Karen Kalinowski will not be basting her Thanksgiving turkey this year with loads of butter like her mother always did, but with a bit of butter and broth.
She’ll steam the green beans, carrots and rutabaga. She’ll whip up some of the Newfoundland bread stuffing that’s long been a family staple, but will also make a low-carb alternative with wild rice, mushrooms, onion and thyme. And there may be pie, but Kalinowski, 61, plans to make herself a carb-, butter- and sugar-free dessert: a baked apple with a crushed sugar-free Werther’s candy and cinnamon sprinkled on top.
Thanksgiving, that holiday associated with indulgent feasting, looks different when you’re on a GLP-1. These drugs, sold under the names Ozempic, Wegovy, Mounjaro and Zepbound to treat diabetes and obesity, have grown in popularity in Canada. In the first half of 2026, Canadian pharmacies logged a total of $2.3-billion in sales of them, according to data from IQVIA Canada, which aggregates prescription sales.
The drugs trigger weight loss by curbing users’ appetites, but eating beyond satiety can sometimes induce a range of digestive issues. It’s made this holiday, marked by second helpings and elastic waistbands, a tricky one for GLP-1 users. Aside from managing what, how much and when to eat, many must navigate the social politics of family gatherings as well, such as whether or not to disclose to their dining companions that they’re on one of these drugs.
Because GLP-1s can profoundly change users’ relationships with food, it makes sense that Thanksgiving and other eating-focused holidays can be anxiety-inducing for people who are taking them, says Andrea Holwegner, a registered dietitian and the chief executive officer of Health Stand Nutrition in Calgary. Some develop aversions to certain foods that were once beloved, others find they cannot tolerate dishes they once ate before – especially if they are spicy or high in fat.
A 2025 study published by the Mayo Clinic found that between 40 and 70 per cent of users of these drugs experienced gastrointestinal adverse effects such as nausea, vomiting, diarrhea and constipation.
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Kalinowski suffers from emetophobia – a fear of vomiting – which means she’s extremely strict about what she eats since starting Wegovy earlier this year. This October, she’s doing all the cooking for Thanksgiving, which she’ll be celebrating at home in Eastern Ontario with a small group of five family members, all of whom know she’s on the drug. Attending the holiday at someone else’s home would be impossible.
“No, you cannot cook for me because I do weigh and measure everything I put into my face,” she says. “I could not be certain that if somebody else was preparing the food that they might not add something that would really significantly impact my day in terms of how I’m going to feel after I eat.”
Some are taking another approach. A survey conducted by Sunlight.com in November, 2025, of 1,250 U.S.-based GLP-1 users found that 40 per cent planned to change the timing of their dose, reduce their dose or skip it entirely on Thanksgiving – some against the advice of their doctor.
On GLP-1 Facebook groups and message boards, users have discussed fasting before Thanksgiving so they might be able to eat more. Holwegner strongly advises against it.
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“Skip now and feast later usually doesn’t end well. People don’t feel well, and they usually have a hard time managing overconsumption,” she said. “On a GLP-1, that’s just going to amplify those side effects in a bigger way.” For diabetics, it can cause dangerous spikes in blood sugar.
She says people should stick to their normal eating schedule and not feel burdened by self-imposed restrictions, or doing the mental math of counting calories.
“Step back and go, ‘What do I love here? What’s the most exciting thing that makes my taste buds spark?’” she says. “Allow yourself to celebrate and eat that thing without any guilt or shame.”
The key is to serve small portions, especially for items that might be higher in fat and trigger adverse reactions, she says.
But that’s often easier said than done. Michelle Epp, 50, who lives in Chilliwack, B.C., started Mounjaro a year and a half ago and says she’s still adjusting to the reality she can’t eat the same sized portions she once did – especially at big food-centred holidays such as Thanksgiving, when all those around her are loading up their plates.
In her first year on the drug, she realized her error after the first few bites.
“I would take the same amount of food that I thought I could eat, and then it was surprising to me how little I actually would eat because I would get full,” she said. She estimates she eats only about 30 per cent of what she used to.
Because her stomach space is limited, she prioritizes protein over everything else. She’s dramatically curbed the sweets she eats, knowing she doesn’t tolerate them well now. The jelly-filled doughnuts, apple fritters and ice cream she’d get at the supermarket have been traded for fruits and vegetables. But she tries to avoid imposing any hard limitations on herself.
“If I am saying I can never have pumpkin pie, then I’m going to really want it. I allow myself to have it, and I have a little bit of it, and then I’m fine.”
This year, Thanksgiving will be at a relative’s home and she’s bracing herself for questions about how little she’s eating and worried about hurting the feelings of people who have cooked things she might only try a bite of.
At restaurants, servers have noticed how much is left on her plate at the end of a meal and asked, “Is there something wrong with your food?” At friends’ homes, her hosts have offered to get her something else to eat.
She’s learned to be brief and discreet, simply telling them, “My stomach is smaller. I don’t eat that much.” That usually ends the line of questioning.
Debbie, 68, is worried her family members might notice that she’s not eating the mashed potatoes or just having a tablespoon of gravy at Thanksgiving dinner, which could lead to the big reveal that she’s on Ozempic.
Debbie, who lives in Chatham, Ont., and did not want her real name used because she’s not shared with most people she knows that she’s taking the drug, dreads the unwelcome comments that might come from two particular relatives who work in the health field.
“When I mention things to them, they’re real naysayers, right? ‘Well, you know those side effects of blah, blah, blah.’ So I’ve just skipped informing them. Don’t spoil my fun!” she says.
Holwegner says in an ideal world, people would not be commenting on others’ bodies or how much they’re eating. But if GLP-1 users do encounter this, they shouldn’t feel any pressure to share that they’re on one of these drugs, she says.
“Just say, ‘Oh, well, I’m just starting with this amount and we’ll see if I have some more after this. Everything looks delicious.’ Leave it at that,” she suggests.
Melody is hoping the subject won’t come up when she hosts her family for Thanksgiving this year in her home near Peterborough, Ont.
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In some ways, it’s easy to discreetly manage GLP-1-related dietary restrictions because others in her family have restrictions of their own. Melody (who did not want her last name used for privacy reasons) is going to make dairy-free mashed potatoes this year for a lactose-intolerant member of the family, and a gluten-free stuffing for one who has celiac disease. The 74-year-old has given up drinking since she started on a GLP-1, but non-alcoholic options are so common now that she doesn’t feel self-conscious saying no to a glass of wine.
Since starting on Ozempic, Melody has a hard deadline of 7 p.m. for when she must stop eating for the day, lest she risk experiencing late-night indigestion. She also avoids high-fat or spicy foods – a plate of nachos recently triggered a bad bout of heartburn.
Since she’s the one hosting, she’s set the start time earlier in the day and plans to serve food no later than 5:30 p.m.
All told, she doesn’t feel like she’s denying herself anything. The cravings she once had for sweets have disappeared, the “food noise” – unwanted thoughts about food – has been quieted.
And the purpose of Thanksgiving has been shifting for her, away from the turkey, stuffing and gravy.
“I still look forward to it. It’s more about the traditions. Sitting down with your family,” she said. “It’s about the chats and different things going on rather than the food.”