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American rabbis, wrestling with Israel’s behavior, weigh different approaches from the pulpit

(JTA) — Rabbi Sharon Brous began a sermon at her Los Angeles synagogue last month with a content warning. “I have to say some things today that I know will upset some of you,” she began. 

That same morning, across the country in New York City, Rabbi Angela Buchdahl was confessing something to her congregants, too: The sermon they were about to hear “kept me up at night.”

Both women — among the most prominent and influential Jewish clergy in the United States — went on to sharply criticize Israel’s new right-wing government, which includes far-right parties that aim to curb the rights of LGBTQ Israelis, Arabs and non-Orthodox Jews.

In taking aim at Israel’s government from the pulpit, the rabbis were veering close to what many in their field consider a third rail. “You have a wonderful community and you love them and they love you, until the moment you stand up and you give your Israel sermon,” Brous told the Jewish Telegraphic Agency. The phenomenon even has an informal name, she said: “Death by Israel sermon.”

Brous would know: A decade ago, she was the target of sharp criticism after she encouraged her congregants at IKAR, a nondenominational congregation, to pray for Palestinians as well as Jews during a period of conflict in Israel. The incident didn’t end her pulpit, but she has come to understand why many rabbis choose what she called “the path of silence” when it comes to Israel.

Now, she said, American Jews must depart from that path. “I want you to hear me,” she said in her sermon. “There is a revolution that is happening, and this moment demands an awakening on both sides of the sea, an honest reckoning.”

All over the country, non-Orthodox rabbis are making similar calculations in response to Israel’s new governing coalition, which has drawn widespread protests over its policy moves. (Orthodox communities, including their rabbis, tend to be more politically conservative and skew to the right of non-Orthodox communities on Israel issues.) Israel’s government is advancing an overhaul of the legal system that would sap the power of the Supreme Court, and is also contending with an escalating wave of violence.

Some rabbis feel more emboldened to speak aloud what they have long believed. Others are finding themselves reconsidering their own relationship to Israel — and bringing their congregants along on their journey. A few still feel that criticizing Israel from the pulpit is a misguided and even dangerous venture, one that could splinter American Jewish communities.

What cuts across the spectrum is a belief that Israel has been discussed too little from the synagogue pulpit. Brous said the tendency of liberal rabbis not to talk about Israel lest they anger their more conservative congregants has resulted in a painful reality: “American Jews have not developed the muscle that we now need to respond to this regime.”

Rabbi Ammiel Hirsch of the Stephen Wise Free Synagogue in New York City launched a new program called Amplify Israel, which he hopes will encourage Reform movement leaders to embrace Zionism even as they navigate a “deeply problematic and even offensive” new Israeli government. (Shahar Azran/Stephen Wise Free Synagogue)

Rabbi Ammiel Hirsch, meanwhile, believes today’s rabbis must be vocal in fending off the influence of “competing values” about Zionism from “various organizations that are either cool on Israel or don’t like Israel or just downright anti-Zionist.”

Last year, angered by a letter signed by dozens of rabbinical students denouncing Israel’s actions during its 2021 conflict with Hamas in Gaza, Hirsch launched an initiative based at his New York City Reform synagogue to equip rabbis with tools to counter what he said was “the growing influence of an anti-Zionist element” in the next generation of Jewish clergy.

The initiative, Amplify Israel, is housed at his Stephen Wise Free Synagogue, and employs another rabbi, Tracy Kaplowitz, to work full-time to galvanize leaders from across the Reform movement to support Israel. Kaplowitz jokes that her new job won’t be complete “until every Reform Jew is a Zionist.”

Hirsch knows the new coalition is complicating his task. “The new government is going to make our promotion of Israel more difficult in the United States,” he said, noting that the government “has elements in it that are deeply problematic and even offensive to most American Jews.” 

He and Kaplowitz contend that it is possible, in their view, for rabbis to criticize aspects of the Israeli government from the pulpit while still remaining broadly supportive of the Jewish state and encouraging their congregants to be the same. They also say the need to build Zionist sentiment within the American rabbinate transcends any particular moment, including this one.

“If we have to transform how we connect to Israel each time there’s an election, we’ll be driving ourselves a little bit batty,” Kaplowitz said.

Rabbi Tracy Kaplowitz is a full-time Israel Fellow at the Stephen Wise Free Synagogue in New York City. She jokes that her job won’t be finished “until every Reform Jew is a Zionist.” (Ryen Greiss/Stephen Wise Free Synagogue)

Hirsch sits on the advisory board of another new pro-Israel initiative, the Zionist Rabbinic Coalition. Helmed by Stuart Weinblatt, senior rabbi at Conservative Congregation B’nai Tzedek in Potomac, Maryland, the group is an interdenominational network of more than 200 rabbis who advocate to ”strengthen the ties between American Jewry and the State of Israel.”

Weinblatt hews to an early generation’s view of how rabbis should approach Israel from the pulpit. He told JTA that he believes his colleagues should always be supportive of Israel in public, even if they choose to pressure the Israeli government and advocate against certain policies in private — which, he says, is “the appropriate vehicle” for voicing concerns. “My position has always been that support for Israel should be unconditional,” he said.

“If we as rabbis are sharply critical of Israel, the result can often lead to a distancing from Israel, which ultimately may diminish the connection people feel to Judaism and the Jewish people,” he added. “People do not always distinguish and differentiate between opposition to a particular policy and broader criticisms of Israel which can do lasting damage.

Asked whether the Israeli government could ever conceivably take a step that would necessitate a public response from American rabbis, Weinblatt ruminated for days. He ultimately told JTA that the current debate around proposed changes to the Law of Return, the Israeli policy that allows anyone with at least one Jewish grandparent to claim citizenship, would be such an example, as that is a policy that would have a direct effect on Diaspora Jews.

Tightening who is eligible under the Law of Return is in fact a goal of some elements of Israel’s governing coalition, although the Diaspora minister assured an audience in the United States that, unlike with the proposed changes to the government’s judicial system — which have earned criticism across the political spectrum — there would be an effort to build consensus and no changes would happen overnight.

Still, the prospect of such a change so alarmed Rabbi Hillel Skolnick of Congregation Tifereth Israel in Columbus, Ohio, that he traveled to Jerusalem to address the Knesset, Israel’s lawmaking body.

“The members of my congregation and my movement have a spiritual connection with Judaism and also a political connection because we live in a democracy, so they see a Jewish democracy as an ideal that they can look to as a light unto the nations,” he said, in a speech he delivered as a representative of the Conservative/Masorti movement. 

“By even questioning the idea of the Law of Return,” he went on, Israel “takes away from both the Jewish connection and the democratic connection they have with this country.”

Skolnick suggested that he was unsure of how to speak to his congregation about the new government and its agenda. “My question to you is, what message can I go home with?” he asked.

Rabbi Stuart Weinblatt, founder and chair of the Zionist Rabbinic Coalition, shown with Israeli President Isaac Herzog. Weinblatt believes American rabbis’ “support for Israel should be unconditional,” and that disagreements with its government should be hashed out in private. (Courtesy of Stuart Weinblatt)

This week, hundreds of American rabbis will be returning to their congregations with messages honed by a week in Israel. The Reform movement just concluded its biennial convention, which was held there for the first time since before the pandemic. Their visit coincided with major developments in the country’s twin crises: The Knesset advanced the judicial reform legislation, and three people were killed in a Palestinian shooting and subsequent settler riot in the West Bank.

In a sign of the balancing act that American rabbis are navigating, the Reform movement’s leader, Rabbi Rick Jacobs, who has been among the earliest and most outspoken critics of the new Israeli government, will also be a featured speaker at Amplify Israel’s conference this May aiming to encourage Zionist sentiment among Reform Jews. 

At the convention, the leader of the Central Conference of American Rabbis called for Reform clergy to move away from defining Israel in stark black-and-white terms — an apparent reference to Jews who speak of “pro-Israel” and “anti-Israel” forces.

In order to connect better with those in our communities around Israel in a nuanced and meaningful way, we must be able to move beyond the pro/con dichotomy which only serves to divide us in ways that are a distraction to the actual issues at hand,” Rabbi Hara Person told the attendees. During the conference, the rabbis attended and voiced support for Israeli protests against their government.

“We are seeing a shift for the better, in my opinion, about how Jews are feeling comfortable critiquing Israel’s policies,” Rabbi Sarah Brammer-Shlay told JTA last fall, before the Israeli elections. Brammer-Shlay was a signer of the 2021 rabbinical students’ letter who graduated from the Reconstructionist Rabbinical College and today is a rabbi and chaplain at Grinnell College. 

That kind of shift has Weinblatt worried. “Sometimes, rabbis are actually out of sync and out of touch with their congregations, who do want to hear messages of support of Israel,” he said.

That may well be the case, particularly at synagogues with aging populations, but survey data suggests that American Jews are moving to the left on Israel at the same time that Israel itself has shifted to the right. The most recent Pew Research Center survey of American Jews, in 2021, found that most have a negative opinion of Israel Prime Minister Benjamin Netanyahu; only one-third think Israel is making a sincere effort to achieve peace with Palestinians; and 10% support the Boycott, Divestment, Sanctions movement against Israel.

While rabbis typically consider what they think their congregants want to hear, they aren’t bound to say it. And some rabbis say this moment is a time to take a stand, even if there is blowback.

Rabbi Jeremy Kalmanofsky of Congregation Ansche Chesed, a Conservative congregation on Manhattan’s Upper West Side, announced in December that his congregation would no longer recite the Prayer for the State of Israel, part of most congregations’ Shabbat morning liturgy since 1948. He said the extremism of Israel’s leadership meant the words no longer applied, and replaced the prayer with the more generally worded Prayer for Peace in Jerusalem.

”I couldn’t just say, ‘God, please guide our leaders well,’” Kalmanofsky said, pointing specifically to the fact that extremist politicians Itamar Ben-Gvir and Bezalel Smotrich were now government ministers who would be the beneficiaries of such prayer. “The things that they’re saying cannot possibly represent the Israel that I want to support.” 

Kalmanofsky had not previously been outspoken as a critic of Israeli policy. He said he has faced some tough feedback from some in his community, including from those who believe this is a moment that demands more, not less, prayer for Israel — “not an unreasonable response,” he said. But a month into the liturgy change, he said he is confident he has made the right decision.

“Something really meaningful had changed in the public life of the state of Israel,” he said. “That deserved real recognition, and a real response.”

Continuing to focus on preserving a Jewish connection with Israel without “dealing like grown-ups” with its “very serious problems” would render the rabbinical voice irrelevant, Kalmanofsky said. “At best, we’re kind of like, ‘blind love, blind loyalty.’ And at worst, we’re totally obtuse, and have nothing meaningful to say about the real world.”

“If you’re going to have a pulpit,” Kalmanofsky added, “you’re going to have to use it once in a while.”


The post American rabbis, wrestling with Israel’s behavior, weigh different approaches from the pulpit 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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