How GLP-1s changed Thanksgiving
Obesity medications are diminishing appetites for the foods that American holidays are known for
Thanksgiving is a festival of overabundance. That’s the whole point of it. But the whole point of weight-loss drugs — the most prescribed medications by value in the US today — is to eat less. Medical experts say that fact is changing Americans’ relationship to food — and to the festivals that focus on it.
More and more Americans are tackling obesity through drugs. KFF, the health policy group, found recently that one in eight now say they are taking GLP-1 drugs like Wegovy or Ozempic.
Meanwhile, public awareness of these drugs is exploding: PwC recently found that consumer interest in Ozempic had risen faster than curiosity about iPhones, Facebook or Uber at comparable points in their development. And President Donald Trump’s deal earlier this month to lower prices for what he calls “the fat shot” will provide access for 15mn more Americans, according to Morgan Stanley.
One recent study found that households with at least one GLP-1 user cut savoury snack spending by over 10 per cent in the first six months. “It’s the most significant shift in the food system in the last 100 years,” says Justin Siegel, faculty director of the Innovation Institute for Food and Health at University of California Davis. “And it’s beginning to impact culture.”
Medical experts say GLP-1s (glucagon-like peptide-1), which were developed to address diabetes, help people to eat less by slowing down gastric emptying — so you feel full for longer. They also affect the “reward” system our brains associate with food: patients often report less craving for fatty or sweet foods — exactly the kind in pride of place on our holiday tables.
That can have big implications for Thanksgiving when “eating too much is part of the ritual”, says Charlotte Biltekoff, professor of American studies and food science and technology at UC Davis. Daniel Bessesen, endocrinologist at the University of Colorado, says his patients on GLP-1s “just can’t eat the way they did in the past”. “If they did, they would get sick.”
Jens Juul Holst, a Danish researcher known for his pioneering work on GLP-1s, says: “If you’re a person for whom nice meals are one of the greatest pleasures in life, and you take that away, then it’s perhaps not so fun.” That, along with common gastrointestinal side effects, “help explain why quite a large number of people stop taking the medications”, he tells me.
But Siegel’s father Brock, 78, is taking the drugs and says he doesn’t feel deprived. Ahead of previous Thanksgivings, he would “look forward to relishing the food knowing I was going to overeat”. This year, he says, “I’m going to enjoy all the flavours but automatically not take as much. It’s very freeing.”
Bessesen suggests food-centred holidays may be more fun for those on GLP-1s. “For some people, holidays are not pleasurable, because there is food around all the time and lots of pressure to eat. So to have less of that is really positive for some people.”
I heard this from a number of people who take the medication (but prefer not to give their full names). Spencer, 35, a West Coast tech entrepreneur, says he’s not suffering: “I’ve been to a Michelin-star restaurant on GLP-1s — and it’s still a wonderful experience,” he tells me. “Now I don’t have to spend willpower on cookies but can spend it on my family and career.”
Ashley, 33, says that for her it has reduced “food noise”. “I would always be wondering, ‘What do I want for lunch? What can I snack on?’ Now I eat maybe a third and I’m full . . . I’m going into this holiday feeling more confident.”
But Thanksgiving is not just about eating — it’s also about being seen to eat. Spencer says there is still a stigma involved: he’s been accused of “cheating” by using medicine to address his weight. Social media is full of advice on how to hide your weight-loss injection pens from visitors.
Still, Spencer is looking forward to Thanksgiving: “I am going to try lots of great things, but I won’t come back and be up five pounds,” he says. Shame there’s no drug to counteract Black Friday shopping overindulgence as well.