If you take semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound), some food-focused holidays like Thanksgiving and Christmas are probably very different for you now. After all, these powerful appetite suppressants can make eating rich foods an uncomfortable experience.
You may be tempted to skip or delay a dose before a special occasion, whether it’s a big holiday meal, an expensive anniversary or birthday dinner, or some other celebration. Or maybe you’re planning a vacation and thinking about skipping a dose to really get your money’s worth from an all-inclusive resort.
An informal survey of social media forums dedicated to the use of injectable weight loss products shows that people are very divided about skipping doses. Some report happily delaying or skipping doses for holidays and vacations and would do so again. Others have tried the technique with poor results. Some people completely reject the idea.
So is it really safe to skip a dose every once in a while? And is that a good idea?
New weight loss drugs significantly reduce your interest in eating
The new weight-loss injections, nicknamed GLP-1s, mimic the actions of hormones the body naturally releases after eating, resulting in complex metabolic effects that work together to suppress hunger.
They have become a global phenomenon for one big reason. they are extraordinarily effective appetite suppressants. For example, a 12-week study found that semaglutide users consumed 24 percent fewer calories and enjoyed additional benefits such as reduced food cravings and enhanced self-control while eating. Participants even had less interest in fatty foods.
That’s great news for weight loss and diabetes management. But using these drugs means learning how to handle celebrations that include being surrounded by loved ones raving about delicious food.
Does skipping doses work?
Dr. Kathryn Saunders, an assistant professor and obesity specialist at Weill Cornell Medicine in New York and co-founder of Intellihealth, said that while skipping the occasional dose of a weight-loss drug is “technically safe,” she doubts it would allow patients to enjoy it. : big meal
Dr. Saunders has seen patients underestimate how slowly these drugs leave their system. “People can get into trouble with this habit given the long half-lives of semaglutide and tirzepatide,” he says. “If someone skips medication for a week to eat larger portions, they can get sick if they assume the medication is out of their system and they eat more than they can.”
He explains that even if appetite returns after a delayed or missed meal, large meals can still cause punitive side effects; Sometimes people feel fine during and even after eating, but a few hours later they vomit out of nowhere,” he says.
Dr. Andrew Craftson, director of the Weight Navigation Program at Michigan Medicine in Ann Arbor, agrees. “Just because you miss a dose doesn’t mean you’re not at risk for side effects. “Individuals should still be advised to chew very thoroughly, eat slowly and moderate their portions to avoid getting into trouble,” he says.
Dr. Craftson suggests that people who regularly experience gastrointestinal side effects from their medications may “have more pronounced symptoms if they miss a dose.”
Postponing the shot by a day or 2 might be “totally reasonable”.
Craftson adds that while delaying a dose to induce hunger may be unwise, there are other valid reasons to change your injection schedule around vacations or travel.
Many people experience their worst digestive problems in the first day or two after a weekly injection and have learned to postpone vaccination on days when vomiting or diarrhea would be particularly inconvenient, such as during job interviews, air travel, or holiday parties. Kraftson calls these short delays “perfectly reasonable.”
If your routine injection is scheduled to be done right before a big holiday meal, it’s probably safe to wait a day or two. this can reduce the risk of partying too much in the bathroom.
Skipping doses can set you up for long-term failure
Sean Hashmi, MD, regional director of clinical nutrition and weight management at Kaiser Permanente Southern California and a medical reviewer for Everyday Health, says delaying or skipping a dose of your medication is medically harmless in the short term. But he strongly warns against the practice for a second reason. Dr.
“This concept that we can stop this drug from doing something that we know isn’t good for us, it’s setting us up for long-term failure,” Hashmi says. “Medically it’s fine, but just remember that if you were an alcoholic, I wouldn’t tell you to go out drinking every Saturday night.”
There is a contingent in the online weight loss community that wholeheartedly agrees with Hashmi’s point of view and plans to stick to their regular dosing schedule throughout the holiday season. Some users are proud to use only small portions of holiday fare and know they are keeping their health in check. And more than a few voices online have reported that when weight loss drugs quiet their “food noise,” it just makes it easier to appreciate everything else that is the holidays.
Tips on how to enjoy special foods while using Ozempic or other weight loss medications
Experts agree that the best strategy for people using weight loss drugs is to manage your expectations of what and how much you can eat, rather than skipping meals.
Saunders offers three simple tips for those still interested in indulging in rich foods every now and then:
- Take small portions, especially if the food is very rich.
- Eat more slowly.
- Stop eating before you feel too full.
Official guidelines for delayed and missed doses
If you are considering a temporary change in your dosing schedule, the manufacturers of semaglutide and tirzepatide provide official guidelines:
- Semaglutide (Ozempic, Wegovy) users are advised to take the missed dose “as soon as possible, within five days of the missed dose.” If more than five days have passed, users should skip the week’s dose entirely and resume their regularly scheduled injections.
- Semaglutide users should never take two doses within 48 hours of each other.
- Users of Tirzepatide (Mounjaro, Zepbound) are advised to take the missed dose “as soon as possible within four days (96 hours) of the missed dose. If more than four days have passed, users should skip the entire week and resume their regularly scheduled injections.
- Tirzepatide users should never take two doses within 72 hours of each other.
Longer drug breaks may mean returning to smaller doses
With short delays, there is no need to worry about dosage strength. “If it’s just a week or two, you go right back to the original dosage,” Hashmi says.
Longer pauses can be more difficult. There are no official guidelines on how to resume your GLP-1 medication regimen after missing two or more weeks. “Nobody really knows yet because the data is still coming out on different practice patterns,” Hashmi says.
The big question is whether you can go back to the dosage you were on before or if you need to withdraw to a lower dosage.
New users of GLP-1 drugs always start with small initial doses before gradually titrating (increasing) their dosage. It takes some time for the body to adjust to these powerful drugs, and these notorious gastrointestinal side effects tend to be at their worst within the first few days of taking a new higher dose. The concern with longer breaks is that your body may lose some of the tolerance that allowed you to increase your dosage in the first place. Going back to a high dose after waiting a few weeks may be more than your body is ready to handle, leading to extremely uncomfortable side effects.
In the absence of clear guidelines, Hashmi says his clinic took a conservative approach. “Once we’ve stopped patients for about a month, we’ll restart them at a lower dose for safety reasons, then quickly ramp them up. We do this to avoid the unpleasant side effects of nausea, vomiting, diarrhea or constipation.” But at the moment that record is based on educated guesses only. “It is not proven. At this moment, we simply do not have an expert opinion.”
Saunders follows an equally cautious strategy with his patients. “When our patients are off medication for a long period of time, we usually recommend starting at the lowest dose and gradually titrating.”
If you have missed more than two regular doses, it may be unwise to restart your previous dose. Call your healthcare provider, who can make a recommendation based on your unique situation.
Bottom line for skipping or delaying doses of weight loss medications
Skipping or delaying a single dose of your weight loss medicine is unlikely to allow you to truly indulge in rich food. These powerful drugs stay in your system for more than a week, and even if your hunger seems to return, high-fat meals can still lead to ugly gastrointestinal side effects.
Longer medication breaks—missing doses for two weeks or more—raise new issues to address, as you may need to return to a lower starting dose to comfortably transition to your current level.
A better plan is to manage expectations around special meals and holidays. Accept your waning appetite, and if you want to eat heavy food, do so in moderation.
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