For as long as I can remember, the holidays have been stressful. Anticipating the awkwardness of spending time with family and friends in uncomfortably close party atmospheres, with inhibition-lowering alcohol to spare. And this year, I’m bringing a complicated +1 to the table: I’m on a GLP-1 weight-loss medication.
Entering a food-centric season on medication that’s known for majorly curbing appetite brings a flurry of concerns: Will I be able to enjoy the foods and drinks I’m used to having without making myself sick with gastrointestinal side effects? How will this affect my family dynamic? Will my mom be upset if I reject her love in the form of casserole? 
See, the outlier in my (predominately overweight) family is my Jewish mother, a lifelong size 4-6. She’s the best cook and pastry chef I know, but hardly ever chows down on her own dishes. When I’ve asked her about this, she says she enjoys watching other people enjoy her food, and also that after spending all that time preparing the food, it no longer appeals to her. Could it also be that she won’t allow herself to eat more than a few bites because she’s concerned about what it could do to her slim, fit figure? Of course — her advice to me has always been to “taste” and not “eat.”
But alas, prior to Zepbound (aka tirzepatide), I had always been a plate-finisher. This tug-of-war has long complicated my relationship with food. Because what ends up happening is that she presents irresistible cakes and pies to her children, but can’t seem to understand the role that this has played in their overindulging. Now, both of my siblings are on GLP-1 drugs too — no doubt due in part to genetics, but also owing to an environment where it was difficult not to fill our plates until they overfloweth.
Our complex relationship with food has also affected our relationship with each other. We’re definitely each other's biggest cheerleaders, but that doesn’t erase the notion of competition. I worry that it’s hard not to compare results. If my brother loses weight faster than me and my sister, there’s an opportunity for us to groan about how easy it is for men to drop weight compared to women. If my sister, the family workout fiend, doesn’t see the same results as the other two sibs, would she be wrong to feel a sense of unfairness? Is all this overthinking an example of healthy, non-disordered thinking about weight? Absolutely not. We’re all just works in progress, and we’re still learning. And that includes my mom.
She’s aware that I’m on Zepbound and was the first person to notice when I changed my eating habits and lost weight. “You lost weight! You look good!,” she said, before expressing relief that I was taking care of my health. But I could see her struggling with what to do with the food she worked so hard on. Over Rosh Hashana (Jewish New Year), she baked several honey cakes, and before she sent me home on the train, she asked, “Do you want this cake?” 
I don’t know. Did I? The answer is probably yes. Yes, I wanted that cake because it’s delicious and sweet, and I love sweets. Yes, I wanted that cake because it’s got that inexplicable taste of home that a mom-baked cake contains that feels like a hug while you’re eating it. Yes, I wanted that cake because who in their right mind doesn’t want cake?! But I said no. She seemed slightly disappointed that I was leaving the cake behind, but proud that I’d decided not to eat it.
Still, I may be safer with my side of the family than my husband’s — all slim Italians culturally predisposed to push food. I can already hear the accusations. (“You didn’t eat anything! Mangia!”) I know that at Christmas dinner, I’ll be faced with lasagna and a million desserts — and not a single overweight person besides me.
I’ve been mentally rehearsing how to deflect any attention around my body. This is something I’ve had plenty of practice with — because the things friends and family members will say to you over the dining room table are absurd. I’ve been congratulated on my pregnancy (I wasn’t pregnant), complimented on how pretty I would be if I’d only lose the weight, and told that my husband would leave me if I got any bigger. (Spoiler alert: I did gain more weight after that comment, and he didn’t go anywhere. What a prince!)
This year, if someone remarks on how little I’m now eating, I’ve got a plan for that: I’ll say, “I’m saving room for dessert,” and hope they’re occupied by something else by the time coffee is served. But what if they outright ask if I’m on a weight-loss drug? Should I fess up and risk opening a Pandora’s Box or keep it quiet? Many people have big opinions about these drugs, who they should be prescribed to, and whether they constitute “cheating” at weight loss. All subjects I’d rather not discuss over a holiday meal.
Still, I’m grateful for Zepbound. I’ve lost weight the old-fashioned way before, but the medication has been a huge help this time around. I’ve always had a problem maintaining a healthy weight. I was chubby in my teens, and by my 20s I was well over 200 lbs. My weight yo-yoed up and down for years until I hit my highest weight at 250 lbs. In my 30s, I dropped 100 lbs. on the WeightWatchers program with the additional help of a personal trainer. Over the years, that number kept creeping up again. Now in my 40s, I’ve discovered that the diet and exercise plan that worked a decade ago is no longer enough.
Before going on Zepbound, I’d think about food 24 hours a day. It was torture. I was hungry all the time. Losing weight seemed impossible. I felt like a failure. I threw myself into the body positivity movement, trying to make peace with my extremely curvy figure. And it worked — I was finally fine with the way I looked. But once I regained all the weight I had previously lost, I started to notice its impact on my health. Walking just a couple of blocks had me breathing like Tony Soprano. I got winded climbing stairs. My doctor put me on a statin for high cholesterol. I realized that, for me, losing weight was necessary for my health.
I was willing to put in the work, and my doctor suggested Zepbound as a tool to help me reach my goal. I still have to watch my portion size, make healthy food choices, and exercise regularly. But the medication has quieted my food noise so I can stay at a caloric deficit without driving myself insane. I am no longer obsessed with where my next meal is coming from, not afraid of being hungry, and not overly concerned about getting my sweets fix.
On some of the online Zepbound boards that I frequent, people debate skipping their dose on the week of the holidays to “enjoy” their favorite foods. While I’m already lamenting that I probably won’t have room for both my mom’s delicious latkes and her cranberry apple crumble cheesecake, I’m not in this camp. I’ve enjoyed delicious foods before. I know I’ll enjoy delicious food again. Just not all the foods on the same day. That’s not deprivation — that’s eating for true physical — not emotional — hunger, something I’m becoming more familiar with as I spend more time on this medication.
One reason it’s easy to sound so blasé about the idea of missing out on my sister’s bangin’ mac and cheese is that these medications can come with side effects. Some common ones are nausea and vomiting, both more likely to happen if you overeat, or eat a lot of overly fatty or sugary foods. I have emetophobia (a fear of vomiting), so risking that is a big nope from me — yet another reason to stick to my small-portion plan.
Sitting with these thoughts, I’ve concluded: This holiday season, my family and friends are probably going to notice that I’m acting differently. I’m going to eat less, and I must make some difficult choices, but that will likely be easier this year than other times when I’ve white-knuckled my weight-loss efforts.
If people notice I’ve lost weight, I can say, “Thanks! I’m in my fitness era.” If they outright ask, “Are you on Ozempic?” I can say, “Yes! Well, Zepbound, but same idea.” Or if I don’t feel like I’m in a safe enough space to dodge follow-up questions, misinformation, and possible pushback, I can say, “I’m making some lifestyle changes as part of my healthcare plan with my doctor.” Worrying about these what-ifs only gives other people’s comments more power over me than they deserve. I know I’ve taken my health into my own hands, so I think I’m good — as long as nobody starts talking about politics.