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Inside the auction house driving the rare-book craze in the Orthodox world

(JTA) – Israel Mizrahi joined dozens of fellow connoisseurs of rare Jewish books last December to watch the livestream of Genazym, the hottest auction house in the market. A bookdealer by trade, Mizrahi was also on the phone being paid to advise a wealthy client who had signed up to make bids. 

But as the auction proceeded, Mizrahi’s advice had little use. His trigger-happy client didn’t seem to care about established valuations: He ended up paying about $50,000 for a book estimated at half that price. “He just pressed the button and kept on bidding until the bidding was over,” Mizrahi said. “There was no convincing him out of it. He spent nearly $600,000 that day and there was no sense to it.”

Behavior that confounds veterans of the rare Jewish book market has become routine at auctions organized by Genazym. 

Mizrahi recalled the sale in 2021 of a Passover Haggadah printed in the 1920s in Vienna. With attractive illustrations of a prominent 19th-century rabbi named Moses Sofer and his family, the book makes for a nice addition to a collection. It also happens to be very common. 

“I sell copies for $100, and I have probably sold 150 copies in my life,” said Mizrahi, whose shop in Brooklyn is a mecca for Jewish book lovers. “It sold for about $5,500 at Genazym’s auction. I currently have it on sale still for $100.”

At the highest end of sale prices, a 16th-century first-edition Shulchan Aruch, a book of Jewish law, commanded $620,000 at a Genazym auction last September, while a copy of Noam Elimelech, a classic rabbinic treatise, printed in 1788, fetched $1.4 million four months later — in both cases at least doubling or tripling what experts thought the items were worth based on past sales of the same texts. 

“Genazym has come on like a freight train into the world of Jewish auctions. Some of the prices realized are far beyond what this market has seen before,” said David Wachtel, the former Judaica consultant for Sotheby’s auction house. 

Since Genazym’s first auction in 2017, it has sold some 1,900 books, manuscripts and other collectible documents for about $26 million plus commission, roughly $12 million above total starting prices, according to an analysis by the Jewish Telegraphic Agency of auction records on Genazym’s website. Genazym has increasingly outperformed the longest-standing Judaica auction firms in New York and Jerusalem. 

A page from an illustrated Passover haggadah printed in Vienna in the 1920s. (Courtesy of Genazym)

It’s hard to tell exactly what’s driving the boom because the identity of Genazym’s customers is confidential and few flaunt their collections widely. One of the auction house’s owners, in a rare public comment, ventured that Jewish buyers are craving a connection with their heritage. What’s clear is that at a time when traditional libraries are cutting back on buying Jewish texts, Genazym is tapping into an emerging luxury market among Orthodox Jews — and fueling the rise of religious texts as both a status symbol and investment vehicle in some communities.

“I know the sellers, the customers and everybody involved and there is a new wealthy class of Orthodox Jews that have a limited range of things they can splurge on,” Mizrahi said. “They don’t go to Vegas, they don’t do crazy vacations. They keep kosher. So this is a way that they can splurge and show off.” 

Rabbi Pini Dunner, who collects rare Jewish books, said investing in Judaica is likely attractive for some in the Hasidic community, whose religious observance is stricter than that of congregants at his Modern Orthodox synagogue in the Los Angeles area. 

“There are people I know here in Beverly Hills who’ve got car collections worth tens of millions of dollars,” Dunner said. “In the Hasidic world that has no currency, just as the wow factor of a Picasso has no currency. An original manuscript or first-edition of the Noam Elimelech has a real wow factor, particularly if you can tell people the book sold for more than a million dollars at a Genazym auction.”

The impression that the Hasidic world has grown wealthier over the last decade or two is widespread and based, at least in part, on the proliferation of luxury products and services tailored for the community in places like Lakewood, New Jersey, and Kiryas Joel, New York. Weddings have become increasingly expensive and elaborate, fine dining options are common, and high-end kosher wine and liquor are more readily available. 

“It wasn’t that long ago that sit-down dining was looked down upon or not even available. Now there are a plethora of options,” said Chaim Saiman, a law professor at Villanova University who studies the intersection of commerce and Jewish law. “It’s no secret that $200 bottles of Scotch appear at kiddush clubs all the time. $50 used to be a big deal, then $100 was a big deal, now we are at $200.”

Where the new wealth is coming from is not totally clear. Limited survey and U.S. Census data suggests that Orthodox Jews feel crunched by costs associated with practicing religion and that there are large pockets of poverty among them, particularly in Hasidic communities, according to Mark Trencher, the founder of Nishma Research, a nonprofit dedicated to studying the Orthodox Jewish community. The prevalence of large families also means that generational wealth can be harder to accrue for Orthodox Jews.

But there have always been high earners whose philanthropy has buttressed their communities, Trencher noted. “There are a lot of people in that community that are very successful in their businesses and they have large amounts of wealth,” he said. “Those people generally are huge donors to charities. From a financial perspective, those communities are probably doing much better than you would expect them to.”

Many of those high earners make their money through entrepreneurship rather than professional success in the white-collar world. Many nursing home chains — an industry valued at an estimated $171 billion and where growth is expected — have Orthodox owners. Amazon has also created new opportunities for Orthodox businessmen. Orthodox landlords, meanwhile, have benefited from skyrocketing real estate prices in places like Williamsburg, Brooklyn.

A page from a 16th-century first-edition Shulchan Aruch, a book of Jewish law, which fetched $620,000 at a Genazym auction. (Courtesy of Genazym).

Recent reporting in The New York Times about the Hasidic education system has provided a window into another stream of revenue for private businesses in the community. Entrepreneurs in the community have responded to the increased availability of government funding for special education in New York in recent years by establishing companies to service Hasidic schools, with the government footing the bill. In one example highlighted by the Times, a married Hasidic couple opened such a business in 2014 when they were 21 and 19 years old; in 2022, their company received more than $38 million in government funding.

The owners of another set of companies providing services to Hasidic schools appear to have used their windfall to purchase rare books through Genazym. The owners were indicted in January for allegedly billing the government for more than $1 million in childcare services that they never provided and otherwise defrauding the government out of more than $2.8 million. 

Prosecutors are seeking to have the alleged fraudsters forfeit seven books and other documents as listed in a federal indictment. They include manuscripts with a rabbinic signature and rare books of blessing and Jewish law, all of which match items listed on Genazym auctions, where they sold for a total of about $274,000. 

Buying Jewish texts at auction can seem like a savvy investment for buyers seeking to safeguard or grow their wealth. Before Genazym launched, a typical Genazym buyer might have invested in U.S. Treasury bills or the stock market, according to Wachtel, the former Sotheby’s consultant. 

“I think Genazym has been able to convince people that this is a good vehicle for establishing and growing wealth,” he said. “That also dovetails with your ability to, let’s face it, show off. Somebody comes to your house, you can show them a first-edition Shulchan Aruch. But you’re not going to say, hey, come look at my T-bills.”

The auction house’s tactics appear tailor-made for this growing market. Its motto is “Own your heritage,” and it’s printed on the catalogs the company distributes through popular Orthodox magazines like Ami or Mishpacha or podcasts, places where people with no prior interest in books might encounter the hype. The catalogs also appear in synagogues in heavily Hasidic areas like Brooklyn or Lakewood, but without the prices printed on them so as not to violate a Jewish prohibition against discussing financial matters on Shabbat. 

The descriptions in the catalogs emphasize any links that exist between the items for sale and notable rabbis from history, especially figures who established rabbinic dynasties that continue to exist today and who are revered by yeshiva-educated Orthodox Jews. The link might be a signature of a rabbi in a ledger from an old fundraising tour that took place 200 years ago. Or it might be that an important rabbi owned the book in question or even prayed out of it. Like a pair of pants of a prominent Israeli rabbi that drew widespread attention when they briefly went up for auction last month, these texts are seen by some as conferring holiness onto those who possess them. By virtue of their pedigree, these artifacts might even be seen as a segula, or Jewish protective charm.

In its promotional materials and live auctions, Genazym also uses more colloquial and hyperbolic language to describe its items than traditional auction houses, which tend to stick to the kind of terminology used by academic scholars. 

“Genazym found a formula to make books and manuscripts really exciting for the layperson, especially in the Orthodox community,” said Yoel Finkelman, a former curator of the Judaica Collection at the National Library of Israel. “They are not using the vocabulary of experts, they’re using plain ordinary language, like ‘very old’ or ‘very rare.’ No one at Sotheby’s would ever refer even to a thousand-year-old book that way.”

Genazym’s unique approach extends to the delivery of items to buyers. A traditional buyer in the rare Jewish book market, like Michelle Margolis, Columbia University’s Jewish studies librarian, might only care that the book they bought is safely delivered. But with Genazym, the books come wrapped in a proper clamshell and velvet bag. “I rolled my eyes when my delivery arrived, but at the same time that’s a lot of investment,” Margolis said, adding that many other auction houses have been cutting costs, for example, by doing away with their customary printed catalogs. 

Jacob Djmal, who lives in Brooklyn, has dabbled in Judaica collecting for many years, an interest he picked up from his grandfather. He remembers suddenly seeing Genazym’s advertising everywhere. “They started reaching out to you in every way possible, finding a demographic that wasn’t aware before. Every Genazym auction I have people texting me — ‘Did you hear about this? Did you hear about that?’ — as if something is happening that had never happened before.”

Sometimes, that is true. A breakout moment came during the December auction, when Genazym cleared $4.4 million in sales, about $2.6 million above total starting prices. 

“If there was any doubt that Genazym were now the most commercially remarkable rare book auction house on Earth, the results of their latest Judaica auction this week put paid to that: essentially almost every lot sold for at least twice [the estimated amount],” a major British book collector living in France said on his anonymous Twitter account, which has around 110,000 followers, in December. 

If there was any doubt that Genazym were now the most commercially remarkable rare book auction house on earth, the results of their latest Judaica auction this week put paid to that: essentially almost every lot sold for *at least* twice estimate…. 1/https://t.co/iAC4sQudIz pic.twitter.com/eeunjqWzAs

— Incunabula (@incunabula) December 13, 2022

It remains to be seen whether Genazym can challenge Sotheby’s Judaica division as the destination for sellers with the rarest and most valuable books. Last year, a medieval prayer book sold for $8.3 million at Sotheby’s and this year, the New York auction house is accepting bids for the oldest known copy of the Hebrew Bible, which is expected to fetch as much as $50 million. 

But Djmal considers especially remarkable about Genazym is not just the high prices but also the way in which rare books have caught on among Orthodox youth as something cool. “My son and his friends in yeshiva are talking about these items,” Djmal said. “These books represent rabbis they have heard about from a young age.”

The team behind Genazym’s success is led by three brothers from the Stefansky family who live in Jerusalem and New York. Before starting an auction house they worked for many years as private dealers in the rare book market. Their names, Chaim, Moshe and Bezalel, rarely appear anywhere and they almost never grant interviews. Chaim Stefansky made an exception for the Jewish Telegraphic Agency and requested that this article not put him in the spotlight nor portray Genazym’s success as a product of his business acumen. 

Stefansky said Genazym has tapped into a universal and deep-seated desire of people to strengthen their identities by connecting with the past. The Jewish community, he said, has been poorly served by an emphasis on historical and even current persecution. 

“Always, we are victimized and we cry,” Stefansky said. “What we have in common maybe is that your grandmother and my grandmother were sharing the same bed in Auschwitz. Give me something positive of my past to be proud of. Your heritage has not only sorrow but also a happy, rich, and huge intellectual tradition. So Genazym comes and tells people about their heritage. It’s yours. It belongs to you.”

He said the same thing can be done with any ethnic or religious group. 

“If you go to the Irish community and press the right buttons in terms of what you know that every Irish person is extremely proud of, I think you’ll be very successful,” Stefansky said. 

He rejected the impression that Genazym’s buyers come primarily from the ranks of the nouveau riche in the Hasidic world. 

“It’s coming from all sections,” Stefansky said. “People will say that there’s a lot of fresh money in the market. But we also have very good old money. We have institutions. And, also, the regular man. Mostly, the regular man, who never knew he could have access to any of this.”

One of the only customers who agreed to be identified and interviewed for this article is Rick Probstein, who says he’s spent more than $100,000 at the company’s auctions. He can’t remember when he started seeing Genazym catalogs but he had never collected Judaica before, which is perhaps surprising given that he’s an Orthodox Jew who’s been working in the collectibles business since he was a child trading baseball cards. 

Today, at 53, Probstein is one of the largest sellers of sports collectibles in the world, operating through a dedicated account on eBay. “I run a humongous business — I am doing something like $160 million a year,” he said of his sales volume. 

Probstein, who lives in Passaic, New Jersey, had long felt a pang of guilt about the lack of Jewish content in his collection. “I collect things but what do I have of my own heritage?” he recalled thinking to himself. “So when I started getting the catalogs, I said, ‘I gotta be a good Jew.’ I started bidding on things and I got really into it.”

Once Probstein got started, the Stefansky brothers began checking in on him, providing concierge service and cultivating him as a client. 

“This is a boutique run by a Jewish family with a personal touch,” Probstein said “They call me on the phone, saying, ‘Rick, did you get the catalog? What did you think? Here are some items that you could really like.’”

Bidding on Genayzm items is not purely sentimental for Probstein. “I’m putting real money into it because I think that from an investment standpoint, it has a lot of upside,” he said. 

Still, the items he buys tend to have personal significance. 

“I am partial to items relating to the Chofetz Chaim,” Probstein said, referring to the rabbi and Jewish scholar Yisrael Meir Kagan, who died in 1933. Probstein’s oldest son is named Yisrael Meir in his honor. The Chofetz Chaim also appeals to Probstein because of his writings about lashon hara, the prohibition in Jewish law against speaking evil of people. “I think that speech is important and he’s sort of the embodiment of that,” Probstein said.

Genazym has sold six letters and a handwritten blessing signed or written by the Chofetz Chaim at prices ranging from about $16,000 to $68,000. 

Ever since Probstein started collecting Judaica, these items have served as a draw for family and friends visiting his home.

“People in my community that come over for kiddush [refreshments after Shabbat service] know that I have this stuff and they always want to see it,” Probstein said. “Nobody ever looks at my sports memorabilia collection because it’s in my office but my Judaica stuff is in my house. They look at the letters and talk about the historical context. People love it.”

The revelation that so many Jews appear fascinated with their own history and want to engage with scholarly tradition comes at a time when many Jewish libraries have been struggling.

The library of the Jewish Theological Seminary in Manhattan, which has the most comprehensive and significant collection of Jewish books outside of Israel, has seen its footprint downsized amid budget cuts at the Conservative movement seminary. Also under financial pressure, American Jewish University was forced to sell its Bel Air campus in Los Angeles, which housed a library. Hebrew Union College, meanwhile, opted to end its Reform rabbinical training program in Cincinnati and even though the campus library has survived the cuts, financial uncertainty remains. 

Genazym’s populist approach might hold lessons for Jewish institutions and university libraries with significant Judaica collections that hope to engage the public around books. 

“The lesson is to lay off the snobbery a little bit,” said Finkelman, the former Judaica curator at the National Library of Israel, which is slated to reopen in a new and more accessible space later this year. “The goal of public institutions is to enable preservation but also to enable public access and public education. There are great stories in books and archives.”

Finkleman said he has encountered sneering reactions to the way Genazym promotes books, and they are similar to the response in the United States when the pop star Lizzo played a crystal flute that belonged to James Madison on stage at the Library of Congress

“There are echoes of the same thing here,” he said. “Get out of the snobby ivory tower and realize you are preserving history for people.”


The post Inside the auction house driving the rare-book craze in the Orthodox world 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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