When Ozempic Comes to Thanksgiving: Navigating Diet Talk While in Eating Disorder Recovery

Thanksgiving is supposed to be about gathering with family and friends, sharing

a meal, and enjoying time together. Yet somehow, food and weight always seem

to become part of the conversation.

“I’m being good until dessert.”

“I shouldn’t be eating this.”

“I’ll have to work this off tomorrow.”

And now, with the growing popularity of GLP-1 medications, there’s a whole new

conversation happening around weight loss, appetite, and how much people are

eating.

For someone struggling with an eating disorder or working toward recovery,

these conversations can be difficult to navigate.

The holidays can already bring up anxiety around food, changes in routine, and

family dynamics. Then you add constant conversations about dieting and weight

loss, and something that’s supposed to be enjoyable can become incredibly

stressful.

So how do we navigate these situations without allowing them to interfere with

recovery?

The GLP-1 Conversation and Why It Matters

We’ve always lived in a culture that places enormous value on weight loss. And

while we’ve seen periods where the conversation seemed to shift toward body

acceptance and challenging unrealistic beauty standards, it feels as though

we’ve taken many steps backwards. The focus on weight loss has become

increasingly pervasive, and at times almost insidious. But with the increasing

popularity of GLP-1 medications like Ozempic, Wegovy, Mounjaro and

Zepbound, conversations about losing weight, eating less, and changing bodies

seem to be everywhere.

I also want to be clear: This isn’t about criticizing anyone who takes these

medications. They have legitimate medical uses, and decisions about treatment

belong between individuals and their healthcare providers.

But I also think we need to recognize the impact of these conversations on

people who are struggling to change their relationship with food and their bodies.

For someone who has worked incredibly hard to move away from restrictive

eating, food rules, and the belief that smaller is somehow better, listening to

others celebrate eating less or losing weight can bring up some very familiar

thoughts and create very valid anger and frustration.

And those thoughts can be difficult to manage, particularly during the holidays.

When Food and Weight Become the Focus

One of the things I frequently talk about with clients is how easily eating disorder

thoughts can resurface when we’re surrounded by messages that reinforce them.

You might find yourself comparing what you’re eating to someone else’s plate.

Maybe you start questioning whether you should have dessert or feel guilty about

enjoying a meal.

Perhaps you find yourself thinking about skipping meals earlier in the day to

compensate for Thanksgiving dinner or making plans to exercise more the

following morning.

These are the familiar patterns that eating disorder recovery works to challenge.

Having these thoughts doesn’t automatically mean you’re moving backward in

recovery. What matters is recognizing them and how you respond.

And sometimes, that means setting boundaries with the people around you.

Before Thanksgiving: Have a Plan

I’m a big believer in being proactive rather than waiting until we’re already

overwhelmed.

A little preparation can make a difference.

Maintain your regular eating routine.

Thanksgiving isn’t a reason to skip breakfast or lunch to save room for dinner.

Continue eating regular meals and snacks, following your treatment team’s

recommendations. Restricting earlier in the day can increase both physical and

emotional vulnerability later.

Identify your support system.

Think about who you can turn to if things become difficult. It might be a family

member, friend, or someone on your treatment team. Having someone you can

check in with can be reassuring.

Think about your boundaries ahead of time.

If you know certain family members tend to comment on food, weight, or

appearance, consider how you’d like to respond. You don’t need a perfectly

rehearsed speech. Sometimes a simple response is enough. Reviewing and

practicing these conversations with your therapist can be very helpful.

Stay connected with your treatment team.

The holidays can be a particularly important time to maintain therapy and

nutrition appointments. If you’re anticipating challenges, talk about them

beforehand.

At the Table: Your Plate Is Not a Group Discussion

I love this reminder because, in all honesty, what someone chooses to eat

doesn’t need to become everyone else’s business.

Unfortunately, we’ve become so accustomed to commenting on food and bodies

that people often don’t recognize how intrusive these conversations can be.

Here are a few ways to respond (Fair Warning: I can be a little snarky, so choose

what feels right for you!)

If someone says, “Are you really eating all that?”

“I’m good, thanks. I’m enjoying my meal.”

“Yes, yes I am, it’s delicious.”

“That was the plan, thanks for checking”

“I didn’t realize my plate needed approval.”

If someone says, “I’m being so bad today.”

“Bad? I thought we were just having dinner.”

“I’m pretty sure the stuffing isn’t judging us.”

“I vote we skip the food guilt and just enjoy Thanksgiving.”

“Eating isn’t bad, it’s just eating.”

If someone comments on your weight or appearance:

“I’d rather talk about what I’ve been up to, rather than what I look like”

“I’m actually much more interesting than what I look like.”

“Can we talk about literally anything other than my body.”

“I didn’t realize my body was on the Thanksgiving agenda.”

If someone starts discussing their weight-loss medication or diet:

“I’m glad you found something that works for you. I’m trying not to engage in

weight-loss conversations.”

“I’m taking the day off from talking about diets, weight and bodies. What else is

new?”

“I think weight loss has been given enough airtime, can we get back to enjoying

the

holiday?”

“I’m trying to stay away from conversations about food and weight. How’s the

family?”

You don’t have to be confrontational. You don’t have to explain your eating

disorder history or justify your choices.

You can redirect the conversation, excuse yourself, or simply choose not to

participate.

And remember, setting a boundary isn’t being difficult. It’s taking care of yourself.

If You Have a Loved One with an Eating Disorder

This is something I wish more families understood: You don’t have to say

something directly to a person for your words to affect them.

Talking negatively about your own body, announcing how much you’re going to

eat, or discussing how you plan to compensate for Thanksgiving dinner can

reinforce the very beliefs someone in recovery is trying to challenge.

And even comments intended as compliments can be difficult.

Telling someone they look healthy, commenting on changes in their body, or

praising how much or how little they’re eating may seem harmless, but these

comments can carry a very different meaning for someone struggling with an

eating disorder.

Instead, focus on the person.

Ask about their life, their interests, their work, or what they’ve been enjoying lately.

There are so many things to talk about that have absolutely nothing to do with

food or weight.

And please, don’t monitor someone’s plate unless that’s part of an agreed-upon

treatment plan.

Support doesn’t have to mean supervision.

Sometimes the most helpful thing you can do is create an environment where

food and bodies aren’t the center of attention.

The Day After Thanksgiving: There’s Nothing to Make Up For

If there’s one message I hope people take away from this article, it’s this:

You don’t need to compensate for enjoying Thanksgiving dinner.

You don’t need to skip meals on Friday, start a cleanse, or exercise to burn off

what you ate.

And you certainly don’t need to feel guilty for participating in a holiday that

involves food.

Diet culture has convinced us that eating certain foods or enjoying a larger meal

requires some kind of correction afterward. It doesn't .

Friday is simply another day. Continue nourishing yourself, return to your usual

routines, and give yourself permission to move forward without punishment.

And if Thanksgiving was difficult? Maybe you struggled with food, experienced an

increase in eating disorder thoughts, or engaged in behaviors you’ve been

working to change. Just remember, that doesn't erase the progress you've made.

Recovery isn’t about getting everything right. It’s about learning to recognize

patterns, understanding what contributes to them, and continuing to make

choices that support your well-being.

Talk about what happened with your treatment team. Explore what was difficult

and what might help you approach similar situations differently in the future.

One challenging day doesn’t define your recovery.

You Deserve to Enjoy the Holidays Too

I often remind clients that recovery is about so much more than food.

It’s about being able to participate in your life without constantly negotiating with

an eating disorder.

It’s about enjoying time with the people you love, being present for meaningful

experiences, and allowing food to be part of your life without controlling it.

Thanksgiving doesn’t have to be perfect. Family members may still make

comments, uncomfortable feelings may come up, and you may need to use

some of the skills you’ve been working on.

But you deserve to sit at the table, enjoy a meal, and be part of the experience

without feeling that your body or your food choices are up for discussion.

If you’re looking for support with an eating disorder, body image, or your

relationship with food, visit the link in my bio or explore our website to

learn more about working with our practice.

Dianna Chillo, LCSW-R, is a licensed clinical social worker specializing in eating

disorders, body image, anxiety, and related concerns. Her New York practice

offers therapy for adolescents and adults, including services provided by

advanced graduate interns under clinical supervision.