Next week marks the beginning of Ramadan, the ninth month of the Islamic calendar and a period of fasting, prayer and reflection for the Muslim community.
Embarking on Ramadan while managing weight loss with GLP-1 agonist medications may feel challenging. So, if you use medications like Mounjaro, Wegovy or Saxenda for weight loss, this article is for you.
With a few mindful adjustments and the right dietary choices, you can observe this period while meeting your health goals and sustaining your energy levels through the daylight hours.
Using GLP-1 Medications Over Ramadan
Glucagon-like peptide 1 (GLP-1) receptor agonists are designed to help you feel fuller for longer, even when you eat less. This makes them ideal for people with type 2 diabetes (because they help control blood sugar levels) and for people looking to lose weight.
GLP-1 medications are a relatively new medical advancement, so it’s likely this is your first time using them over Ramadan.
When using GLP-1 medications, it’s important to prioritise your health at all times – both during Ramadan and outside of Ramadan. If you break your fast due to illness, as per Islamic guidelines, missed fasts can often be compensated later. Make sure you listen to your body as exhaustion can lead to stress on both the body and mind.
By following this advice, you should find it easier to complete your fasting safely during Ramadan.
Pause or Continue Using GLP-1s?
The first thing you should consider is whether or not to continue using the medication while you fast.
Many people choose to take a break from their medication while observing Ramadan. However, if you stop the medication, your appetite and food noise will gradually return back to previous levels. (That’s why it’s so important to build healthy food and exercise habits while using GLP-1s.)
After a period of appetite suppression on GLP-1s, this hunger may feel even more pronounced. This could make fasting more challenging as it might be harder to maintain the usual level of willpower needed to fast.
You may also notice you are much hungrier than normal when you break your fast. This “rebound hunger” can make it more difficult to choose healthier food and there’s a possibility you might slip into previous snacking habits. However, using GLP-1s appropriately and safely can help manage it.
Pausing GLP-1 medication can also be unsafe. When you stop taking your medication, its levels decrease in your body. As a result, the same dosage may be too strong for your system when you restart. This raises the risk of serious side effects.
If you’re thinking about pausing your medication, speak to your healthcare provider, who can guide you on the appropriate course of action.
Take It At the Same Time
If you decide to continue your medication over Ramadan, it’s a good idea to to be consistent when you take it. Stick to your prescriber’s directions and take the medication once a week, on the same day and at the same time.
Patients can take their medication either before suhoor (the pre-dawn meal), or after iftar (post-sunset meal).
The half-life of GLP-1 medications (the time it takes for the amount of drug in the body to be reduced by one-half) is around one week. It takes around one to three days for the medication to reach maximum concentration in your body. So as long as you are taking your injection on the same day each week, at roughly the same time, it will still be as effective.
Avoid Increasing Your Dose
At Simple, we’d prefer that you stick to your current pre-Ramadan dosing strength, as it makes it easier to predict how you’ll feel throughout the month.
Increasing your dose during the month of Ramadan can also pose some risks. You might potentially have more side effects when observing fasting. This may be harder to deal with if you’re also moving up a dose (which can also increase your risk of side effects).
Side effects can increase your risk of dehydration, which can cause you to become very unwell.
To help make sure this month is as problem-free as possible, sticking to your current dose will help limit side effects. This will give you more time and energy to focus on your spiritual goals.
If you are thinking of increasing or decreasing your dose – or if you have any queries – your healthcare provider will help you decide the safest option for you.
Watch Out For Low Blood Sugar
GLP-1 medications are “associated with a low risk of hypoglycaemia” (low blood sugar). Fasting can also lower your blood sugar levels. So anyone who wishes to fast while using GLP-1 pens should be aware of the signs and symptoms of low blood glucose as you change your eating patterns.
The most noticeable early warning signs of hypoglycaemia are:
- Feeling hungry
- Trembling or shaking
- Sudden sweating
- Tiredness and dizziness
And, as your blood sugar drops further, you might experience blurred vision, heightened pulse and palpitations, paleness and tingling lips. Going too long without balancing your blood sugar may lead to confusion and you might even lose consciousness.
If you start experiencing any of these symptoms, break your fast and eat something to help balance your blood sugar. This is especially important if you have any other health conditions.
As the fourth pillar of Islam, fasting in Ramadan is a time of reflection, forgiveness, spiritual discipline and empathising with the less fortunate. So remember, when it comes to fasting, there are some exceptions to the rule if it will cause harm. For example, you don’t have to fast if you have long-term medical conditions like diabetes.
It’s important to stay safe and healthy on GLP-1s during Ramadan and assess your risks of side effects. Consult a healthcare professional if you have any doubts or concerns about using your medication at this time. If you’re a patient with us, contact our clinical team, who will help you decide what’s best for you.
Healthy Eating Advice: Ramadan on GLP-1s
If you are using a GLP-1 drug over Ramadan, continue eating a healthy, balanced diet made up of whole foods and drink plenty of water.
Where possible, avoid large or calorie-dense meals at both suhoor and iftar. The most common side effects of GLP-1 medications tend to be related to your digestive system: nausea, vomiting, diarrhoea and constipation. Eating a large amount of food will make you much more likely to experience side effects from your medication. So start steady with easier foods and pace yourself throughout the night.
If you are concerned about side effects, or feel they are too much to handle while you fast, speak to your doctor, one of our pharmacists or another healthcare professional.
Even if you do not feel hungry, do not skip your suhoor or iftar meals. It’s vital to make sure you are still eating enough, particularly while your body is undergoing the strain of a fast (and, for some people, still maintaining the same level of physical activity).
A healthy, balanced diet and staying hydrated between iftar and suhoor will help ensure your bowel habits remain healthy. During this time, many Muslims partake in congregational prayers, which require standing. So drinking water or diluting juice (squash) is a great way to stay replenished.
Ramadan Fasting Tips
Begin with a Gentle Iftar
Traditional Ramadan fasting practices typically begin by breaking the fast with a small serving of dates, fruit, and water.
These foods gently raise blood sugar levels, replenishes energy and restores hydration after a long period without food or water. A gentle iftar also helps reduce the risks of your stomach reacting poorly to food.
Pause for Maghrib Prayer
After iftar, many observe a pause for Maghrib prayer. This can allow the body to start digesting and develop natural satiety signals. This mindful break helps control hunger and prevents overeating during the subsequent main meal.
Choose Healthier Cooking Methods
A variety of foods from different cultures are enjoyed during iftar such as crispy pakoras, samosas (fried pastries) and kebabs. While these foods are tempting, deep-fried foods can be high in unhealthy fats and refined carbohydrates. This can lead to feelings of sluggishness and digestive discomfort.
Consider alternative cooking methods such as grilling, baking or air-frying to enjoy these treats with less oil. This way, you can savour your iftar treats and keep your weight loss goals on track.
Embrace Mindful Eating
After hours of fasting, it’s natural to feel eager to eat. However, consuming your meal slowly allows you to appreciate the flavours of your food, aids digestion and helps prevent overeating.
This mindful approach can lead to better recognition of your body’s hunger and fullness cues. Even outside Ramadan, learning these cues can help cultivate a healthy gut, which in turn supports your overall well-being.
Stay Hydrated
Between iftar and suhoor, prioritise hydration by drinking plenty of water and consuming hydrating foods like cucumbers and watermelon.
Coconut water is a great way to replenish lost fluids and electrolytes, preventing dehydration among other health benefits. Limit caffeinated beverages as they can contribute to dehydration.
Key Takeaways
- Start Iftar with Light Foods like dates, fruit, and water for better digestion.
- Pause for Maghrib Prayer before the main meal to help control hunger.
- Break Your Fast if you Experience Hypoglycemia Symptoms like dizziness, sweating, or confusion.
- Avoid Large Meals at Iftar and Suhoor to prevent digestive discomfort and manage appetite effectively.
- Stay Hydrated Between Iftar and Suhoor, limiting caffeine and choosing water-rich foods.
Always consult a healthcare professional before making changes to your medication or diet during fasting.
Hopefully, this advice might make your fast feel a little more approachable, and set you up for a month of community, self-reflection and deepening your faith. Ramadan Kareem! And Eid Mubarak when Eid al-Fitr comes.
Clinically reviewed by: Mariam Al-Hajaj, GPhC reg: 2232929
Diet advice reviewed by: Ayisha Mushtaq ANutr, Association for Nutrition reg: 39412
References
Muslim Aid. (n.d.). Ramadan Rules. [online] Available at: https://www.muslimaid.org/media-centre/blog/ramadan-rules/
C. Fookes, BPharm (2019). Drug Half-life Explained. [online] Drugs.com. Available at: https://www.drugs.com/article/drug-half-life.html
Anderson, J., Gavin, J.R., Kruger, D.F. and Miller, E. (2022). Optimizing the Use of Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes: Executive Summary. Clinical Diabetes, 40(3). doi: https://doi.org/10.2337/cd22-0020
NHS (2023). Low Blood Sugar (hypoglycaemia). [online] NHS. Available at: https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/
