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A Black writer explores how Germany remembers its ‘unthinkable’ past

(JTA) — For his 2021 book “How the Word Is Passed,” winner of the National Book Critics Circle Award for Nonfiction, poet and journalist Clint Smith explored the landscape of American memory — specifically how the history of slavery is explained, commemorated, distorted and desecrated in sites across the United States.

While on tour promoting the book, he explained in an interview Tuesday, he’d often be asked if any country had gotten it right when it came to memorializing its own dark past. “I kept invoking the memorials in Germany, but I had never been to the memorials in Germany,” Smith said. “As a scholar, as a journalist, I felt like I had to do my due diligence and excavate the complexity and the nuance, and the emotional and human texture, that undergirds so many of these places and spaces.”

The result is December’s cover story in the Atlantic, “Monuments to the Unthinkable.” Smith traveled to Germany twice over the past two years, visiting Berlin’s Memorial to the Murdered Jews of Europe, its Topography of Terror Museum, the museum in Wannsee where the Nazis plotted the Final Solution, and the concentration camp at Dachau, talking to historians and curators along the way. As a Black man wrestling with how America accounts for the crimes of its past, he went to learn from the experience of the Germans, who “are still trying to figure out how to tell the story of what their country did, and simultaneously trying to figure out who should tell it.” 

In an interview, Smith talked about the inevitable differences between the Holocaust and the Atlantic slave trade, the similarities in how two countries — and communities — experience their histories, and how his article could serve as a bridge between African-Americans and Jews in a time of increasing tension between them. 

Smith spoke to JTA from his parents’ home in his native New Orleans. 

This interview was edited for length and clarity.

Jewish Telegraphic Agency: Your book is about the ways America succeeds and fails to come to terms with slavery, and your article is about the ways Germany is, in your phrase, “constructing public memory.” I was struck by someone who warned you, “Don’t go to Auschwitz.” What were they saying? 

Clint Smith: It was Frederick Brenner, a Jewish man and a remarkable photographer who has photographed the Jewish Diaspora across the world for the past several decades, who said that, because people are standing [at Dachau] and they’re taking selfies, and it’s like “me in front of the crematorium” and “me in front of the barracks.” That was deeply unsettling to him, especially as someone whose family was largely killed in the Holocaust. 

I don’t want to be reductive about it and say that you don’t want people to go to these spaces and take pictures. I think it’s all about the sort of disposition and sensibilities one brings to a space. If someone went to the Whitney Plantation in Louisiana, I don’t necessarily want them doing puckered-lip selfies in front of a slave cabin. I can understand why people wouldn’t want those places engaged with in that way, but you do want tourists to come, right? I mean, before the pandemic, 900,000 people visited Dachau every year, and part of what brings people to Dachau is seeing and taking a picture of the crematorium, taking a picture of themselves on this land in that space where history happened, and posting it online. And maybe that serves as a catalyst for somebody else to make that journey for themselves.

You did go to Dachau, which you call a “memorial to the evil that once transpired there.”

I am a huge believer in putting your body in the place where history happened. I stood in many places that carry the history of violence: plantations, execution chambers, death row. But I’ve never experienced the feeling in my body that I felt when I stood in the gas chamber at Dachau. And you just see the way that this space was constructed, with the sort of intentional, mechanized slaughter that it was meant to enact on people. The industrialized nature of it was something unlike anything I’d ever experienced before and it made me feel so much more proximate to that history in ways that I don’t think I would have ever experienced otherwise. 

Physically standing in a concentration camp and physically standing and putting my body in the gas chamber fundamentally changed my understanding of the emotional texture and the human and psychological implications of it. Because when you’re in those spaces you’re able to more fully imagine what it might have been like to be in that space. And then you can imagine these people, these families, these women, these children who were marched into camps throughout Europe. You can never fully imagine the fear, that sense of desperation that one would have felt, but in some ways, it’s the closest we can get to it if you are someone who did not have family who lived through or survived the Holocaust. It provided me with a radical sense of empathy. And that’s why I took the trip in the first place.

A tourist takes a selfie inside the Memorial to the Murdered Jews Of Europe in Berlin, Sept. 25, 2019. (Beata Zawrzel/NurPhoto via Getty Images)

By contrast, there are the memorials that are not historical sites, but either sculptural or architectural, like Berlin’s Memorial to the Murdered Jews of Europe, nearly five acres of concrete slabs. What do you think makes an effective memorial that isn’t necessarily the historical place itself, but a specifically memorial project? 

Well, for example, the big one in Berlin. It’s just so enormous. The scale and scope of it was unlike anything I’d ever seen before. I tried to imagine what an American analog would be like. What if in the middle of downtown Manhattan there was a 200,000-square-foot memorial, with thousands of stone columns, dedicated to commemorating the lives of indigenous people who were killed in the early Americas? Or a 200,000-square-foot memorial in the middle of downtown D.C., not far from the White House, to the lives of enslaved people?

With that said, what I found really valuable were the people I spoke to, who had very different relationships to that space. Some thought of that memorial as something that was so meaningful because of its size and because of its scope, and because it was a massive state-sanctioned project. And then there were others who thought that it was too abstract, that it was too passive, even in its name, right, the “Memorial to the Murdered Jews of Europe,” which sounds as if something happened to people without naming the people who enacted the harm and who committed the crime. Those are the sort of nuances and complexities that I wanted to spend more time with, and found really valuable because, in the same way, descendants of enslaved people here in the United States have many different conceptions of what the iconography of slavery should look like or what repair and reparations to slavery should be made.

You write about the “stumbling stones” or “Stolpersteine”: Those are the small brass plaques placed in the streets, inscribed with the names of Holocaust victims and placed in front of their last known residence. The stones are exactly the opposite scale of the Berlin memorial.

Right. I think that is the memorial that I was most struck by: the largest decentralized memorial in the world, with 90,000 stones across 30 different European countries. I remember the moment I was walking down the street looking for landmarks and saw my first Stolpersteine, and I only saw it because at that moment the clouds moved and the sun shone off the brass stone. You see the name, the birth date, the deportation date, the death date, the place where the person was killed. You walk past another home, you see seven; you walk past another home, you see 12. You begin to imagine entire lives based on the names and information that exist on these stones. It creates this profound sense of intimacy, this profound sense of closeness to the history and it’s so human, because it’s individual people and individual names.

One of the most valuable things about the stumbling stone project, I think, is all the work that precedes it. It’s the school students who are doing research to find out about the lives of the people who were taken from the home across the street from their school. It’s the people in the apartment complex, who come together and decide that they’re going to figure out who were the Jewish families who lived in that apartment complex before them. And sometimes it’s really remarkable, granular details about people’s lives: what their favorite food was, what their favorite flavor of ice cream was, what the child liked. 

Artist Gunter Demnig lays “stumbling stones” that memorialize persecuted or murdered Jews on the streets of Frankfurt. (Boris Roessler/picture alliance via Getty Images)

As Gunter Demnig, the originator of the project, says, 6 million people is a huge abstraction, and now it becomes about one man, one woman, one child, and [people] realize that it truly was not that long ago. There are so many survivors of the Holocaust who are still with us. Gunter Demnig, his father fought for the German army. He represents this generation of people who are engaging in a sort of contrition for the acts of their parents and their grandparents. 

You ask in the piece what it would look like for a similar project to be created in the United States as a memorial to enslaved people.

I’m from New Orleans, and the descendant of enslaved people in New Orleans, which was at one point the busiest slave market in the country. And as Barbara Steiner, a Jewish historian, said to me in Germany, entire streets [of New Orleans] would be covered in brass stones! That was such a striking moment for me. That helped me more fully realize the profound lack of markers and iconography and documentation that we have to enslaved people in our landscape here in the United States relative to that of Germany.

Why are physical monuments important? I have sometimes wondered why we spend so much money on the infrastructure of memory — statues, museums, memorials — and if that money could be better used for living memorials, like scholarships for the descendants of victims, say, or programs that study or archive evidence of genocide. Why is it important to see a statue or a museum or even a plaque?

First off, museums and statues and memorials and monuments are by no means a panacea. It is not the case that you put up some memorials or you lay down some Stolpersteine and suddenly antisemitism is gone. Obviously, Germany is a case study and is experiencing its own rise in antisemitism. And that’s something that’s deeply unsettling, and is not going to singularly be solved by memorials and monuments. 

With that said, I think there is something to be said to regularly encounter physical markers and manifestations of the violence that has been enacted and crimes that have been done in your name, or to the people that you are the descendant of. I try to imagine Germany without any of these memorials and I think it would just be so much easier for antisemitism to become far more pervasive. Because when your landscape is ornamented by things that are outlining the history that happened there, it is much more difficult to deny its significance, it is much more difficult to deny that it happened, it is much more difficult not to have it shape the way you think about public policy. I do believe that if we had these sorts of markers in the United States, it wouldn’t solve the racial wealth gap, it wouldn’t solve racism, it wouldn’t solve discrimination. It wouldn’t eradicate white nationalism or white supremacy. But I do think it would play some role in recalibrating and reshaping our collective public consciousness, our collective sense of history in ways that would not be insignificant. 

And to your point, my hope is that those things are never mutually exclusive. It’s a conversation that’s happening here in the United States with regard to how different institutions are accounting for their relationship to slavery. Universities are coming up with reports, presentations, panels and conferences that outline their relationship to the history of slavery, especially since the murder of George Floyd [in 2020]. Activists and descendants have pushed them to not just put out a report, or put up a plaque or make a monument. It’s also about, well, what are you going to do for the descendants of those people? Harvard, where I went to grad school, put $100 million aside specifically for those sorts of interventions. Places like Georgetown have made it so that people who were the descendants of those who are enslaved have specific opportunities to come to the school without paying. And people of good faith can disagree over whether those initiatives are commensurate with or enough to atone for that past, and I think the answer is almost inevitably no.

Certainly people on what we like to think of as the wrong side of history understood the importance of physical monuments in creating memory.

The origin story of my own book was that I watched the monuments come down in 2017, in my hometown in New Orleans, of Jefferson Davis, Robert E. Lee. I was thinking about what it meant that I grew up in a majority Black city, and there were more homages to enslavers than there were to enslaved people. What does it mean that to get to school I had to go down Robert E. Lee Boulevard? That to get to the grocery store, I had to go down Jefferson Davis Parkway? That my middle school was named after a leader of the Confederacy? And that my parents still live on a street today named after someone who owned 115 enslaved people? The names and iconography are reflective of the stories that people tell and those stories shaped the narratives that communities carry. And those narratives shape public policy and public policy is what shapes the material conditions of people’s lives.

One thing about Germany is that its national project of memory and repentance has been accompanied by a vast reparations program — for Israel, Jewish survivors, their families and programs to propagate Jewish culture. I wonder if you think Germany could have moved ahead without reparations? And can America ever fully grapple with the legacy of slavery without its own reparations?

The short answer is no. America cannot fully move forward from its past without reparations. The important thing is not to be limited and reductive in the way that we conceive of what reparations are or should look like. In some ways, I’m as interested if not more interested in what specific cities and states are doing in order to account for those histories and those crimes. For example, in Evanston, Illinois, they created a specific program to give reparations to Black families who experienced housing segregation, in a certain period of time, given how prevalent redlining was in and around Chicago in the mid-20th century. I know in Asheville, North Carolina, there’s a similar program that’s thinking about how to meaningfully engage in repair to the descendants of communities that were harmed from some of the policies that existed there. This is not to say that those programs themselves are perfect. But I think we sometimes talk about it so much on a federal level, that we forget the local opportunities that exist.

West German Chancellor Konrad Adenauer signs the reparations agreement between his country and Israel, Sept. 10, 1952. (United States Holocaust Memorial Museum, courtesy of Benjamin Ferencz, from “Reckonings”)

Many people who were redlined or experienced housing covenants — all the sort of insidious manifestations of wealth extraction that were part of Jim Crow — are still alive today. So sometimes it’s not even a question of what you have to give the descendants. Sometimes it’s like, what do you give the actual people who are still here? 

That’s an important distinction you make in your article, about the difference between grappling with the past in Germany and the United States. In Germany, there are so few Jews, while in the U.S. we see the living evidence of slavery, not the evidence of absence.

That’s perhaps the greatest difference that allows for both a landscape of memory to be created in Germany, and also allows for Germany to pay reparations in ways that the United States is reluctant to do: Jewish people in Germany represent less than one quarter of one percent of the population of Germany. One of the folks I spoke to told me that Jewish people in Germany are a historical abstraction. Because there’s so few Jewish people left, because of the slaughter of the Holocaust. I think about the reparations that were given to Japanese Americans who were held in incarceration camps during World War II. They got $20,000 checks, which is not commensurate with what it means to be held in a prison camp for multiple years, and cannot totally atone for that. But part of the reason that can be enacted is that there’s a limited amount of people. There are 40 million black people in this country. So the economic implications of reparations are something fundamentally different here in the United States. 

So let me ask you if there’s anything else you wanted to mention that we haven’t talked about.

I want to name specifically for your readers that I’m not and would never intend to conflate slavery and the Holocaust. They are qualitatively different historical phenomena that have their own specific complexities and should be understood on their own terms. With that said, I do think it can be helpful to put the two in conversation with one another, specifically in the profound ways that these two monumental periods of world history have shaped the modern world and how they are remembered in fundamentally different ways. 

And there are similarities as well, which you write about.

I did find so many parallels. The Jewish people I spent time with in Germany explained that some of the manifestations of racism and anti-Blackness in the United States are not so different from the sort of manifestations of antisemitism that exist in Germany, especially as it relates to public memory. When I was at the museum devoted to the Wannsee conference, the executive director, Deborah Hartmann, told me that she and Deidre Berger [the chair of the executive board of the Jewish Digital Cultural Recovery Project Foundation] were talking about how Jewish people did not always have a seat at the table when these monuments and memorials were being built. Jewish people were not allowed to participate beyond a certain extent, because many Germans felt that Jewish people were not objective. Jewish historians couldn’t be taken seriously because they were too close to the history.

That just echoes so much of what Black scholars and historians have been told about their ability, or the lack thereof, to study the history of Black life. The godfather of African-American scholarship, W.E.B. Du Bois, was told by white scholars that he couldn’t be taken seriously because he was too close to the history of slavery.

Meanwhile, Deborah Hartmann talked about how so many of the historians and scholars who played a role in shaping the landscape of memory in Germany were themselves “close to the history,” including former members of the Hitler Youth.

Somebody sent me a message that really meant a lot to me this past week, basically saying that my essay is an exercise in “solidarity via remembrance” — in a moment where, unfortunately, there have been a lot of public manifestations of ideas and antisemitic remarks that might threaten to rupture a relationship between Black and Jewish people. Obviously, we didn’t time it this way: I worked on this piece for a year. But it’s my hope that as someone who is a Black American, who is the descendant of enslaved people, who is not himself Jewish — that my respectful, empathic, curious, journey reflects the long history of solidarity that has existed across Black and Jewish communities and that that I hope we never lose sight of.


The post A Black writer explores how Germany remembers its ‘unthinkable’ past appeared first on Jewish Telegraphic Agency.

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Why NBA Teams Start Defending Before Half Court

Image Source: Infographic by author

An NBA defender who meets a ball handler near the opposite baseline is trying to interfere with the possession before the offense gets organized. The immediate reward need not be a steal. Making a guard change direction, protect the ball, or find another receiver can interrupt the route into a play. But pressure has several possible results, and slowing that first journey does not necessarily slow the whole game.

In Logan Murdock’s November 2025 report on full-court defense, Phoenix Suns guard Jordan Goodwin described his aim: “Try to make them take at least six seconds off the clock.” That was his target, not a measured average. Indiana Pacers coach Rick Carlisle described another purpose: getting opponents to play faster than they prefer. Both approaches interfere with timing, though one delays the setup while the other hurries decisions.

The shot clock helps explain the difference. In a normal NBA possession following a made basket, the offense has 24 seconds, with the countdown starting when the inbound pass is legally touched on the court. It must also advance out of the backcourt within eight seconds. Crossing half court does not start a fresh shot clock. Time spent getting there leaves less time to create a shot. A defensive deflection that stays inbounds does not restart the countdown.

Defensive pressure also needs careful interpretation in basketball betting. An NBA matchup on the Bovada website cannot be reduced to whether one team presses: the combined score depends on how often both sides get the ball and what they do with their chances. A defender delaying the first pass into an offense can leave less time for a good attempt. A turnover followed by a quick basket has a different effect.

Those possibilities make defensive intensity an incomplete description of a scoring outlook. A team can force its opponent to work harder while creating quick attacking chances for itself. It can also concede an easy chance when pressure fails. Understanding the tactic means separating its purpose from its outcome, rather than treating an aggressive defender as evidence that the game must produce fewer points.

Pressure does not always mean a trap

One defender following the ball is different from two defenders closing around it. The first can contest the dribbler while teammates remain with their own assignments. A trap commits another player to the ball, so teammates elsewhere must cover the passing options and protect the basket.

A stopped dribble changes the contest. Once a player voluntarily picks up the ball, he cannot simply start dribbling again. He can still pivot, pass, or shoot, but moving away from pressure with another dribble is no longer an option. A defender can therefore restrict movement without taking possession. This is also why a guard’s choice to keep the dribble alive deserves attention: it preserves a way to move while searching for a pass.

Watch where the ball goes next. A trap can succeed by forcing an awkward pass that another defender intercepts. The players surrounding the ball do not have to be the ones who take it away. Reaching for a steal also differs from keeping the ball handler contained; abandoning position can give the guard a route past the pressure.

The offense has answers. In the Murdock report referenced earlier, Golden State guard Brandin Podziemski described using his body to shield the ball against smaller defenders and quickness to get beyond longer opponents. Beating the first defender can leave that player trailing, creating a temporary advantage farther upcourt. The remaining defenders then have to respond to an attack before their teammate has time to recover.

Three possible outcomes of early pressure: delayed setup, hurried decisions, or an attacking advantage when pressure is beaten

The work before a highlight

Former NBA guard Keith Bogans gives a defender’s perspective in his conversation with Vernon Maxwell. Discussing Jaden McDaniels, Bogans says that seeing a defender pick up a superstar across the court gets him excited in the way a dunk or crossover excites other viewers.

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His reaction focuses on the challenge being accepted. The scorer has someone to deal with before reaching a preferred attacking position. Bogans also describes the recognition that such defensive work receives from teammates and coaches, even when it attracts little attention elsewhere.

The assignment does not end when the scorer passes. The defender still needs to follow the play and be ready for the ball to return. Early pressure can force a star to give up the ball without removing him from the possession. Watching the next pass shows whether the defense has actually disrupted the attack or merely moved it.

When defense creates offense

Indiana scored 19 points off turnovers in Finals Game 6 against Oklahoma City on June 19, 2025. The figure does not isolate full-court pressure.

A change of possession ends one team’s opportunity and begins another’s. The team winning the ball can attack immediately or organize its offense, depending on the space and defenders ahead. Pressure therefore cannot be assessed only by the time an opponent spends bringing the ball forward.

Look beyond the pickup point. Does the offense arrive late but still organized? Does it make a hurried pass? Does the ball handler escape and make the remaining defenders cover extra ground? The first defender can use up time without winning the ball. If the guard gets past him, watch whether the other defenders can stop the drive without leaving someone open.

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In ex-Knick Michael Sweetney, Jewish friends mourn a beloved coach ‘who knew exactly how to show up’

Tamir Goodman stuck out like a sore thumb, a yarmulke-wearing redhead at a practice for a showcase of Greater Washington’s top high school talent. The year was 2000, and Goodman, an Orthodox Jewish hoops prodigy, had already been on the cover of Sports Illustrated. What he did not have at that practice was a friend.

But when the all-star team’s coach had players pair up for shooting practice, one teammate approached Goodman: the 6-foot-8, Georgetown-bound power forward Michael Sweetney.

“He’s like, “Hey, I’ll be your shooting partner,” Goodman, 44, recalled by phone Thursday. “And from that moment, we just never left each other.”

Sweetney, who went on to play for the New York Knicks, later said he had never met a Jewish person before that day. But when he died Wednesday of complications from a heart attack, he had not only one Jewish friend mourning his passing, but hundreds.

Mike Sweetney, left, with Tamir Goodman on a trip to Israel in 2019. Courtesy of Tamir Goodman

Orthodox Jewish New Yorkers, who got to know Sweetney through his years teaching basketball at their schools, summer camps, synagogues and even birthday parties, remembered him in tributes Thursday as a humble mentor, a model of courage and a loyal friend in times of Jewish vulnerability.

Those early shooting sessions with Goodman, it turned out, had planted the seed for Sweetney’s post-NBA basketball endeavors, including a four-year stint at Yeshiva University, where he served as an assistant during the men’s team’s famous 50-game win streak.

“The world lost a giant today,” Elliot Steinmetz, Yeshiva’s head coach, wrote Thursday on X. “I lost a close friend. The basketball world lost a beloved star. Our Jewish community lost an ally and someone who knew exactly how to show up.”

Sweetney, who was 43, is survived by his wife, India, and three children.

A perfect matchup

Sweetney brought undeniable but understated starpower to the basketball-obsessed Orthodox community. That community’s embrace also helped Sweetney find purpose after his playing career and reignite his love for the game.

After starring at Georgetown, Sweetney was selected ninth by the Knicks in the 2003 NBA Draft — eight picks after LeBron James. But Sweetney’s career in the league lasted just four years, derailed by struggles with weight and depression that followed his father’s sudden death. (He later revealed he had contemplated suicide as a rookie.) He played another decade for pro teams in China and Latin America before washing out of the sport.

Sensing that his friend was in a bad place, Goodman invited Sweetney to Israel in 2019 to help with a basketball camp he had started.

“I told him a lot of good things happen when you come to Israel,” Goodman said. During the visit, Sweetney opened up about the challenges he had been experiencing. Goodman suggested he go into coaching, and soon connected him with Steinmetz — a Knicks die-hard — who offered him a job.

“When Tamir called me about him, initially, I’m like, ‘Oh, cool, I get to talk to Mike Sweetney, that’ll be fun,’” Steinmetz said Thursday in an interview. “Once I spoke to him the first time, I’m like, ‘That’s just such a nice guy.”

A Yeshiva League staple

Sweetney’s entry into the world of Orthodox Jewish basketball, initiated by Goodman, helped facilitate his turnaround, transforming a point of professional failure into a source of inspiration for others.

A classic back-to-the-basket player in his day, Sweetney relished working with the Yeshiva forwards, who delighted in trying their post moves on a former NBA lottery pick.

“All the bigs’ favorite part of practice was going up against Mike,” recalled Gabriel Leifer, a team captain during Yeshiva’s win streak.

Sweetney was getting something out of the work, too. Those who worked with him up close could see his passion for the sport — which had become a dark place for him — coming back to life.

Sweetney signs autographs on Yeshiva’s home court. Courtesy of Elliot Steinmetz

Harold Katz, a coach who occasionally helped with the Yeshiva program, said that despite his NBA pedigree, Sweetney had no pretenses when it came to learning the school’s motion offense. Instead, he seemed to enjoy it. “He would always say it’s fun — like playing this way is fun.” Katz remembered. “He’d say, ‘I wish I played in this.’”

Sweetney told the New York Post in 2019 that the Jewish world had helped him find stability after basketball.

“I’m comfortable here. I’m treated well here. It’s been amazing,” he said at the time. “To be happy and be at peace, I would’ve been shocked. I wouldn’t have thought it was possible.”

The coaching roles — at Yeshiva and at Ramaz, an Orthodox high school where he coached the girls’ team — also helped Sweetney book speaking engagements and countless youth basketball clinics. He also became an advocate for Black-Jewish relations.

“It starts off that, ‘Oh my God, there’s this big NBA guy who’s at all the YU games,’” Steinmetz said, “but then people start talking to him and they fall in love with his personality because he’s just such a warm, caring guy.”

Driving to and from Yeshiva games over the years, Steinmetz and Sweetney grew close — a friendship that held even after the latter left Yeshiva in 2023 to work in the mental health arena.

The true testament to the kind of person Sweetney was, Steinmetz said, came after they stopped working together, on Oct. 7, 2023. Steinmetz was in Israel at the time; the first text message he received as the attacks were unfolding, he said, was from Sweetney.

“He’s like, ‘Please confirm for me that you’re okay,’” Steinmetz said. “Two days later: ‘Hey, did you get home yet?’ He just cared. He wasn’t checking a box — he cared.”

If you are in crisis, please call, text or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

The post In ex-Knick Michael Sweetney, Jewish friends mourn a beloved coach ‘who knew exactly how to show up’ appeared first on The Forward.

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Sacred fasting meets Ozempic

Millions of people worldwide – as many as 1 in 8 adults in the U.S. – are on GLP-1 medication, such as Ozempic, Mounjaro, Wegovy and Zepbound, for treating diabetes or for weight loss.

These drugs are adding a medical twist to religious observances that involve fasting, such as the Jewish holiday of Yom Kippur, which will be observed from sundown on Sunday until nightfall on Monday. Traditionally, fasting on Yom Kippur means forgoing food and water for about 25 hours, which can strongly affect a person’s metabolism.

Other religious traditions include different types of fasts. For example, Muslims who fast during Ramadan neither eat nor drink from dawn to sunset, but they break their fast each night. Christian and Hindu traditions also include dry fasts as well as partial fasts, such as Lent and Navratri, in which people avoid certain foods.

As a specialist in obesity medicine, I work with many patients who take GLP-1 drugs. Most people can safely fast for Yom Kippur or other religious or cultural observances. But depending on their circumstances, they may need to plan ahead, take certain precautions and be clear on when it’s medically advised that they break their fast.

Common GLP-1 side effects and fasting

GLP-1 drugs such as Ozempic, Mounjaro, Wegovy and Zepbound mimic a natural gut hormone– glucagon-like peptide 1 – that lowers your blood sugar by triggering insulin release when your blood sugar is high. These drugs also slow how quickly food passes through the stomach, which reduces appetite to aid in weight loss.

GLP-1s have some common side effects that can occur in anyone taking them, including nausea, vomiting, dizziness, constipation and dehydration. Fasting may exacerbate them, especially in people who are prone to an upset stomach. GLP-1 side effects are also more common when a patient is increasing their dose, which usually happens monthly as tolerated until they reach their full dosage.

That’s why, if you’re planning to fast for Yom Kippur, it’s best to avoid starting a new GLP-1 medication or increasing the dose of your medication sooner than two weeks or so before the holiday.

GLP-1 drugs work by simulating a gut hormone produced in the body, spurring the release of insulin and slowing down digestion.

Timing your dose

If you take GLP-1 drugs as weekly injections, which is the most common way of dosing these medications, you should stick to your schedule even if you plan to fast. These drugs stay in your system during the entire week, so moving or skipping that weekly dose right before fasting can interfere with their effects on blood sugar or weight loss.

If your weekly injection falls on Yom Kippur, you can generally go ahead and administer it as scheduled. Some patients do report increased nausea on their injection day – if that happens to you, you may wish to delay the injection until after the fast, if you’ve cleared it with your doctor.

Patients who inject GLP-1 drugs daily may need to adjust the timing. For patients taking these medications for diabetes treatment, it may make sense to do the injection right before the meal that breaks the fast or to hold off until after the fast. This helps reduce the risk of stomach side effects, which can occur when these medications are taken on an empty stomach.

More recently, many patients have switched to oral GLP-1 medications. These pills must generally be taken on an empty stomach with a small amount of water, at a set time before taking any other drugs or any food or beverages.

Because fasting for Yom Kippur includes abstaining from drinking, taking the pill as directed may involve breaking the fast. That means you’ll need to decide in advance whether to take the medicine before the fast begins, after the fast ends or on an alternative schedule. It’s best to avoid simply skipping the daily dose scheduled for Yom Kippur and taking a double dose after the fast.

Skipping the dose won’t be harmful if you’re taking the medication for weight loss. But if you have diabetes, skipping it could dangerously elevate your blood sugar. And doubling the dose later could lead to serious side effects, such as pancreatitis, an inflammation of the pancreas that can lead to hospitalization.

Diabetes versus weight loss

If you’re using GLP-1 medications solely for weight management, fasting for 25 hours should not pose serious issues beyond stomach upset. In rare cases, though, combining these drugs with fasting can stress the pancreas enough to cause pancreatitis.

Fasting on GLP-1s carries the biggest risks for diabetic patients. That’s because GLP-1 medications are often used alongside other drugs that work primarily by lowering blood sugar, which raises patients’ overall risk of a blood sugar crash.

The greatest concern is in patients taking a GLP-1 medication together with insulin or drugs that stimulate insulin production, such as sulfonylureas. The GLP-1 medication itself may not cause a drop in blood sugar. But because it suppresses appetite and lowers glucose levels, these other medications can magnify the risk of low blood sugar during a prolonged fast.

If that’s your situation, talk to your doctor about whether you can adjust the timing, dose and type of insulin you take and reduce your dose of sulfonylurea in order to fast safely.

In general, people who have Type 1 diabetes or poorly controlled diabetes are strongly advised not to fast – as are people who:

  • Experience frequent or severe drops in blood sugar.
  • Have hypoglycemia unawareness – an absence of warning signs for high blood sugar.
  • Are managing diabetes during pregnancy.
  • Have severe kidney disease with a high risk of dehydration.
  • Experience severe gastrointestinal side effects from GLP-1 medications.
Not overeating along with drinking plenty of water beforehand is helpful for anyone fasting – but crucial for people on GLP-1 medications.

From prefast prep to the post-holiday meal

Regardless of what GLP-1 medication you take and for what indication, if you plan to fast you’ll need to do some pregaming, monitor how your fast is going and be mindful of how you break it.

  • First, if you are unsure about anything, talk to the clinician who is monitoring your GLP-1 drug treatment so you can decide together whether fasting is safe for you and whether your situation requires any special precautions.
  • Before fasting, it’s important to eat a normal meal that includes protein and to avoid both overeating and undereating. Overeating is never recommended when on GLP-1 medications, and undereating can set you up for more side effects during the fast. Although GLP-1 therapy can substantially reduce appetite, patients should avoid skipping the prefast meal entirely.
  • GLP-1 medications don’t just decrease appetite – they can also suppress the body’s natural thirst signals. So before your fast begins, aim to stay hydrated to prevent getting dehydrated while fasting.
  • If you are diabetic, make sure you fast under close guidance from your doctor – and make sure you are checking your blood sugar during fasting. Using a glucose monitor is a good idea, particularly if you are taking insulin or other glucose-lowering medications. The goal is for your blood sugar to remain within your usual daily nonfasting range.
  • Be ready to break your fast right away if you start feeling dizzy, confused, faint, nauseated or acutely ill, or if your blood sugar dips too low or spikes too high. These symptoms are dangerous and need to be addressed immediately. Stash a rapid source of carbohydrates – even just some glucose tablets or a few hard candies – within reach so you can access them quickly if needed.
  • Finally, plan a gentle, balanced meal to break the fast rather than an unusually large meal, which may provoke nausea, abdominal pain, reflux or vomiting. It’s generally best to avoid higher-fat foods, too, since they can slow down digestion.The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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