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Obesity medications will have some people spending the holidays without an appetite

ARI SHAPIRO, HOST:

New obesity treatments tamp down hunger hormones, often to a dramatic degree. So some are navigating life, and holidays like Thanksgiving, without an appetite. NPR's Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: Kim Tyler's kitchen is the family hub. It's where her mother, cousin, daughters and four grandkids gather daily to feast on the things she makes.

KIM TYLER: I'm the one that's trying new recipes and making everyone try something new. And if I'm traveling, I always want to try something I've never tried before.

NOGUCHI: Her cabinet overflows with spices purchased during her travels.

TYLER: I've got every vinegar under the sun (laughter).

NOGUCHI: Halibut and salmon pulled from waters near her home in Soldotna, Alaska, fill her freezer.

TYLER: I made osso bucco with moose. That was fun. I think it's a mom thing. It's a family thing. You know, I'm really looking forward to Thanksgiving because I get to make dinner for everybody.

NOGUCHI: But Tyler herself has no desire to eat since last summer, when she went on Ozempic, a diabetes drug that also helps people lose weight. It switched off decades of what she calls emotional binge eating.

TYLER: It's almost an apathy. I still love to cook for people. I still love to watch my family eat. I still like to make things for people. I just don't care for it for myself. I'm completely apathetic.

NOGUCHI: Most patients seeking to treat diabetes or obesity find this freedom from hunger liberating. But Christopher McGowan says there are some surprising effects that disturb some patients. McGowan is CEO of True You Weight Loss in Cary, N.C.

CHRISTOPHER MCGOWAN: Some patients will say they lost a friend. You know, food has been comfort for them for years, as it is for most of us. And suddenly they're robbed of that. And they're learning and relearning how to cope with stressors when they can't turn to food.

NOGUCHI: The holiday fixation on food and family can compound that stress because of comments about weight loss or how little you're eating. McGowan advises patients to come prepared with responses, and he tells them to try to savor the social benefits of eating together.

MCGOWAN: Take small amounts of each thing. You know, really enjoy it and express your enjoyment and satisfaction and tell the chef, whoever that is, how much you're enjoying it.

NOGUCHI: But Tyler, the grandmother in Alaska, says the drug changed what she enjoys. Food is now a numbers game. She tracks her consumption of everything from grams of protein to glasses of water, not to mention the 53 pounds she's shed to date.

TYLER: And think I have to be careful that I haven't traded one obsession for another. The numbers I keep talking about - that's the obsession now. I've never weighed myself for years and years and years, and now I can get a little obsessed about it.

NOGUCHI: That also worries Johanna Kandel, CEO of the National Alliance for Eating Disorders. She says the new drugs may potentially worsen an already grave prevalence of eating disorders. Specifically, she worries about a newly recognized condition called ARFID, short for avoidant/restrictive food intake disorder. Kandel says ARFID is characterized by an extreme disinterest or even fear of food. And like other disordered eating, it can also affect how they relate to others.

JOHANNA KANDEL: There's a lot of comments like, can you just eat? Or I know that when I was going through my eating disorder, it was like everyone held their breath as I was sitting there and eating.

NOGUCHI: But Kim Tyler says her lack of appetite hasn't made her less social. If anything, the joy of food has been replaced by the joy of being able to exercise and play outside with her grandkids.

TYLER: So I have so much fun with them, and I can do more with them.

NOGUCHI: Occasionally, Tyler remembers sugary or salty things she loved and misses.

TYLER: Soy sauce. Oh, the loss of soy. The loss of my Hawaiian shoyu has been very difficult (laughter).

NOGUCHI: But for now, she's fine with the trade-offs of life without an appetite. Will she or many others using obesity drugs long term eventually bore of that life? Maybe.

TYLER: I'm still only three months in. Ask me a year from now if it's a chore.

NOGUCHI: Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.