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An Orthodox woman says she is no longer welcome to pray at a New York synagogue because she is trans

(JTA) — When Talia Avrahami was asked to resign from a job teaching in an Orthodox Jewish day school after people there found out she was transgender, she was devastated. But she hoped to be able to turn to her synagogue in Washington Heights, where she had found a home for the last year and a half.

The Shenk Shul is housed at Yeshiva University, the Modern Orthodox flagship in New York City that was locked in battle with students over whether they could form an LBGTQ club. Still, Avrahami had found the previous rabbi to be supportive, and the past president was an ally and a personal friend. What’s more, Avrahami had just helped hire a new rabbi who had promised to handle sensitive topics carefully and with concern for all involved.

So Avrahami was shocked when her outreach to the new rabbi led to her exclusion from the synagogue, with the top Jewish legal authority at Yeshiva University personally telling her that she could no longer pray there.

“Not only were we members, we were very active members,” Avrahami told the Jewish Telegraphic Agency. “We hosted and sponsored kiddushes all the time. We had mazel tovs, [the birth of] our baby [was] posted in the newsletter, we helped run shul events. We were very close with the previous rabbi and rebbetzin and we were close with the current rabbi and rebbetzin.”

Avrahami’s quest to remain a part of the Shenk Shul, which unfolded over the past two months and culminated last week with her successful request for refunded dues, comes at a time of intense tension over the place of LGBTQ people in Modern Orthodox Jewish spaces.

Administrators at Shenk and Y.U. said they are trying to balance Orthodox interpretations of Jewish law, or halacha, and contemporary ideas around inclusion — two values that have sharply collided in Avrahami’s case.

Emails and text messages obtained by JTA show that many people involved in Avrahami’s situation expressed deep pain over her eventual exclusion. They also show that, despite a range of interpretations of Jewish law on LGBTQ issues present even within Modern Orthodoxy, the conclusions of Yeshiva University’s top Jewish legal authority, Rabbi Hershel Schachter, continue to drive practices within the university’s broader community.

“I completely understand (and am certainly perturbed by) the difficulty of the situation. Nobody wants to, chas v’shalom [God forbid], oust anybody, especially somebody who has been an active part of this community,” the synagogue’s president, Shimon Liebling, wrote in a Nov. 17 text message to his predecessor. But, he continued, “When it came down to it, the halachah stated this outcome. As much as we laud ourselves as a welcoming community, halachah cannot be compromised.”

Liebling went on, using the term for a rabbinic decision and referring to a ruling he said the synagogue rabbi had obtained from Schachter: “A psak is a psak.”

The saga began this fall, several weeks after Avrahami lost her short-lived job as an eighth-grade social studies teacher at Magen David Yeshivah in Brooklyn, which she had obtained after earning a master’s degree at Yeshiva University. She had been outed after a video of her in the classroom taken during parent night began circulating on social media.

Around the High Holidays, when Orthodox Jews spend many days in their synagogues, Avrahami learned that people within the Shenk Shul community were talking about her, some complaining about her presence. As she always had, she had spent the holidays praying in the women’s section of the gender-segregated congregation.

Concerned, Avrahami reached out to the new rabbi, Shai Kaminetzky. He confirmed the complaints and told her he wanted further guidance from a more senior rabbi to deal with the complex legal issue before him: Where is a trans woman’s place in the Orthodox synagogue?

For Avrahami and some others who identify as Modern Orthodox, this question has already been resolved. They heed the rulings of the late Rabbi Eliezer Waldenberg, known as the “Tzitz Eliezer,” an Orthodox legal scholar who died in 2006. He ruled that a trans woman who undergoes gender confirmation surgery is a woman according to Jewish law.

But Waldenberg’s determination is not universally held among Orthodox Jews — and one prominent rabbi who does not accept it is Hershel Schachter. In a 2017 Q&A, Schachter derided trans issues, saying about one trans Jew, “Why did he decide that God made a mistake? He looked so much better as a man than as a woman.” He also suggested that a trans person asking whether to sit in the men’s or women’s section should instead consider attending a Conservative or Reform synagogue, where worshippers are not separated by gender.

“We know we’d have no problem if we were at a Reform or Conservative synagogue when it comes to the acceptance issue. The thing is, that’s not the only thing in our life,” Bradley Avrahami told JTA.

The couple became religiously observant after spending time in Israel and the two now identify as Modern Orthodox. They were married by an Orthodox rabbi in 2018, and when they had their baby via surrogate in 2021, it was important to them that the infant go through a Jewish court to formally convert to Judaism. Avrahami seeks to fulfill the Jewish legal and cultural expectations of Orthodox women, wearing a wig and modest skirts. The pair both adhere to strict Shabbat and kashrut observance laws.

“We didn’t want to be the only family that kept kosher at the synagogue, we didn’t want to be the only family that is shomer Shabbat and shomer chag,” Bradley Avrahami added, referring to strict observance of the Sabbath and holiday restrictions. “It kind of becomes isolating.”

Kaminetzky kept both Talia Avrahami and Eitan Novick, the past president, in the loop about his research, in which he consulted with Schachter. It was a natural place for him to turn: He had studied at Yeshiva University’s Rabbi Isaac Elchanan Theological Seminary and learned from Schachter there. And while the Shenk Shul includes members not affiliated with Yeshiva University, it is closely entwined with Y.U., occupying space in a university building and hiring rabbis only from a list of options presented by the university.

After speaking with Schachter, Kaminetzky reached a conclusion, according to messages characterizing it by Liebling, the synagogue president.

“He made an halachic decision that Talia isn’t able to sit in the women’s section for the time being,” Liebling wrote Nov. 17 in a message to his predecessor as president, Eitan Novick. But Liebling left the door open for change, writing, “All in all, the ‘official shul policy’ is still being decided.”

He said Kaminetzky had spoken extensively the previous evening with the Avrahamis and had been determined to share his judgment in a way that was respectful “despite the difficult-to hear halachic conclusion.”

Liebling added a parenthetical: “I honestly can’t imagine how difficult it is for them. If I were told I couldn’t sit in the men’s section, I’d be beyond heartbroken and likewise feel displaced.”

Talia Avrahami did indeed feel heartbroken. She told Kaminetzky and others that she felt like she wanted to die, alarming her friends and prompting some of them to reach out to the rabbi. “The concern about Talia’s well-being is likewise the #1 — and only — factor on my mind right now,” Kaminetzky told one of them that night.

The Avrahamis stopped attending the Shenk Shul, but they held out hope for Kaminetzky to change his mind, or for the synagogue to set a firm policy that would permit her participation. Over the next six weeks, though, they heard nothing — a situation that so disappointed Novick that he and his wife also stopped attending. (Kaminetzky’s third child was born during this time.)

“We really feel like this is a pretty significant deviation from the community that we have been a part of for 11 years, which has always been a very accepting place,” Novick said. “This is just not the community that I feel comfortable being a part of if these are the decisions that are being made. It’s not just about the Avrahamis.”

While Avrahami waited for more information, Yeshiva University and Schachter were already in the process of rolling out what they saw as a compromise in a different conflagration over LGBTQ inclusion at the school. Arguing that homosexuality is incompatible with the school’s religious values, Yeshiva University has been fighting not to have to recognize an LGBTQ student group, the YU Pride Alliance, and has even asked the Supreme Court to weigh in after judges in New York ruled against the university. This fall, the school announced that it would launch a separate club endorsed by Schachter, claiming it would represent LGBTQ students “under traditional Orthodox auspices.” (The YU Pride Alliance called the new club “a desperate stunt” by the university.)

Multiple people encouraged Avrahami to make her case directly to Schachter. When she headed to a meeting with the rabbi on Jan. 1, she hoped that putting a face to her name and explaining her situation, including that she had undergone a full medical transition, might widen his thinking about LGBTQ inclusion in Orthodoxy.

The meeting lasted just 15 minutes. And according to Avrahami, who said Schachter told her she was the first trans person he had ever met, it didn’t go well.

In an email to another rabbi who attended the meeting, Menachem Penner, Avrahami said Schachter had called her “unOrthodox” and accused him of “bullying Rabbi Shai Kaminetzky into accepting bigoted psaks.”

Penner, the dean of Yeshiva’s rabbinical school, characterized the conversation differently.

“Rabbi Schachter rules that it is prohibited to undergo transgender surgery and does not accept the opinion of the Tzitz Eliezer post-facto,” he wrote in an email response that day in which he denied that Kaminetzky had been pressured to follow Schachter’s opinion.

“That’s simply a halachic opinion that many hold,” Penner wrote. “He did not call you ‘unorthodox’ — you come across as very sincere in your Judaism and he wished you hatzlacha [success] — but simply said that the surgery was unorthodox, meaning it was not something that is accepted by what he feels is Orthodox Judaism.”

The meeting so angered Avrahami that she asked Liebling to refund her Shenk Shul dues that day, saying that Kaminetzky had kicked her out of the congregation.

“Of course! I’ll send back the money ASAP!” Liebling responded. “I’m so sorry how things are ending up.”

Yeshiva University and Schachter, through a representative, declined to comment, referring questions directly to the Shenk Shul. Kaminetzky directed requests for comment to a representative for the Shenk Shul.

“We have had several conversations with the Avrahamis and we understand their concerns,” the Shenk Shul said in a statement. “It’s important to emphasize that the Avrahamis were not asked to leave the congregation.”

That response doesn’t sit right with Novick, who said blocking Talia Avrahami from praying on both the men’s and women’s sides of the synagogue was tantamount to ejecting her.

“They seem to be trying to have their cake and eat it, too,” he said of the synagogue’s leadership. “They may not be wrong in saying they didn’t tell Talia she was ‘kicked out’ of Shenk, but they’ve created a rule that makes it impossible for her to be a full participant in our community.”

Bradley Avrahami argued that the rabbis who ruled on his wife’s case were short-sighted, giving too little weight to the fact that Jewish law requires Jews to violate other rules in order to save a life. Referring to that principle and pointing to the fact that transgender people are at increased risk of suicide, he said, “It was pikuach nefesh for the person to have the surgery.” His brother, he noted, survived two suicide attempts after coming out as trans.

“They really just don’t understand the harm that they caused when they make these decisions and put out these opinions,” Bradley Avrahami said. “A rabbi should not take a position knowing that that position will cause someone to want to harm themselves.”

Bradley Avrahami said he has received several harassing calls to his work number at Yeshiva University’s Azrieli Graduate School, where he is liaison for student enrollment and communications and taught Hebrew in the fall 2022 semester. Talia Avrahami, meanwhile, has struggled to find a job to replace the one she left under pressure in September, although she recently announced that she had landed a temporary position.

For now, they are attending another synagogue in Washington Heights, though Talia says she and her husband would consider returning to Shenk Shul if she were invited back and permitted to participate.

So far, there are no signs of that happening. On Jan. 1, after her meeting with Schachter, Talia sent a WhatsApp message to Kaminetzky.

“We elected you because you said you would stand up for LGBT people, not kick us out of shul,” she wrote.

The message went unanswered.


The post An Orthodox woman says she is no longer welcome to pray at a New York synagogue because she is trans 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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