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From ‘how to’ to ‘why bother?’: Michael Strassfeld writes a new guide to being Jewish

(JTA) — “What the son wishes to forget the grandson wishes to remember.” That’s known as Hansen’s Law, named for the historian Marcus Lee Hansen, who observed that while the children of immigrants tend to run away from their ethnicity in order to join the mainstream, the third generation often wants to learn the “old ways” of their grandparents.

In 1973, “The Jewish Catalog” turned Hansen’s Law into a “do-it-yourself kit” for young Jews who wanted to practice the traditions of their grandparents but weren’t exactly sure how. Imagine “The Joy of Cooking,” but instead of recipes the guide to Jewish living had friendly instructions for hosting Shabbat, building a sukkah and taking part in Jewish rituals from birth to death. Co-edited by Michael Strassfeld, Sharon Strassfeld and the late Richard Siegel, it went on to sell 300,000 copies and remains in print today.

Fifty years later, Rabbi Michael Strassfeld has written a new book that he calls a “bookend” to “The Jewish Catalog.” If the first book is a Jewish “how to,” the latest asks, he says, “why bother?” “Judaism Disrupted: A Spiritual Manifesto for the 21st Century” asserts that an open society and egalitarian ethics leave most Jews skeptical of the rituals and beliefs of Jewish tradition. In the face of this resistance, he argues that the purpose of Judaism is not obedience to Torah and its rituals for their own sake or mere “continuity,” but to “encourage and remind us to strive to live a life of compassion, loving relationships, and devotion to our ideals.” 

Strassfeld, 73, grew up in an Orthodox home in Boston and got his master’s degree in Jewish studies at Brandeis University. Coming to doubt the “faith claims” of Orthodoxy, he became a regular at nearby Havurat Shalom, an “intentional community” that pioneered the havurah movement’s liberal, hands-on approach to traditional practice. He earned rabbinical ordination from the Reconstructionist Rabbinical College when he was 41 and went on to serve as the rabbi of Congregation Ansche Chesed on the Upper West Side and later the Society for the  Advancement of Judaism, the Manhattan flagship of Reconstructionist Judaism. 

“To be disrupted is to experience a break with the past and simultaneously reconnect in a new way to that past,” writes Strassfeld, who retired from the pulpit in 2015. This week, we spoke about why people might find Jewish ritual empty, how he thinks Jewish practices can enrich their lives and how Passover — which begins Wednesday night — could be the key to unlocking the central idea of Judaism.

Our conversation was edited for length and clarity.

Jewish Telegraphic Agency:  I wanted to start with the 50th anniversary of the “Jewish Catalog.” What connects the new book with the work you did back then on the “Catalog,” which was a do-it-yourself guide for Jews who were trying to reclaim the stuff they either did or didn’t learn in Hebrew school?

Michael Strassfeld: I see them as bookends. Basically, I keep on writing the same book over and over again. [Laughs] Except no, I’m different and the world is different. I’m always trying to make Judaism accessible to people. In the “Catalog” I was providing the resources on how to live a Jewish life when the resources weren’t easily accessible. 

The new book is less about “how to” than “why bother?” That’s the challenge. I think a lot of people take pride in being Jewish, but it’s a small part of their identity because it doesn’t feel relevant. I want to say to people like that that Judaism is about living a life with meaning and purpose. It’s not about doing what I call the “Jewishly Jewish” things, like keeping kosher and going to synagogue. Judaism is wisdom and practices to live life with meaning and purpose. The purpose of Judaism isn’t to be a good Jew, despite all the surveys that give you 10 points for, you know, lighting Shabbat candles. It’s about being a good person. 

So that brings up your relationship to the commandments and mitzvot, the traditional acts and behaviors that an Orthodox Jew or a committed Conservative Jew feels commanded to do, from prayer to keeping kosher to observing the Sabbath and the holidays. They might argue that doing these things is what makes you Jewish, but you’re arguing something different. If someone doesn’t feel bound by these obligations, why do them at all?

I don’t have the faith or beliefs that underlie such an attitude [of obligation]. Halacha, or Jewish law, is not in reality law. It’s really unlike American law where you know that if you’re violating it, you could be prosecuted. What I’m trying to do in the book is reframe rituals as an awareness practice, that is, bringing awareness to various aspects of our lives. So it could be paying attention to food, or cultivating attitudes of gratitude, or generosity, or satisfaction. My broad understanding of the festival cycle, for example, is that you can focus on those attitudes all year long, but the festivals provide a period of time once in the year to really focus on, in the case of Rosh Hashanah and Yom Kippur, for example, saying sorry and repairing relationships.

In “Judaism Disrupted: A Spiritual Manifesto for the 21st Century,” Michael Strassfeld argues that the challenge of each generation’s Jews is to create the Judaism that is needed in their time. (Ben Yehuda Press)

Passover is coming. Probably no holiday asks its practitioners to do so much stuff in preparation, from cleaning the house of every trace of unleavened food to hosting, in many homes, two different catered seminars on Jewish history. Describe how Passover cultivates awareness, especially of the idea of freedom, which plays an important part thematically in your boo

The Sefat Emet [a 19th-century Hasidic master] says Torah is all about one thing: freedom. But there’s a variety of obstacles in the way. There are temptations. There’s the inner issues that you struggle with, and the bad things that are out of your control. The Sefat Emet says the 613 commandments are 613 etzot, or advice, that teach us how to live a life of freedom. The focus of Passover is trying to free yourself from the chains of the things that hold you back from being the person that you could be, not getting caught up in materiality or envy, free from unnecessary anxieties —  all these things that distract us or keep us from being who we could be. 

The Passover seder is one of the great rituals of Judaism. We’re trying to do a very ambitious thing by saying, not, like, “let’s remember when our ancestors were freed from Egypt,” but rather that we were slaves in Egypt and we went free. And at the seder we actually ingest that. We experience the bitterness by eating maror, the bitter herb. We experience the freedom by drinking wine. We don’t want it just to be an intellectual exercise.  

Unfortunately the seder has become rote. But Passover is about this huge theme of freedom that is central to Judaism. 

I think some people bristle against ritual because they find it empty. But you’re saying there’s another way to approach rituals which is to think of them as tools or instruments that can help you focus on core principles — you actually list 11 — which include finding holiness everywhere, caring for the planet and engaging in social justice, to name a few. But that invites the criticism, which I think was also leveled at the “Catalog,” that Judaism shouldn’t be instrumental, because if you treat it as a means to an end that’s self-serving and individualistic.  

Certainly rituals are tools, but tools in the best sense of the word. They help us pay attention to things in our lives and things in the world that need repair. And people use them not to get ahead in the world, but because they want to be a somewhat better person. I talk a lot these days about having a brief morning practice, and in the book I write about the mezuzah. For most Jews it’s become wallpaper, but what if you take the moment that you leave in the morning, and there’s a transition from home to the outside and to work perhaps, and take a moment at the doorpost to spiritually frame your day? What are the major principles that you want to keep in your mind when you know you’re gonna be stuck in traffic or a difficult meeting?

And a lot of traditional rituals are instrumental. Saying a blessing before you eat is a gratitude practice.   

But why do I need a particular Jewish ritual or practice to help me feel gratitude or order my day? Aren’t there other traditions I can use to accomplish the same things?

Anybody who is a pluralist, which I am, knows that the Jewish way is not the only way. If I grew up in India or Indonesia and my parents were locals I probably wouldn’t be a rabbi and writing these books. 

But a partial answer to your question is that Judaism is one of the oldest wisdom traditions in the world, and that there has been a 3,000-year conversation by the Jewish people about what it means to live in this tradition and to live in the world. And so I think there’s a lot of wisdom there.

 So much in Jewish tradition says boundaries are good, and that it’s important to draw distinctions between what’s Jewish behavior and what’s not Jewish behavior, between the holy and the mundane, and that making those distinctions is a value in itself. But you argue strongly in an early chapter that that kind of binary thinking is not Judaism as you see it. 

Underlying the book is the notion that Rabbinic Judaism carried the Jewish people for 2,000 years or so. But we’re living in a very different context, and the binaries, the dualities — too often they lead to hierarchy, so that, for example, men matter more than women in Jewish life. And we’ve tried to change that. We are living in an open society where we want to be more inclusive, not less inclusive. We don’t want to live in ghettos. Now, the ultra-Orthodox say, “No, we realize the danger of trying to live like that. We don’t think there’s anything of value in that modern world. And it’s all to be rejected.” And it would be foolish not to admit that in this very open world the Jews, as a minority, could kind of disappear. But I think that Judaism has so much value and wisdom and practices to offer to people that Judaism will continue to be part of the fabric of this world — the way, for example, we have given Shabbat as a concept to the world.  

You know, in the first 11 chapters of the Torah, there are no Jews. So clearly, Jews and Judaism are not essential for the world to exist. And that’s a good, humbling message.

OK, but one could argue that while Jews aren’t necessary for the world to exist, Judaism is necessary for Jews to exist. And you write in your book, “If the Jewish people is to be a people, we need to have a commonly held tradition.” I think the pushback to the kind of openness and permeability you describe is that Jews can be so open and so permeable that they just fall through the holes.

It certainly is a possibility. And it’s also a possibility that the only Jews who will be around will be ultra-Orthodox Jews.

But if Judaism can only survive by being separatist, then I question whether it’s really worthwhile. That becomes a distorted vision of Judaism, and withdrawing is not what it’s meant to be. I think we’re meant to be in the world.

Your book is called “Judaism Disrupted.” What is disruptive about the Judaism that you’re proposing?

I meant it in two ways. First, Judaism is being disrupted by this very different world we’re living in. The contents of the ocean we swim in is very different than in the Middle Ages. But I’m also using it to say that Judaism is meant to disrupt our lives in a positive way, which is to say, “Wake up, pay attention.” You are here to live a life of meaning and purpose, and to continue as co-creators with God of the universe. You’re here to make the world better, to be kind and compassionate to people, to work on yourself. In my mind it is a shofar, “Wake up, sleepers, from your sleep!” “Judaism Disrupted” says you have to pay attention to issues like food, and justice, and teshuva [repentance].

You were ordained as a Reconstructionist rabbi. Do you think your book falls neatly into any of our current denominational categories?

[Reconstructionist founder] Rabbi Mordecai Kaplan’s notion of Judaism as an evolving religious civilization is the one that I feel closest to. But I feel that the denominational structure isn’t particularly useful anymore. There’s basically two categories, Orthodox and the various kinds of liberal Judaism, within a spectrum. The modern world is so fundamentally different in its relationship to Jews and Judaism that what we’re seeing is a variety of attempts to figure out how to respond. And that will then become the Judaism for the next millennium. It’s time for a lot of experimentation. I think that’s required and out of that will come a new “Minhag America,” to use Isaac Mayer Wise’s phrase for the emerging custom of American Jews [Wise was a Reform rabbi in the late 19th century]. And we don’t need to have everybody doing it one way. As long as people feel committed to Judaism, the Jewish tradition, even if they’re doing it very differently than the Jews of the past, they will be writing themselves into the conversation.


The post From ‘how to’ to ‘why bother?’: Michael Strassfeld writes a new guide to being Jewish 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.

*

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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