The “Holiday Pause” For GLP-1s Is Quickly Approaching — but Is It Safe?

It's no secret the holidays are filled to the brim with cozy parties, fun drinks, and good food. But in order to maximize the celebration, some people are "pausing" their Ozempic (and other similar meds) to have more of an appetite during the festivities. According to experts, it's known as the great "holiday pause."

Quick primer: Ozempic is an FDA-approved prescription injectable medication originally created to help people with type 2 diabetes. It belongs to a class of medications called GLP-1 (glucagon-like peptide 1) receptor agonists that work by increasing the amount of insulin released into the body after a meal, essentially mimicking gastrointestinal hormones that trigger digestion, signal satiety, and suppress appetite, per the website. As a result, weight loss is a common side effect of the drug. (FYI: Ozempic is only FDA-approved to treat type 2 diabetes, although a higher dose of the active ingredient in the medication, semaglutide, sold under brand name Wegovy, is FDA-approved for weight-loss under certain circumstances.)

So because GLP-1s significantly reduce your appetite and curb cravings, users of the medication are pausing their meds around meal-centric holidays. But is this practice safe? Here, an MD explains exactly what you need to know about the holiday pause, and starting and stopping weight-loss drugs.

Meghan Garcia-Webb, MD, is a triple board-certified physician and founder of Weight Medicine MD.

"The holiday pause is when patients elect to skip a dose of their GLP-1 medication the week of a holiday, so they have more of a regular appetite and eating experience," says Meghan Garcia-Webb, MD. Many people rely on a GLP-1 medication to curb their appetite, but since much of the holidays revolve around food, people are skipping doses of their prescription so they can "fully indulge" in holiday treats (aka the "holiday pause").

"The benefit of the 'holiday pause' means your appetite may be slightly larger, and you can probably tolerate larger portions than you can while on the medication," Dr. Garcia-Webb says. Heavier meals are known to trigger reflux, nausea, vomiting, and/or diarrhea for those on a GLP-1 medication, so skipping a week of the drug is intended to minimize side effects after a large Thanksgiving or Christmas meal, she says.

In general, you should never alter or self-dose a medication without a doctor's approval, including GLP-1s. "It's not usually dangerous, but it's not something I regularly promote because the more doses skipped, the more likely a patient is to have significant side effects (such as nausea, diarrhea, constipation, stomach pain, fluctuations in blood sugar levels, and even flu-like symptoms) when they start again," Dr. Garcia-Webb says.

Plus, if you miss several doses in a row, you may have to decrease your dosage when restarting, which can set back your goals, Dr. Garcia-Webb says. "It's definitely not something I would make a habit of, otherwise you're essentially underdosing yourself and you won't be getting the full benefit of the medication."

Instead of a total holiday pause, Dr. Garcia-Webb recommends people just delay their dose for a day or two. So, if you regularly take the medication on Wednesday, change your dosing day to Friday or Saturday the week of Thanksgiving (for a small reprieve on Thanksgiving Thursday), then gradually set it back to Wednesday over the next few weeks, she explains.

That said, if you take a GLP-1 for diabetes, you should never pause your medication, Dr. Garcia-Webb says. "GLP-1s can help lower your blood sugar, so if you're planning on eating a traditional holiday meal, [pausing doses] will likely cause your blood sugar to go much higher, and you won't have the added help to bring it down from the GLP-1 medication."

No, Dr. Garcia-Webb doesn't recommend it. "Holidays are a part of life, like vacations, birthdays, weddings, and other special events, and this medication is not an 'as needed' medication," she says. "It needs to be used consistently."

Skipping GLP-1 doses over the holidays can also lead to an "all or nothing" mindset, which is especially harmful for those with a history of disordered eating or binge eating, Dr. Garcia-Webb says. "The whole idea for these medications is that they help people have a more moderate, mindful approach to food, so remember why you went on them in the first place." You can still enjoy food and treats in moderation while on a GLP-1 medication, so it's not about restriction vs. allowance. It's about a balanced approach and working with a doctor to find what works for you.

That said, if your doctor gives the thumbs-up, missing one dose of a GLP-1 medication shouldn't have an enormously significant effect. "As long as you were tolerating the medication well prior to stopping, I wouldn't anticipate significant adverse events, though you might have slightly more side effects when you restart," Dr. Garcia-Webb says. "But in general, I would love if people stayed on the medication through the holidays and used it as a tool to help them stay healthy at times when they would have had more trouble in the past."

Andi Breitowich is a Chicago-based freelance writer and graduate from Emory University and Northwestern University's Medill School of Journalism. Her work has appeared in PS, Women's Health, Cosmopolitan, and elsewhere.