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Around the holidays, when many people are baking cookies for Santa, enjoying cocktail parties, or having family parties, some adults who use popular medications for diabetes or weight loss consider skipping a week or two.
These medications can suppress appetite or sometimes cause uncomfortable side effects that some people want to avoid during the holiday season. And according to some doctors, some of their patients want to fully enjoy their favorite foods, or they want to save some money when they have high expenses.
“People would be surprised to do this,” said Dr. Judith Koerner, a professor of medicine at New York Presbyterian/Columbia University Irving Medical Center in New York.
“Sometimes you wonder if you're going on a picnic or a vacation,” she said. “I have patients in other situations where they are taking the medication and we keep them at the current dosage and we don't talk during the holidays.
Dr. Alyssa Dominguez, a USC endocrinologist at Keck Medical in Los Angeles, says some of her patients ask about skipping doses during the holidays.
“Patients come to me asking about skipping these medications during holidays, vacations. Another thing that often comes up is the delay in starting the medication or increasing the dosage,” said Dominguez.
“It's not uncommon for someone to want to maintain their weight or stop gaining weight,” she said. “These drugs have side effects such as nausea, stomach pain, constipation or diarrhea. So, of course, if someone is thinking about starting the drug or increasing the dose, why would someone not want to see those symptoms if they are going to be on a plane for a long time or inside Totally understandable. Foreign country.”
In addition, if these drugs are not covered by insurance, they can be expensive – from several hundred dollars to About 1,000 dollars per month.
GLP-1 receptor agonists and dual agonists – such as Ozempic, Wegovy, Mounjaro and Zepbound – are commonly used as weekly injections. GLP-1 receptor agonists act by mimicking the GLP-1 hormone In the intestine, and dual agonists act like both GLP-1 and GIP hormonesIt controls blood glucose and appetite.
In most cases, when people start with these medications, they are prescribed a low dose and gradually increase to a higher dose over the following weeks.
But the effects of taking a break on your body depend on why you took the drug in the first place, Koerner said.
“If you have type 2 diabetes and are taking medication to control your blood sugar, you should be aware that if you skip doses, your blood glucose levels may rise. But if you are well-controlled with type 2 diabetes and your blood sugar is slightly elevated, this may not be clinically significant.
Dominguez said the risk of high blood sugar levels is if a person with diabetes skips the dose. But for other people who use these drugs specifically for weight loss, the risks are different.
“We would expect that a person would have a decreased appetite and be more prone to constipation, so they might eat more, which could interfere with some weight loss efforts,” Dominguez said.
However, “these drugs stay in your body for a while. So even if you skip a dose, it's not like the dose goes down to zero,” Koerner said. You will still have some of the medication in your system, so you may still have an effect to help control your appetite. These are things to consider.
of Order information for Ozempic Note that if one misses a dose, it should be taken within five days. If more than five days pass, the person should skip the missed dose and give the next one on the regularly scheduled day.
Same goes for b. Munjaro And A zipper. The prescription information recommends taking a missed dose within four days, but if more than four days have passed, the missed dose should be skipped and the next dose should be given on the regular day.
of Order information for Wegovy Note that if a dose is missed and the next one is more than two days away, the patient should take the missed dose as soon as possible. But if the next dose is less than two days away, they should not take the missed dose and continue their regular schedule.
For most of these medications, “you can skip your medication for up to two weeks without having to go back to a lower dose. So, from a safety perspective, it's manageable,” says Dr. Deborah Horne, MD, director of obesity medicine at UTHealth Houston, Texas.
“However, I don't recommend that someone go overboard just because they want to get a little extra for the holiday season,” she said. “We're concerned that you're more likely to experience side effects after two weeks,” such as nausea, constipation, diarrhea or vomiting.
For many patients, maintaining their dosage schedule is important during the holidays.
“People actually, at least in my patient population, actually prefer to stay on it because the holidays are tough, right?” said Dr. Eduardo Gruvald, medical director of the Center for Advanced Weight Management at UCSD's Bariatric and Metabolic Institute.
Some providers have talked about how to keep their patients on their medications and still enjoy their favorite treatments, such as by trying a smaller dose.
“Keep that amount of food where you can handle it. We know that if you overeat on these GLP-1 drugs, it can cause nausea or uncomfortable stomach pain,” Horn said. “Just be careful about the volume.”
For some people, feeding every four hours helps, she says, which can reduce side effects. “Some people may struggle with nausea and these GI side effects if they don't eat for a long time.”
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While it can be tempting during the holidays, try to keep a close eye on foods high in fat and carbohydrates.
“Some symptoms, such as nausea, can be aggravated by fatty or heavy foods,” Dominguez said. “So you shouldn't deviate too much from what you eat. Otherwise, you may experience some unpleasant side effects.
But “putting some nice fiber or protein next to them can help alleviate some of the GI symptoms associated with it,” Horne said.
It can also be helpful to avoid alcoholic beverages while partying, Koerner said.
“Sometimes people cannot tolerate drinking alcohol with the medicine. “The other thing is that if you have a little exposure to alcohol, you may find that your judgment isn't as healthy as it used to be, and that may lead to eating things that you can't tolerate,” she says.
If you take a holiday break from your GLP-1 medication and notice side effects when you restart your dose, “consider seeing your health care provider, because we may prescribe anti-nausea medications in those situations,” says Horn.
Finally, there are still plenty of ways to enjoy the holiday season with activities or gatherings that don't involve food: gift wrapping, caroling, or ice skating.
“The holidays aren't always about the food,” Koerner said. Even though this is such a big part, we have to remember that it's about family and friends and being together.