ask, ‘Is that all you are eating?’ You say ‘Yes,’ and leave it at that.”
From her own personal struggle with obesity, Shelly said she tries not to let others’ opinions dictate her emotions. “Sometimes for your own sanity you have to let it roll off and don’t let it bother you.”
Patients shouldn’t have to explain their choices or give into peer pressure to appease others, said Abby Jellinek-Johnson, a dietitian with Harmony Nutrition in Alpharetta. But if they are comfortable discussing their food choices on Thanksgiving, they can explain how overeating makes them feel.
“It’s always a good idea to let them know: ‘I’m taking weight loss medication and it’s harder to eat the same portions I used to and it can actually make me sick.’”
The weight loss drugs can have side effects that include nausea and vomiting, which may become worse with higher fat and sugar foods that are Thanksgiving staples and stay longer in the stomach.
Jellinek-Johnson encourages patients to “indulge and enjoy what they like to eat” but control their portions. If their favorite is sweet potato souffle, for instance, they can savor half a cup instead of filling half their plate with it. “People who are struggling with their weight have a lot of guilt around food,” she said.
“When you have more control over your appetite, you can have a few bites of apple pie and not rush through it and feel guilty about it. You can enjoy a couple of spoonfuls and walk away.”
In terms of food choices, she said patients who are preparing the meal can cut down the fat in their favorite traditional foods by cutting the butter, avoiding heavy whipping cream and substituting lower-fat ingredients.
The order you eat can help stabilize your blood sugar so you feel better throughout the meal, Jellinek-Johnson said. Start with a small plate of salads or non-starchy vegetables such as collard greens that have more fiber and then follow with a lean protein such as turkey before taking a small amount of your starchy favorite.
“Listen to your body. It takes at least 20 minutes for your brain to receive a signal that you are full. If you try to eat too fast you can become nauseous.”
She also advises patients to incorporate physical activity throughout the day to avoid nausea, and to stay hydrated to avoid constipation.
Both medical experts cautioned against tasting all the foods served. “A little bit of everything could be a whole lot,” Shelly said. She stressed enjoying time with family over the menu.
“Don’t let one dinner stress you out. Don’t allow it to overwhelm you. Have a plan for what to do.”
What’s Isbitts’ plan for her first post-Ozempic Thanksgiving? “I try to keep portions small as I did when I was on Ozempic. When I’m not on Ozempic I have a more significant appetite, which makes it harder to stop once I get full,” she said. “I’m much more attuned now with my body. I’m much more aware that I’m full and I have to make the decision to stop eating.”
Here are a few holiday foods the Atlanta medical advisers say to savor or limit if you are on weight loss medicine:
Savor
Green salads
Vegetables (even corn!)
Turkey
Fruit
Limit
Stuffing and gravy
Sweet or mashed potatoes
Ham
Cakes and pies
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