Foods To Avoid, Pausing Medication

The holidays can feel strange for people who are taking Ozempic and other popular weight-loss drugs.

It’s the most food-centric time of the year, but these medications reduce appetite. 

Chocolate, cookies and cakes are everywhere, but overindulging in treats high in fat and sugar can lead to nausea and stomach problems for patients on these drugs, doctors say.

Part of the joy of the season may be gone — or feel different — when food habits change.

“Food is comfort, food is pleasure. So for some, there may be a feeling of loss if they can’t eat all the things they normally would,” Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in North Carolina, tells TODAY.com.

“Many different cultures put a great emphasis on food as being part of the celebration and the holidays,” adds Dr. Cecilia Low Wang, endocrinologist at UCHealth and professor at the University of Colorado School of Medicine.

“And sometimes it can be really difficult if you’re not enjoying your food or you don’t have that appetite, or maybe certain things are giving you more side effects.”

Journalist Johann Hari lost 42 pounds with Ozempic but was taken aback when he didn’t feel happier.

“I realized it was about my inability to comfort eat, and how bad that was making me feel,” he told TODAY.com. “On Ozempic, you can’t overeat.”

Weight-loss drugs quiet food noise and come with side effects

About 12% of Americans have taken a GLP-1 drug, according to the KFF Health Tracking Poll.

This class of medications includes Ozempic and Mounjaro, approved to treat Type 2 diabetes, but sometimes prescribed off-label for weight loss. Wegovy and Zepbound have been approved to treat obesity.

The most common side effects for all of these medications include nausea, diarrhea, vomiting, constipation and stomach pain, according to their manufacturers. More serious side effects are possible.

GLP-1 drugs mimic at least one hormone produced by the gut to signal fullness, so people have reduced appetite, and when they do eat, they feel full sooner. 

The medications can stop “food noise,” or constant intrusive thoughts about food. Dr. Maria Daniela Hurtado Andrade, an endocrinologist at the Mayo Clinic’s Precision Medicine for Obesity program, says one patient told her, “I was living to eat. Now I’m eating to live.” Hurtado Andrade is a consultant for Novo Nordisk, the pharmaceutical company that makes Ozempic and Wegovy.

Patients also say they can’t eat as much as they used to.

Weight-loss drugs and holiday eating

“Some people are actually really happy that they can get through the holidays without being tempted by all the things that they’re normally tempted by,” Low Wang says.

“Instead of the huge quantity that maybe one might have been wanting to have in the past, now just a little bit is enough.”

Low Wang, who chairs the FDA’s Endocrinologic and Metabolic Drugs Advisory Committee, says she’s expressing her own views, and not speaking on behalf of the panel or the FDA.

Pepper Schwartz, who has been using Ozempic since 2022 and lost about 25 pounds, says she’s relieved she doesn’t want to overeat during the holidays.

“I look forward to the holiday — I don’t see it as temptations hell. It’s not that difficult to navigate when your cravings are calmed,” Schwartz, 79, who lives in Snoqualmie, Washington, tells TODAY.com.

“I like to taste everything, so I will have a bite. I just don’t eat the whole thing… You learn that you don’t have to eat everything on the plate.”

She recalls a recent gathering where “an amazing lemon” cake was served. Schwartz says she had three bites, left the rest and didn’t feel deprived.

Jamel Corona, who’s been taking Wegovy since December 2021 and lost about 50 pounds, describes her holiday eating as “very minimal.” She says she’s physically unable to eat a lot of food, so she immediately defaults to leftovers.

“That way I can still try everything, just at a later time,” Corona, 38, who lives in Chicago, tells TODAY.com. 

“I do miss eating the homemade desserts in real time. It makes me sad that I would love to eat them, but I will be miserable later on with stomach pain, nausea.”

Stopping and restarting Ozempic

Some people take a break from weight-loss drugs for trips or special occasions, a practice doctors caution against.

About 12% of U.S. patients who are taking a GLP-1 medication like Ozempic and Wegovy plan to skip their doses over the holidays, according to a survey by Levity, a weight loss management service.

The top reasons cited were to enjoy holiday foods including cookies and sweets, and to avoid side effects from rich foods.

Corona says she sometimes skips the dosage to be able to eat a bit more and drink alcohol, which she has trouble tolerating while on her weight-loss drug.

One of Hurtado Andrade’s patients is a foodie who confessed she skips her dose before trips with friends to be able to enjoy eating in restaurants — “She doesn’t find that enjoyment while on the medication,” the doctor says.

Hurtado Andrade advises against it. 

Patients who discontinue the medication for a few weeks and then restart it are more likely to have side effects, she says.

They’ll have to lower the dose and start the titration process — which involves slowly increasing the dose by small amounts — all over again, McGowan says.

“I would discourage the interruption of GLP-1 therapy for any reason,” he warns. “Instead of interrupting treatment so you can overindulge, let’s find ways to indulge in a healthy way.”

Holiday eating on weight-loss drugs

If you’re going into the holidays and holiday meals while taking a weight-loss drug, doctors shared these tips:

• Nothing is off limits as long as it’s in moderation, McGowan notes. Eat small portions, have a little taste and enjoy small bites.
• Focus on foods that are easy to digest such as turkey and other lean proteins, he says. Avoid heavier, greasy, fatty foods, or those with high sugar content. “Those are going to sit like a rock in your stomach and make you feel sick, cause nausea,” McGowan says.
• Pay attention to your hunger and satiety signals, and not try to eat past the point of fullness, Low Wang advises. If you’ve been eating less and suddenly consume a lot of rich foods, it will probably make you feel worse, she adds.
• The most important thing is mindful eating, Hurtado Andrade says. Eat slowly and don’t overindulge to the point of discomfort, “because the stomach really can’t handle as much food when you’re on one of these medications,” McGowan notes.
• Reframe the celebration. Rather than focusing on food, enjoy being with people you love; take walks with family and friends; and enjoy music, old movies and board games, Low Wang says.