Dec 17, 2023 - Health

Ozempic "holiday": What to know about a weight loss treatment pause

Illustration of a semaglutide needle with a sign resting atop it that says Away for the Holidays

Illustration: Natalie Peeples/Axios

Wanting to enjoy Christmas cookies and other holiday treats, some people on diabetes and weight management drugs like Ozempic are considering a pause in treatment.

Why it matters: Doctors caution that stopping and starting the medications known as GLP-1 agonists can lead to unwanted side effects like nausea — and can contradict the way the drugs are meant to be used.

What's happening: Semaglutide — the active ingredient in Novo Nordisk's Wegovy and Ozempic — is effective at quieting thoughts about food in users' heads (that many call "food noise") and limiting appetite and food intake.

  • "There's also some suggestion that the pleasure associated with food might be dampened … for some people," Peter Antall, Lark's chief medical officer, tells Axios.
  • And treatment could lead to food aversions. Antall says he has patients on semaglutide drugs who say they no longer enjoy fried foods and beer, in particular.

On TikTok, Facebook and Reddit, some people on GLP-1 treatments — particularly for weight loss — post about skipping or delaying doses ahead of the holidays to eat more or prevent side effects like feeling uncomfortably full after dinner.

  • Another factor that goes into the decision to stay away from the shots over the holidays is to avoid answering questions about new eating habits.
  • TikToker Julie Stoll-Kelly shared that she skipped her semaglutide dose before Thanksgiving, but she still "wasn't that hungry" for the holiday meal. "I don't think I'll miss my dose for Christmas or … any holiday in the near future," she said in a video.

Yes, but if you decide to pause, it's "not the end of the world," Antall says.

  • It's important to talk to your health care provider to determine the best approach, experts say.
  • You might be advised to restart at a lower dose to minimize potential side effects like nausea, bloat, diarrhea and constipation.
  • Of note: There are no withdrawals with these kinds of medicines, but patients could experience a rise in appetite or food noise while taking a break, Spencer Nadolsky, the medical director of WeightWatchers, tells Axios.

Between the lines: Many more users of GLP-1 medications are being forced to skip a dose due to the ongoing global shortages or the high cost of the drugs.

  • "It's expensive around the holidays. If you're paying out of pocket, you're trying to stretch it. … We have three kids and I'm buying them Christmas presents," Mounjaro user Caley Svensson, who spends more than $1,000 for her prescription of four single-use doses, tells Axios.
  • Svensson, who says she's lost 90 pounds on tirzepatide medication, used to be anxious about holiday eating. But this month she's confident that she can eat smaller portions and listen to her body, even while stretching her low-maintenance dose for an extra few days.

Be smart: There are still a lot of unknowns when it comes to how semaglutide medications and other weight loss treatments impact eating behaviors.

  • What we do know: Typically when on the drugs, patients are full faster, their stomachs empty slower and they don't eat as much.
  • "We don't entirely understand what's happening in the brain in terms of neural networks and where the action is happening, [and] we don't really know long-term effects," Robert Gabbay, chief scientific and medical officer for the American Diabetes Association, says.

How to move GLP-1 meds

Here's what the drug manufacturers say about moving or skipping doses:

  • Mounjaro: To change the day of the week for the tirzepatide injection, "make sure there are at least 3 days (72 hours) between doses." Missed doses should be taken "as soon as possible within 4 days (96 hours) after the missed dose."
  • Ozempic: The semaglutide medication can be moved to another day of the week "as long as your last dose was taken 2 or more days before." Missed doses should be taken "as soon as possible within 5 days after the missed dose."
  • Wegovy: The day of the week can be changed "as long as your last dose of Wegovy was given 2 or more days before." The semaglutide medication's website says to take a missed dose as soon as possible if the "next scheduled dose is more than 2 days away (48 hours)."
  • Zepbound: Make sure there are at least 3 days (72 hours) between doses. Take missed doses "within 4 days (96 hours) of your scheduled dosing."
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