It’s Thanksgiving. Will Ozempic make it better or worse?

Last month, Gabie Caballero received a call from her brother inviting her to his home in Houston for a Thanksgiving party. “As soon as he started talking about food and Thanksgiving, I felt overwhelmed,” Ms. Caballero, 46, said.

Ms. Caballero takes Mounjaro, a diabetes drug similar to Ozempic, to lose weight. She is one of many Americans preparing for a food-focused vacation while taking a drug that can dull the appetite.

It has been the year of Ozempic. The drug, approved for diabetes in 2017 but now widely known for its weight-loss effects, saturated TikTok and became fodder for late night shows and gossip headlines and even a punch line at the Oscars.

Ozempic and similar drugs radically reduce how much a person wants or can physically eat. People feel full faster and for many the cravings disappear. The drugs can also cause unpleasant gastrointestinal side effects: vomiting, diarrhea, constipation, nausea that some liken to morning sickness, and stomach pain.

All of this may seem fundamentally incompatible with Thanksgiving.

At its best, the holiday is a day of gratitude, togetherness and indulgence — an opportunity to enjoy piles of home-cooked food, followed by the opportunity to unbutton your jeans or put on a pair of sweatpants to watch a football game.

But Thanksgiving also has a reputation for causing conflict: Many come face to face with the relatives they avoid for the rest of the year, and find themselves drinking a little too much wine and arguing about politics, or worse, about Tofurkey.

Tensions are high. Plates are full. Families can be quick to judge. What Happens When Weight-Loss Drugs Clash With Thanksgiving?

“Why aren’t you eating?”

Last Thanksgiving was Yanet Coombes’ first big holiday since Mounjaro started treatment for her type 2 diabetes. She and her husband spent 10 hours preparing classic American dishes and Peruvian additions like papa a la huancaína, a spicy yellow sauce poured over potatoes, for a group of about fifteen people who hosted them at their home near Chicago.

When Ms. Coombes, 41, sat down to eat very small portions, an interrogation broke out at the Thanksgiving table. “There was a lot of ‘Why aren’t you eating?’ or ‘Why isn’t there more on your plate?’” she said. She batted away some questions with sarcasm and answered others, but they continued, “Aren’t you hungry?” ‘Don’t you feel like you’re missing something?’”

While other holidays draw people away from the table with religious services or gift-giving, Thanksgiving sees no such distraction, says Amy Bentley, a food historian at New York University. “It’s really just the meal,” she said. “That’s it, that’s the holiday.”

The typical menu consists of “very salty, very heavy, very satisfying” dishes, said Dr. Bentley, even as some Americans have taken into account the myths central to the holiday and adapted the meal with additions from other cuisines.

That reality has put many people taking Ozempic and similar medications into compounding mode. Some wonder whether they should tell family members they are taking the medications to avoid offending their smaller appetites, while others worry about inviting judgment. There’s some heated talk on Reddit forums about skipping doses: Should someone sacrifice their weekly shot so they can pile on the pumpkin pie?

Dr. Scott Hagan, an assistant professor of medicine at the University of Washington who studies obesity, said patients ask him if they can skip doses of Ozempic or similar medications before a food-focused event like Thanksgiving. He advises them not to do this, for a few reasons: For people with diabetes, missing a dose of Ozempic and then consuming a high-carb meal can lead to a blood sugar spike. And when people restart their doses, they may experience more intense side effects.

Those who endure the discomfort of eating a larger amount than they are used to while taking the medication may experience acid reflux, he said. They may feel so full that they are in pain.

“It can be a very tough holiday,” said Dr. Hagan.

‘Eating habits are so visible’

Regina Foley, 59, said she looked forward to Thanksgiving because it was the only day her food didn’t stand out. Now that she’s on Wegovy, this is the first year she hasn’t gotten excited about sweet potato pie with marshmallows or Pillsbury cookies. “It’s like, take it or leave it,” she said. “It doesn’t have that adrenaline rush and anticipation like it used to.”

Her 21-year-old daughter, Maeve, also uses the drug. She started a few months after her mother talked about how the medication had reduced her spiraling thoughts about food.

Maeve was used to confiding in her mother about her meal-related anxieties: on previous Thanksgivings, she would first eat with her mother, father, and brother and then go to her friend’s house for a second meal, where she would eat until she felt no more. felt capable. of moving. Guilt and shame soon arose, and she texted her mother, who wrote back that she understood, that she was there for her daughter.

“The compulsive nature of it, the free rein to just eat a bunch of crap, is what has changed,” Regina said.

This year, Maeve said she and her mother are home from the day in Old Saybrook, Conn. could enjoy, instead of fearing the aftermath.

“I’m actually really enjoying spending time with my parents and my brother and then with my boyfriend’s family without the major worries I normally have about food,” Maeve said. “I think it will definitely be a new experience. And it will be really fun to have my mom to do it with me.”

The holiday highlights the eating habits of family members, says Adrienne Bitar, a lecturer in American studies at Cornell and author of a book on diet culture. Any deviation from the standard menu – whether due to Ozempic, a food allergy or veganism – can attract excessive attention. Family members may express unwanted observations about a person’s body, or make moral judgments about using the weight loss medications.

“It would be difficult to find another occasion where one’s eating habits are so well reflected in an environment that is often characterized by high levels of family tension and fraught family dynamics,” said Dr. Bitar.

She also thinks the drugs could change the way people respond to questions about their food. “Instead of saying, ‘Hey, Uncle Bob, stop it,’” she said, someone who has been prescribed Ozempic by a doctor might respond along the lines of, “This is a medical decision that’s not up for debate.” between you and me right now. the Thanksgiving table.”

Alexa Rimmer, 29, remembers how self-conscious she felt last Thanksgiving. She had been taking Mounjaro for two months and was nervous whether her mother and grandmother would comment on how little she ate: a single piece of turkey, a spoonful of mashed potatoes, a slice of pumpkin pie.

“My mother always did the stereotype: ‘This is the day to go all out, don’t feel guilty’ – that kind of thing where you feel pressure to eat a lot with your family. That is the event that everyone participates in to bond,” she said.

She was pleasantly surprised when no one commented on her portions. She had decided not to tell anyone in her family that she was taking the medication, for fear they would consider it an eating disorder. “I was really worried that there would be a conversation about, ‘Oh, is this a problem, are you uncomfortable with yourself?’” she said.

Weeks later, when she was back home in Jupiter, Florida, for Christmas, her mother took her aside to ask if she was taking a weight-loss medication. Alexa told her. Her mother also had a confession: she was on Ozempic.