Caitlin Whyte (Host): This is Flourish. I'm your host, Caitlin Whyte, and I'm thrilled to have on Dr. Eva Wolf, an internal medicine physician and obesity medicine specialist from Prisma Health. In today's episode, we'll be delving into the topic of GLP-1 and the holidays, how to eat well, and feel good; exploring how you can enjoy holiday feasts without compromising your health or comfort.

Doctor, I am definitely excited to get into a topic like this. My first question is, why might traditional holiday meals, often large and rich, be uncomfortable or challenging for someone on a GLP-1?

Dr. Eva Wolf: Well, the way I explain how a GLP-1 works is it makes your stomach feel smaller and empty slower. So, a large meal is going to be uncomfortable for people taking that kind of medicine.

Host: And you touched on this already a bit, but can you explain a little bit further how those GLP-1 medications like Ozempic, Wegovy, how they work, especially in relation to that hunger and how digestion works?

Dr. Eva Wolf: With your digestion, it delays the gastric emptying, meaning that the food that you put into your stomach is going to stay there a lot longer. And then, as far as hunger, that is definitely going to be augmented, especially at the higher doses. So, people taking these medicines don't get as hungry as often. They don't think about food as often as they did before taking the medicine. So, they may think less about food, which is a relief outside of the holidays. But then when we come to the holidays, they may have a harder time navigating such a large meal.

Host: Well, exactly, meals are so much larger, it feels like, during whatever holiday is coming up for you this winter. What are some practical strategies for managing those portion sizes and choosing foods that support comfort and health during these big meals?

Dr. Eva Wolf: Well, a traditional move is to pick a smaller plate that supports your plan to not overeat, and that will help you not feel sick. If your appetite is reduced through a medicine, we want to really prioritize the nutrient-dense, minimally processed foods, and use our mindful eating habits. That way, we are supporting the metabolic benefits of a GLP and avoiding the common side effects and the nutritional risks tied to the reduced appetite and reduced food intake.

Host: Now, are there any specific nutrients or certain types of food that people on GLP-1 should prioritize or even avoid during holiday gatherings?

Dr. Eva Wolf: Protein is very essential for our bodies, and it helps keep your blood sugar steady. And folks on a GLP-1 may inadvertently not get enough of that nutrient. And so, when we're building our plate or the menu, we want to focus on our lean proteins and we don't want to miss out on the vegetables for our fiber. We want to steer away from more fatty meats and fried foods because excess fat consumption can lead to a lot of nausea when you're taking those medicines.

Host: Well, besides the physical discomfort that can maybe come with eating too much on a GLP-1, during the holidays, how can someone navigate those social stigmas or pressures or judgements when they're eating less than others at the table?

Dr. Eva Wolf: I think it's very important to communicate your plan with your host family and friends. Remember, these are people that love you, they want to support your goals, and they want you to feel well. So, communicating ahead of time that you've made some changes for your lifestyle, you're not going to eat as much will help it not be such a topic on the day of.

And then, being present in the time with your family and friends. Focus more on the non-food traditions and the opportunities for connection. You can serve others with volunteering. You can take in the changing leaves and holiday decorations. You can do a holiday-themed craft or a puzzle, watch the parade together, catch some football. Take a walk as a family. There are a lot of non-food items that we can still participate in, even when you're eating a little differently than before.

Host: I love that idea of just remembering that you are most likely with friends and/or family. And either way, you should be surrounded by those who love you and support you. Thank you for that reminder. Now, even besides all of the main course food that we're enjoying in the next couple weeks, let's talk about holiday treats and sweets like desserts or even alcohol. While on GLP-1s, what should people keep in mind if they indulge in these things?

Dr. Eva Wolf: When taking a GLP-1, it is important to limit the sweets, which I know it's a hard one Around the holidays. But foods and drinks with sugar can make you feel ill. If you're taking a GLP-1 for that very special treat that you enjoy around the holidays, I recommend having it after your meal is complete so you can pick a smaller portion, eat mindfully and savor that to avoid overdoing it. But also, we've noticed that some people's tastes change when they're taking the GLP. So, you may have less hunger and attraction to that treat that you previously found very enjoyable. So, this might even be easier for patients than they anticipate.

When it comes to alcohol, drinks that contain sugar and/or alcohol are just not going to be consistent with either a weight loss plan or feeling healthy when taking a GLP-1 because drinks that contain sugar and/or alcohol could make you feel sick if you're on this type of medicine. But there's plenty of easy swaps to make. Picking zero-calorie soft drinks. Maybe instead of a mimosa, just have some sparkling water with some OJ splashed in there. Cranberry juice inside of some sparkling water is a festive low-sugar mocktail. For some people on GLPs, carbonated water can make them nauseated or they might worry about belches. So, picking plain water as your base, and then adding a little bit of juice is a better mocktail option.

Host: Definitely some great ideas to keep in mind, Doctor. And when it comes to drinking, why is hydration so important, whether or not we're even drinking alcohol.

Dr. Eva Wolf: Hydration's essential to prevent constipation and dehydration when you're taking a GLP-1, as that can happen. When you're picking your hydration choices, we want to pick the beverages that support your goals. So, that's where those fun mocktails can really tie in. But you can make some more swaps. Instead of apple cider, have apple cider-flavored herbal tea. There's plenty of fun herbal teas that don't have a lot of sugar. You can pick a sugar-free cocoa to be holiday themed. And also, be very careful with coffee drinks. Those frequently have much more sugar than you would expect. And those sugary drinks, again, can make you feel very sick when you take a GLP-1. Some savvy patients use protein shakes as their creamer to ensure their coffee is low in sugar and boosted with protein. And when making those swaps, I highly recommend using a fun visually-appealing glass or mug when you're changing up your drink choices so you don't feel left out.

Host: And should patients consider adjusting even their medication schedule around big food events like the winter holidays or maybe a vacation, or is consistency when it comes to that medication more important?

Dr. Eva Wolf: I think that adjusting the medicine without consulting your provider could backfire, because if you reduce the doses of your medicine and then try to get back on, it might be very abrupt for your system after taking a break. So, I think that you should stay on your consistent schedule, especially if you're already tolerating the medicine, and then adjust your eating plan around that. And that will be more consistent with your goals of the medicine to either control your diabetes or to manage weight.

Host: Doctor, to wrap it all up, what advice would you give to someone who wants to stay on track with their health goals during the holidays without feeling deprived or isolated or like they're missing out?

Dr. Eva Wolf: The biggest thing is to discuss your plan with your family and friends so they can support your goals and make sure you're enjoying your protein and plant-focused meals. Practice your mindful eating. Reduce portion sizes and ensure regular meal timing. Also, be mindful to support your own hydration and avoid going overboard with the fatty food or sweets in order to feel your best.

Host: Thank you so much for this conversation, Doctor. That was Dr. Eva Wolf, discussing how to enjoy holiday feasts and treats while on GLP-1 medications. For more information, visit prismahealth.org/flourish. And if you enjoyed this podcast, please share it on your social channels and explore our entire podcast library for topics of interest to you. I'm Caitlyn Whyte and this is Flourish. Thanks for listening.