Branneisha Cooper was terrified of attending her first holiday gathering after starting Mounjaro. The 28-year-old started the injectable medication on Nov. 2, 2022, just a few weeks before Thanksgiving.
“I told my family … do not take offense that I don’t eat that much on Thanksgiving,” she says. “Because for Black families, it’s like ‘oh you not eating the mac and cheese no more, was it nasty?’”
Mounjaro, a GLP-1 drug, is FDA-approved to treat type 2 diabetes and obesity, but it can be prescribed off-label for weight loss. Cooper, based in Flint, Texas, says she’s struggled with her weight for most of her life. After trying diet after diet, nothing seemed to help her lose weight, which became even more difficult after a polycystic ovarian syndrome diagnosis.
In 2022, she told her primary care doctor she was willing to undergo weight loss surgery. After taking into consideration her family history with type 2 diabetes, Cooper’s doctor prescribed Mounjaro. Within the first week on the medication, she lost seven pounds.
“I don’t have any plans right now of getting off of it,” she says. “When I started, I was 241 pounds. I’m now 158 and I’m at my goal. I don’t want to lose any more weight.”
But, reaching her weight loss goal with the help of the medication, didn’t come so easy. Last year, her insurance stopped covering Mounjaro, because she wasn’t clinically diagnosed with type 2 diabetes. So, her doctor switched her to Zepbound, another GLP-1 drug that’s used to treat weight loss and type 2 diabetes.
Fatima Cody Stanford, an obesity medicine physician-scientist at Massachusetts General Hospital, says while each patient is different, some of her patients taking a GLP-1 medication have expressed a decreased desire for food.
“If the pathology that’s defective is the GLP-1 pathway, then patients can see significant shifts in their eating behaviors,” Stanford says. “What I’ll hear patients say is this idea of food noise. They forget about food. They don’t even have a preference for food anymore.”
GLP-1 drugs, like Mounjaro, Zepbound, and Ozempic, are typically taken as weekly injections that mimic the effect of hormones triggered by food and tend to slow down digestion and curb hunger. While the long-term effects of these medications are unknown, their popularity continues to soar. So much so that patients with type 2 diabetes who were prescribed Ozempic faced pharmacy shortages.
Navigating the Holidays
Attending family gatherings, specifically the holidays, also came with its own challenges. Some family members didn’t understand why Cooper wasn’t eating as much as she used to. And she has publicly shared her experience using GLP-1 medications on social media, attracting a mix of supporters and negative commentors.
While the debate about who should use GLP-1 drugs, or not, continues to flare — it doesn’t negate the fact that patients like Cooper are seeing results from the medication. With a decreased appetite, she admits she doesn’t have the same strong cravings she used to. But she pushes back on the misconception that people don’t eat at all while using it.
“Some days I’m struggling to get food in. But we really be eating on the medication,” she says. “I’ve gotten hate comments and troll comments where people will be like ‘You’d rather starve yourself than actually go to the gym.’ Honestly, the medication doesn’t work unless you work with it.”
This year marks her third holiday season on a GLP-1 medication. Now, Cooper is much more confident about handling questions about her body and maintaining a balanced view about holiday meals. Instead of avoiding all the common foods Black families prepare for Thanksgiving or Christmas, she prioritizes “memories over macros.”
Healthy Modifications, Healthier Outcomes
Innocent Clement, a general internist and the founder and CEO of Ciba Health, a digital platform that works with patients to prevent and reverse chronic disease, says it’s important for patients to balance traditional foods within the Black community with healthier modifications. For example, he recommends using a leaner cut of meat or reducing added sugar, so as not to lose the cultural significance of the meal.
“I think it’s important to provide culturally relevant education that allows for tailored nutrition that respects cultural preferences — because it’s very difficult to tell someone to stay away from certain foods,” he says. “We want to respect tradition while promoting healthy choices.”
But Clement recognizes it’s not just about eating healthier foods. About 80% of health outcomes are driven by social determinants of health. The U.S. Department of Health and Human Services defines those determinants as economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community contexts.
Since most health outcomes result from social determinants of health, it’s no surprise that Black Americans have higher than average rates of chronic disease — including disparities in access to healthy food and health insurance. Many of Stanford’s patients present with multiple diagnoses. If someone is living with obesity, she says, it’s not uncommon for them to have high cholesterol or high blood pressure.
Recent clinical studies have found that GLP-1 drugs have been shown to improve obstructive sleep apnea and osteoarthritis. And it’s not unusual for Stanford to hear from patients they’ve seen improvement in their management of substance use disorder and alcohol use disorder. Which means GLP-1 drugs help resolve multiple conditions patients have concurrently.
Choosing to Be Present
After more than two years taking GLP-1 medications, Cooper says they’ve helped manage her PCOS and lower her high blood pressure. There were times throughout her journey where she had to navigate side effects and feelings of discomfort. But she reminds people she wouldn’t have been able to lose 83 pounds without the medication.
As she lives through her third holiday season while on Zepbound, she encourages others who are new to GLP-1s to enjoy themselves and be present in the moment. Shifting her mindset from worrying about gaining back that weight to enjoying the time spent with family has been freeing for her.
“You’re on the medication for you,” Cooper says. “You now have control over the food noise and over your compulsion. Long-term success means feeding your body the th
