The end of the year is a time when parties and get-togethers are part of the festive season. This month, especially, your patients may ask about how they can stay on a wellness journey while still participating in celebratory events. As a trusted healthcare provider, consider these tips and strategies to help your patients stick to their wellness goals.

Be Proactive or Wait for Patients to Ask?

With the rise in demand for GLP-1s, you discuss strategies for maintaining a healthy lifestyle often in your practice. Now that the end of the year is upon us, your patients may share concerns about feeling tempted during holiday parties.

Some say both healthcare providers and patients should play a role.

“PCPs [primary care providers] should absolutely be proactive, but some responsibility also falls with patients to take this time of year seriously,” said Zachary Bittinger, MD, a family medicine physician at the Ohio State University Wexner Medical Center in Columbus, Ohio. “A few days or holidays does not undo a year’s worth of work, but this time of year is heavy in meals with extra carbs, sugars, and fats. I make sure to have this conversation with all my patients, but I spend extra time with those that are more worried about this affecting their health.” 

A warning should also be given about excessive alcohol use while taking GLP-1s.

He said it’s about balance. “We don’t want to feel like we’re ruining our holiday and family time, but we also need to know our weakness for certain dishes or meals,” Bittinger said. “And if your traditions don’t generally include many healthy options on the plate, it might be time for new traditions.”

What About Patients With Diabetes?

This stretch of time during the year is particularly tricky for people with diabetes and other blood sugar problems.

“Candy, desserts, and carbs are everywhere this time of year. We need to understand that our patients deserve to treat themselves but also to recognize the dangers of leftovers and easier access,” said Bittinger.

And when a patient is on insulin the stakes are even higher: Skipping meals can become more dangerous, and alcohol makes blood sugar more unpredictable. “Overall, PCPs and patients alike need to be extra wary about balance so that a holiday isn’t ruined by a trip to the hospital,” he added.

Should You Offer Advice to Patients With Obesity?

Obesity is very challenging, said Bittinger.

“On one hand, it’s important to discuss that it is very possible to be very fit and healthy and still not have a BMI that is considered ‘normal,” he said. “In this case, this time of year might be more dangerous for shame; our loved ones might mean well, but hurtful comments about someone’s body and any relation to what’s on their plate are simply inappropriate.” 

On the other hand, he said, obesity and elevated BMI are associated with increased risks for a variety of conditions, including high blood pressure, high cholesterol, diabetes, polycystic ovary syndrome, and more. “So we want to make sure our holiday meals do at least largely fit into our overall plan for lifestyle changes to minimize those risks,” he further said.

What About Patients Taking GLP-1s?

GLP-1s might show a lot of promise with managing weight, but they are not a miracle.

“They have their limits,” Bittinger added. “I tell my patients every time that if we aren’t cautious with diet and lifestyle changes, only a little weight or none at all might come off, or maybe it comes off and comes right back.”

For the holidays, a reminder about side effects is warranted. Patients may experience nausea, vomiting, and a variety of other gastrointestinal problems especially with richer meals and larger portions. “It’s the exact foods this time of year is known for,” Bittinger said. PCPs should have discussions with patients, so they don’t complicate their health.

How to Discuss Moderation With Patients

Some experts say a whole-year approach is a good strategy to keep on track, especially during parties.

“For patients with obesity, my diet guidance does not change much during the holidays. I still recommend a whole food, high vegetable, high protein diet approximating a Mediterranean diet,” said Brett Castrodale, MD, a family physician in the Department of Family Medicine at the University of Virginia in Charlottesville, Virginia. “I remind patients they should fill most of their plate with vegetables and lean proteins and enjoy these foods first — before going for the carb-heavy foods and desserts.”

It’s also important to mark occasions with some latitude for enjoyment.

“I encourage patients to have fun and not stress too much about their intake over holidays. Patients who feel highly restricted may be on a diet that is unsustainable,” he continued. “I recommend patients eat enough to feel full...just fill up on the healthy foods.”

Specific Tips for Patients

Cook with intention. If the patient is attending a potluck style meal, they could bring a healthy but hearty meal, one which they could have a large portion, said Castrodale. “This makes it less likely you’ll fill up on honey biscuits and pecan pie,” Castrodale said.

Rethink splurges. Althoughit is okay to splurge a bit over the holidays, Castrodale advises to fill up on lean proteins and vegetables and keep portions of carbs and desserts small. “I tell patients that 90% of the time, they should stick to their successful diet plan, but 10% of the time it’s okay to ‘cheat’ if they feel the desire to do so,” he said.

Caution patients about alcohol. For patients with diabetes, warnings are key. “Alcohol may cause acute hypoglycemia and delayed hypoglycemia several hours later. Risk is very high for patients who take insulin or insulin-secretagogues,” he said. The American Diabetes Association r ecommends two or fewer daily alcoholic drinks for men, and no more than one daily alcoholic drinks for women.

Walk after meals. Not only can it keep your patient from experiencing a “food coma” but also it can boost metabolism and may even burn a few calories.

Bittinger and Castrodale reported no disclosures.