Long Islanders on GLP-1 weight loss drugs navigate the holidays with smaller bites, 'pregaming'

Linda McMahon, 57, of Patchogue chuckled recalling her Thanksgiving with the "Mounjaro crew" — herself and friends who are taking GLP-1 medications.

"If you saw our plates you would have laughed," she said.

Instead of the usual heaps of ham, mashed potatoes and green bean casserole, they had small servings of each.

"I didn’t even touch the bread," McMahon said. "But I did have some pumpkin ale."

It’s the season for holiday parties and family gatherings with food-packed tables and endless glasses of wine and spirits. The festivities can present a special challenge for the growing number of people taking GLP-1 medications like Wegovy, Ozempic and Mounjaro, which have led people to see dramatic weight losses.

Some focus on small portions and allow themselves a treat here and there. Others like to "pregame" by eating healthy food before a party. And then there are those who skip one or two weeks of the medication, saying it will allow them to better enjoy the holidays.

"When I talk to my patients I say ‘Thanksgiving, Christmas Eve, Christmas — those are just one day, I don’t really care what you eat,’ " said Dr. Michael Kaplan, who is board certified in obesity medicine and a founding partner of the Long Island Weight Loss Institute. "But going off the medicine that is helping them usually is counterproductive."

McMahon has lost 112 pounds in the three years she has been on the medication. "I’m healthy, I feel great," she said. "I tell people I still live, I just eat a little bit and that’s it."

GLP-1 drugs (Glucagon-like peptide-1 receptor agonists) act like hormones naturally released in the body when a person eats. People who take these drugs are less hungry and fuller for longer periods of time because their digestion has slowed.

Originally used for patients with diabetes, certain GLP-1 medications are now approved for people with obesity leading to a boom in use and concerns about access and rising insurance costs.

Spending on GLP-1 receptor agonists increased from $13.7 billion to $71.7 billion between 2018 and 2023, according to a report published earlier this year. A tracking poll released last month by KFF, a nonprofit health policy organization, found 1 in 8 adults were taking a GLP-1 drug and 1 in 5 had taken one at some point to lose weight, treat diabetes or for another chronic condition.

The most common side effects of GLP-1 drugs include, nausea, vomiting and diarrhea. Sometimes changing the dose or type of medication can ease those symptoms, patients said, while others reported having no side effects at all.

"They get rid of the food noise," Kaplan said. "The deprivation factor is gone ... so if you normally eat a really large piece of lasagna, now you're going to have two bites of it and feel like you already ate it."

BYOF, sipping cocktails

The holidays can be especially challenging for Tamara Oliver, not only because she's on Zepbound, but she's also vegan. If she is going to the home of a friend or family, she offers to bring her own food. Before going to a holiday gathering at a restaurant, she checks the menu.

Through exercise and two different GLP-1 medications, the mom of triplets lost almost 90 pounds over the last three years and got rid of her painful sciatica.

But she does allow herself a taste of the forbidden now and then — like the non-vegan peppermint bark she received as a gift last Christmas.

"Oh my stars!" the 58-year-old Selden resident, recalled thinking after trying the candy. "I didn’t think that would be so good ... I ate some and then some and then regretted it, but you are never going to be perfect. It’s OK."

Oliver said she has never had side effects on the Mounjaro, which she was on initially or Zepbound, but the compounded GLP-1 she tried when the other medications were unavailable left her violently ill with gastrointestinal issues. 

She said some people are critical of GLP-1s and wonder about long-term success.

"It's like anything you do," Oliver said. "You still have to work. You still have to eat the right way. You still have to be kind to yourself. Those things don't change."

Ingrid Dodd, a 57-year-old Lido Beach resident, said the use of GLP-1 has completely transformed her holiday experience — for the better.

"I was so obsessed with food, I would stress out so much about December, all the parties and drinking, but now it’s made my holidays so enjoyable," said Dodd, who owns a public relations and digital marketing firm.

Dodd said sometimes she "pregames" a protein shake before heading out to a party and makes sure she drinks a lot of water, which helps with digestion. Exercise is key to keeping her maintenance weight.

"I concentrate a lot on making my bones strong, make sure I am eating a lot of protein, guided by a doctor," she said. "You can’t do this without a professional who knows what they are doing."

Dodd hasn’t given up her favorite party drink, an espresso martini with Baileys Irish Cream. She just sips one throughout the night.

Smaller bites

Senior Nurse Practitioner Faina Norinskiy tells her patients that food is a big part of holiday celebrations, and that’s OK.

"We don’t want them to feel excluded," said Norinskiy, bariatric program coordinator at Long Island Jewish Valley Stream. "I tell them if they are going to a dinner party to make sure their other meals are good quality and balanced with protein so they are less tempted."

She also counsels them to feel comfortable whether they say yes or no to a serving.

"You don’t have to have three pieces of pie," she said. "You can have a few bites and then push it away. Patients are worried that they will be judged."

Some patients ask about skipping a week or two of their GLP-1 doses because they want to eat more during the holidays. Norinskiy advises against it.

"I tell them they can still enjoy the food but just smaller quantities," she said.

That strategy works for Christine Bond, 57, of Queens, who said she can still eat the foods she likes while taking GLP-1 medication with one big difference.

"I still love ice cream, but now I can have a scoop of ice cream and be like, ‘Wow, that was really good, but I’m done,’ " she said.

Bond has never experienced gastrointestinal side effects but makes sure she has enough fiber to help with digestion.

She plans to sample some of her holiday favorites — sweet potato pie, stuffing, macaroni and cheese — at holiday meals but not "gorge" herself.

"I’m not obsessing about food anymore," said Bond, who has lost 122 pounds. "I just enjoy the moment."