Wegovy and weight loss drugs mean less food guilt this Thanksgiving
For most of her life, Claudia Stearns dreaded Thanksgiving. As someone who struggled with obesity since childhood, Stearns hated the annual turmoil of obsessing about what she ate — and the guilt of overindulging on a vacation built around food.
Now, after losing nearly 100 pounds using medications including Wegovy, a powerful new obesity drug, Stearns says the “food noise” in his head has become very, very quiet.
“Last year, it was so nice to be able to just enjoy my meal, to focus on being with my friends and family, to focus on the joy of the day,” says Stearns, 65. , of Somerville, Massachusetts. “It was a whole new experience.”
As millions of Americans struggling with obesity gain access to a new generation of weight-loss drugs, Stearns’ experience is becoming increasingly common — and more visible at times of year when cooking, eating and a sense of abundance can define and intensify gatherings. relatives and friends. Medical experts and consumers say the drugs change not only what users eat, but also how they view food.
For some, this means better mental control over their meals. Others say it saps the enjoyment of social situations, including traditionally food-centered holidays like Thanksgiving, Passover and Christmas.
“It’s something that really changes a lot of things in their lives,” says Dr. Daniel Bessesen, chief of endocrinology at Denver Health, who treats obese patients. “They move from food being the focus to what’s just not the focus.”
Undermining the festivities
New obesity drugs, initially designed to treat diabetes, include semaglutide, used in Ozempic and Wegovy, and tirzepatide, used in Mounjaro and recently approved as Zepbound. Now also intended for weight loss, the drugs given as weekly injections work very differently from any diet. They mimic powerful hormones that come into play after people eat to regulate appetite and the feeling of fullness communicated between the gut and the brain. Users can lose up to 15 to 25 percent of their body weight, according to studies.
“That’s how it works: It reduces the rewarding aspects of food,” says Dr. Michael Schwartz, an expert in metabolism, diabetes and obesity at the University of Washington in Seattle.
For Stearns, who started treatment in 2020, using weight-loss medication means she can take a few bites of her favorite Thanksgiving pies — then stop.
“I wouldn’t feel full,” she said, “but I would feel satisfied.”
Yet such a shift may have broader implications, both religious and cultural, as it alters the experience of festive and religious holidays that are often built around interactions with food – and largely so.
“I’m Italian. For us, it’s like going to church, going to a table,” says Joe Sapone, 64, a retiree from Atlantic Highlands, New Jersey, who lost about 100 pounds through dieting. and Mounjaro. He no longer needs what he calls the “culinary orgy” of the holidays, but he admits it was an adjustment.
“Part of getting there is disconnecting the right timing from what you eat,” he says. “Will I still have fun if I don’t eat as much?”
Pleasure changes
Many users appreciate what they see as greater control over what they eat, even during the emotionally charged holiday season.
“Maybe I’m more selective about what foods I put on my plate,” says Tara Rothenhoefer, 48, of Trinity, Florida. She lost more than 200 pounds after participating in a clinical trial testing Mounjaro for weight loss in 2020. “I don’t care about bread as much. I always eat what I like.
But others who take these medications lose their appetite completely or suffer side effects—nausea, vomiting, diarrhea—that interfere with the enjoyment of any food.
“Over the years, I’ve had a handful of patients who were really unhappy because they didn’t enjoy food in the same way,” says Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co- founder of Intellihealth, a company specializing in obesity. clinical and software company specializing in the treatment of obesity.
But, she added, most people who have turned to weight-loss drugs have spent years battling the physical and mental burden of chronic obesity and are relieved to discover a diminished desire for food – and grateful to lose weight.
Studies show that when people stop taking these medications, their appetite returns and they gain weight back, often faster than they lost it. An initial analysis revealed that two-thirds of patients who started taking weight-loss drugs were no longer using them a year later.
This may be due in part to high costs and ongoing supply shortages. But the broader question of what it means to change a fundamental human drive like appetite also needs to be considered, says Dr. Jens Juul Holst of the University of Copenhagen. He is one of the researchers who first identified the gut hormone GLP-1, or glucagon-like peptide 1, which ultimately led to the new class of anti-obesity drugs.
Speaking at an international diabetes conference this fall, Holst offered a philosophical critique of the real-world impact of new drugs.
“Why did you lose weight?” It’s because you lost your appetite. It’s because you’ve lost the pleasure of eating and the reward of a good meal,” Holst told his colleagues. “And how long can you stand that?” That’s the real, real question.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Education Media Group. The AP is solely responsible for all content.
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