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Rabbi arrested, banned from Cleveland universities over his anti-Palestinian activism

(JTA) – For days, students and police at Cleveland State University had been trying to figure out who stole a banner belonging to a campus Palestinian rights group.

The banner, which belonged to the student group Palestinian Human Rights Organization, read “CSU Solidarity for Palestinian Rights” and was illustrated with an outline of Israel, the West Bank and the Gaza Strip collectively emblazoned in the Palestinian flag. A dove holding an olive branch appeared on top of the image.

Then, on Jan. 19, police charged their top suspect: a local Orthodox rabbi, whose presence on campus had become all too familiar. A few days later the man confessed to the theft on Instagram, announcing that he had stolen the banner from the school’s student center “as an act of civil disobedience.”

“This incitement to annihilation of Israel should have never been permitted at CSU,” Rabbi Alexander Popivker, a 46-year-old Cleveland Heights resident whose neighborhood is six miles from the school, wrote on social media accompanied by a picture of the flag he stole. 

It was far from Popivker’s only recent run-in with local university students. 

A former Chabad-Lubavitch emissary in Naples, Italy, who now works in the Cleveland area as a handyman and part-time rabbi for a Russian-speaking Jewish community, Popivker has become known around town as a vigilant and omnipresent pro-Israel advocate. He can often be spotted counter-protesting at local pro-Palestinian demonstrations, or putting on displays of his own, with his wife Sarah on hand filming every contentious encounter. 

One major theme of his protests, and his worldview, as he explained to the Jewish Telegraphic Agency: “Palestinians and Nazis are the same thing.”

For the last year, Popivker had been making weekly trips to Cleveland State, occasionally accompanied by other students or community members, to give public demonstrations that elaborate on that idea — sometimes with the aid of swastika-emblazoned props. In the early going, the university provided him with police protection and said his visits to campus were protected by free speech laws. 

But he also sought out students online and in-person whom he deemed to be “brainwashed” by anti-Zionist messaging. One such online campaign against a law student prompted the student to file an order of protection against Popivker last fall, an order supported by a prominent Jewish dean at the university. Popivker promptly violated the order by returning to campus.

Cleveland State University main campus, Cleveland, Ohio. (Getty Images)

In late January, university authorities had enough. They arrested Popivker and, following a hearing, declared him persona non grata on campus, banning him from the university grounds for at least two years. Popivker has also been banned from nearby Case Western Reserve University, where he had advocated before focusing on Cleveland State.

In the midst of a nationwide university climate in which pro-Israel advocates claim Jewish students face regular antisemitic harassment for their real or perceived Zionist beliefs, here was a documented case of the opposite: a Jew and outspoken Zionist, who has no affiliation with the schools at which he advocates, accused of harassing anyone he perceived as a threat to Israel, including students who had never sought him out directly. 

The Ohio chapter of the Council on American-Islamic Relations has spoken out numerous times against Popivker and praised university police for arresting him; a petition the group backed, labeled “Stop harassment on campus” and mentioning Popivker by name, has garnered close to 700 signatures.

Jewish groups, including civil rights groups, have been less forthcoming about situation. Hillel International declined to comment for this story, and the directors of Cleveland’s regional American Jewish Committee and Jewish Community Relations Council offices did not return requests for comment. Jewish on Campus, a nationwide university antisemitism watchdog group that tracks what it defines as anti-Zionist social media harassment of Jewish students, also did not return a request for comment.

Jared Isaacson, the executive director of Cleveland Hillel, told the Jewish Telegraphic Agency that the center was “not very familiar with this story.” Cleveland Hillel coordinates Jewish student life at a consortium of Jewish universities including Cleveland State and Case Western, where its student center is located, as well as at least one other school where Popivker has made his presence on campus known in some form. 

But, Isaacson said, “Cleveland Hillel is deeply committed to countering antisemitism and hate in all forms, and we believe that no student — Jewish or otherwise — should ever feel threatened or intimidated because of their identity.” 

Popivker says he has support from the New York-based Lawfare Project, which bills itself as an “international pro-Israel litigation fund.” He told JTA that the organization “is watching over my cases and providing guidance.”

In a statement, the Lawfare Project called Popivker “a Jewish civil rights activist” but did not confirm that it is backing him, saying only that the group is “currently reviewing the matter.”

The group, which frequently files lawsuits on behalf of students who allege antisemitism on their campuses, said in a statement to JTA that the order of protection was a “double standard” that “should be alarming to anyone who cares about the fight against Jew-hatred.”

Lawfar recently settled a multi-year lawsuit with San Francisco State University over student reports of antisemitic harassment on campus stemming from anti-Zionist activists disrupting an event featuring the mayor of Jerusalem. The settlement compelled the university to hire a coordinator of Jewish student life.

Popivker will have his work cut out for him if he fights the charges. He had exhibited “behavior detrimental to the university community” by stealing the Palestinian banner and separately affixing an Israeli flag to university property, Matthew Kibbon, Cleveland State’s associate vice president of facility services, wrote in the university’s decision declaring him persona non grata.

The rabbi “was not banned for the content of his speech, but how he chose to exercise it,” a Cleveland State spokesperson told JTA in a statement. The university also provided JTA a list of recent campus police interactions with him, including the initial Jan. 11 report of the banner’s theft; Popivker’s visit to campus on Jan. 18, during which police advised him that the student’s order of protection did not permit him to be there; and his return visit on Jan. 25, during which he was arrested.

From Popivker’s perspective, he is simply speaking out on Israel’s behalf for a campus that has a large pro-Palestinian activist presence but few Jewish students. (There are fewer than 200 Jewish undergraduates on Cleveland State’s campus out of 11,784 students, according to Hillel International.) His goal is to educate, he says, informed by his status as a Jewish refugee from the Soviet Union. And he believes he is being targeted by local pro-Palestinian activists, who, he said, have gone after his kippah and Israeli flags.

“I never attacked anyone. I never raised my hand up to anyone,” he told the Jewish Telegraphic Agency, saying that he was motivated by civil rights icons Martin Luther King Jr. and John Lewis. “I’m going to a public university. I’m staying in the free speech zone. And I raise awareness about what’s going on. There’s a bunch of students that have become my friends that come to study with me regularly.” 

One of those students, senior Tyler Jarosz, told JTA he became friends with Popivker after seeing him visiting campus to advocate for Israel. Not knowing much about Jews or Israel himself — “I thought Israel was a very peaceful state,” Jarosz said — the student was taken with Popivker’s demonstrations and said he learned a great deal from them. 

“He didn’t just lecture me like a teacher would,” Jarosz said. “He was actually very engaging. He asked questions.” 

Jarosz said he never witnessed the rabbi harassing anyone on campus, and said he always tried to engage people in peaceful dialogue, despite what he described as harassment directed at him by some Muslim students. He recalled one Popivker visit to campus for Israel’s independence day, when the rabbi was offering falafel to students, and said he witnessed one student throw the falafel back at him and threaten to “rape” him.

Other students tell a different story. One campus paper, the Cauldron, reported that the rabbi has targeted visibly Muslim and Arab students on campus, demanding to know their views on Israel. Popivker “makes me wary of coming into campus,” a student member of the Palestinian Human Rights Organization group told the Cauldron. “I’m forced to be on constant edge and take the longer way to class in order to avoid him.” Another student told a different campus newspaper, “It’s almost as though he deliberately looks for Palestinian individuals just to target them.” 

The chair of the law school’s National Lawyers Guild student chapter told the Cleveland Jewish News that their group’s efforts to engage Popivker in reasonable dialogue failed when he began using “racial slurs and insulting language.”

A swastika Alexander Popivker drew on a Palestinian scarf (alleged by some students to be a keffiyeh, or ritual Muslim prayer scarf) while mounting a pro-Israel demonstration on the campus of Cleveland State University. Popivker then shared the image to his Instagram, Feb. 3, 2023. (Screenshot)

In images from one Popivker demonstration, the rabbi can be seen drawing a swastika with a Sharpie marker on what the Cauldron reported was a keffiyeh, a scarf worn by Arabic men, but which Popivker told JTA was a Palestinian scarf with no spiritual significance. He has also yelled phrases including “Palestinians are Nazis” and “Palestinians are the KKK,” and constructed a stage with images further linking Palestinians to Naziism, according to reports. Popivker’s own Instagram videos show him approaching groups of students to argue about Israel as he films them, calling some of them “terrorists” when they go after his flags. One of his video captions mentions “a Middle Eastern looking student.”

Cleveland State increased its safety protocols as a result of Popivker’s activities, locking some additional entrances around campus. But much of his activities have been online, too.

Last fall Popivker trained his attention on a law student who was involved with campus Palestinian rights groups and had made some anti-Israel posts online, including sharing an image of a child whom pro-Palestinian groups claimed had been a victim of an Israeli bombing, and sharing a socialist group’s post quoting, “From the river to the sea, Palestine will be free.” 

Documents show that Popivker emailed and called the student’s employer and law school seeking to have her disciplined for her beliefs, writing among other things that she was a “mouthpiece of terrorism and racism against Jews.” He also made Instagram posts targeting her. In response, the student filed for and received the order of protection against him, which Popivker later claimed was unwarranted because he had never met the student in person. 

In its statement to JTA, the Lawfare Project homed in on this sequence of events, saying that Popivker’s decision to email the student’s school and employer about what he believed to be antisemitic social media posts was “a tool routinely used by civil rights activists to fight discrimination.”

Popivker asked Jarosz to send a letter attesting to his character for the order of protection hearing, which he did. “Alex understands and respects everyone of every background that he comes across,” the student wrote in his letter. “I have personally witnessed the demonization they have done of him.” Speaking to JTA weeks later, Jarosz said the court case was “bogus,” but said he was unaware of the emails, social media records and phone transcripts reviewed by JTA showing that Popivker had contacted the student’s employer and school.

At the order of protection hearing, a transcript of which Popivker sent to JTA, a key witness who advocated for the restriction was law school dean Lee Fisher, a former attorney general and lieutenant governor of Ohio. Fisher is Jewish. 

“We share a hatred of antisemitism,” Fisher told Popivker during the hearing, according to the transcript. The dean also identified himself as “pro-Israel, very much so.” But Fisher made clear he was critical of Popivker’s activities on campus. Asked by Popivker about a specific social media post the student had made, Fisher responded, “Even if she made a mistake by posting it, it did not warrant the kind of reaction I believe that you had.”

Fisher had also met with Popivker previously, in a session mediated by a local rabbi who was a friend of Popivker. “I told him that I was concerned for the health and safety of our students,” the dean said during the hearing. He had implored Popivker to stop his campus activities, but the rabbi refused.

It’s the initial order of protection, which Popivker said had already effectively banned him from campus, that the rabbi says he truly opposes. He saw it as evidence that “they were basically working together with Palestinians” to “cover up the fact that they have an antisemitic group that openly propagates a destruction of Israel.” Popivker visited campus several times after receiving the order of protection but was permitted to stay with only a warning from campus police, Jarosz recalled.

This state of affairs lasted until the rabbi stole the Palestinian student group banner to, he said, “shine a light on this antisemitism.” Popivker described to JTA how he entered the student building, walked up to the third floor where he knew the banner was, and used scissors to remove it and take it with him: “Clip, clip, clip.” He was subsequently thrown in jail — his second such stint in Cleveland for pro-Israel activities, he said, criticizing local law enforcement for not providing him with kosher food while he was behind bars. 

Outside of campus, Popivker is active in other areas. Last year, he organized a GoFundMe to support the family of a former classmate of his who was killed by an Islamic State supporter in a terrorist attack in Beersheba, Israel. He also applied to fill a January vacancy on the Cleveland Heights city council, but later withdrew his application. 

After being barred from Cleveland State University, Rabbi Alex Popivker took to holding his anti-Palestinian protests on a street outside a local casino. (Courtesy Popivker)

While Popivker may preach nonviolence, his social media activity points to more radical ideologies, as well. On Instagram, he has shared an image of the flag of the Jewish Defense League, an extremist Jewish group that advocates violence against enemies of Jews, founded by convicted terrorist Rabbi Meir Kahane, as well as an image with a logo of Im Tirtzu, a right-wing Israeli group that has in the past been accused of inciting violence against Israeli human rights groups. Popivker told JTA he is not a member of either group, but that “if I think it’s aligned with what I believe in, I’ll share it.”

Popivker says that, for now, he’s done with his brand of “civil disobedience” and won’t be making his weekly visits to Cleveland State’s campus. “I do have five wonderful boys and a loving wife, and as much as Cuyahoga [County’s] jail is an educational experience in life in many ways, I do not want to go there every week,” he said.

Instead, days after his arrest and campus ban, Popivker posted a photo of himself with an Israeli flag to social media — this time outside a casino a mile away from campus.


The post Rabbi arrested, banned from Cleveland universities over his anti-Palestinian activism 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.

The post Sacred fasting meets Ozempic appeared first on The Forward.

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