Holidays bring time with family, cultural celebrations and rest, but Thanksgiving, often centralized around food, may also ignite anxiety for some people.
As some reach for additional helpings of their favorite seasonal dish Thursday, others may feel apprehensive due to self-restricting habits, a desire to weight-watch or lifestyle changes following medication usage.
Robin Darling, a registered dietitian at the CHI Memorial Center for Cancer Support, said there's always been a concern toward weight loss in the general population.
"Everybody's always wanting an easy way or a quick way or something that will help motivate them or stimulate the weight loss," she said.
(READ MORE: Debbie Spielman takes on role as CEO of Children's Hospital at Erlanger)
Darling said people are concerned about the holidays, whether it's one meal on Thanksgiving, at an event or party.
"What you have to realize is it takes about 3,500 calories to make a pound," she said.
It takes a lot of food to consume that amount of calories over the course of one meal, she said.
TIPS AND TRICKS
Darling said she tells patients to keep in mind that there are strategies to help them navigate parties or holiday situations.
While people often say there are a lack of healthy options at a typical Thanksgiving meal, this is usually false.
"If it is, then you be the one to bring the healthy option," she said.
Opt for green beans instead of green bean casserole, or make potatoes with less butter and heavy cream, she said.
Darling suggested people take a glance at all Thanksgiving meal options and then pick their favorites instead of filling their plates.
"Choose those items that you can't find any other time during the year and focus a little bit more on those," she said. "You can fill a plate, but not a platter, so don't get the largest plate you can fill."
Tips for a healthier Thanksgiving meal
- Substitute milk for half-and-half
- Avoid casseroles
- Roast vegetables
- Get a small piece of a dessert item
- Fill a second plate with non-starchy vegetables or lean protein like turkey
- Opt for dishes that are often not eaten year-round, like stuffing or dressing instead of macaroni and cheese
Source: Robin Darling, registered dietitian
Table setup can be intentional. Hosts should set their guests up for good eating habits by not putting the buffet options at the table where everyone eats, Darling said.
Vegetables or items like turkey can be brought to the table if a host wants guests to get seconds, she said. Those options are healthier with more nutrients, often containing less fat and total calories.
"If you're eating at a table with food, we tend to keep picking and getting extras even when we're not hungry," she said. "Kind of know your own cue when to settle down, but don't have the food right in front of everyone."
After a meal, avoid lying down to take a nap, she said.
Walking after dinner is always good because it aids digestion, Darling said. Throwing a football in the yard, working a puzzle 0r playing games are all ways to create more activity and do something fun as a family.
Leftovers are another opportunity to strategize and can be put in small containers, Darling said.
"A lot of what I tell people is that, when we're talking about weight loss or holidays, everybody ends up bringing a dish, and then they don't know what to do with all the leftovers," she said. "Well, I tell people always be willing to take home a plate."
Instead of eating two plates at lunch, save one for the evening, she said.
"Go ahead and fix your plate so you get to have your favorite foods, but put it in the refrigerator," she said. "Wait four or five hours to have that second meal."
Hosts should make sure guests return home with plates or other food so it's not left for them to consume, she said.
ANXIETY
Other sources of anxiety, like traveling long distances in airplanes or by car, may be mistaken for food anxiety, Dr. Jon Cohen, a psychiatrist, said.
Some may overeat or overindulge as a way of coping with anxiety from being around family members they don't relate to or see outside of holidays, Cohen said.
"Are people feeling anxious about the expectation that we're going to all sit around and be one big, happy family when we're not necessarily?" he said.
Cohen said people shouldn't starve themselves before the Thanksgiving meal and should consume a light breakfast or eat somewhat normally to avoid feeling famished and overeating later.
(SIGN UP: Get today's Chattanooga area news, sports and entertainment directly to your inbox. Sign up for our free newsletters at timesfreepress.com/newsletters.)
People should give themselves grace, he said.
"You might call it a cheat day on a diet, you know, if you are trying to watch what you eat and trying to maintain a slimmer figure," he said.
Cohen said he thinks of Thanksgiving as one day where binge eating is socially sanctioned and accepted.
A holiday where high-calorie food choices are pushed at people and others are over-indulging may be difficult for people who are trying to monitor their weight, Cohen said.
It may be helpful to remember that eating differently on Thanksgiving does not mean good patterns have been lost or that someone will revert to previous unhealthy habits, he said.
WEIGHT LOSS TRENDS
Dr. Rishabh Shah, a general and bariatric surgeon at CHI Memorial Hospital, said there has been a huge increase in the number of people seeking to get on weight loss drugs like Wegovy, Ozempic and Mounjaro.
He said he believes the increase in awareness was due to the medications being popularized by the news, social media and celebrities.
"The medications are very good," he said. 'They help people lose a lot of weight, but, again, it needs to be a part of an all-encompassing lifestyle change."
Shah said he's noticed people who take the medication will eat less but continue to consume the same types of food they ate previously.
(READ MORE: How CHI Memorial robotic-assisted surgery can help pancreatic cancer patients)
Cohen said Thanksgiving may be difficult for someone who is taking a weight-loss medication.
"A lot of them experience, 'I am not hungry and not that thirsty,'" he said. "It's difficult when everyone around them is wanting to have thirds and eat all afternoon, and they just get full very quickly, very easily."
Those people shouldn't feel they are keeping a shameful secret, Cohen said, and should feel comfortable explaining how their medications affect them.
"If somebody were on chemotherapy for cancer, we wouldn't be pushing them and say, 'Why are you not eating more?'" he said. "We'd understand that this medicine - the chemotherapy - makes them nauseous, and there's a limit to how much they can eat."
Shah said everyone should practice healthy eating habits around the holidays, including the Rule of 20s. The rule calls for chewing each bite 20 times, putting your fork down for 20 seconds in between each bite and not eating after 20 minutes.
Hunger comes from both the belly and brain, Shah said, but brain hunger lags behind the belly hunger. Eating slowly allows one's brain hunger to catch up with their belly hunger.
Shah advised people to eat protein first and to avoid heavy, starchy carbs until later in their meal after both protein and vegetables.
"Protein helps you feel full for longer," he said. "It doesn't give you that immediate fullness like carbs do. When you mainly eat carbs, you feel hungrier quicker, so that you want to have another meal."
THANKFULNESS
In the midst of anxiety, Cohen said the holiday is still a time to feel appreciation and gratitude for the people gathered around the Thanksgiving table with you.
It's a holiday for giving thanks for things like having a home to enjoy the celebration in, as opposed to others who are less fortunate and without a place to live, family or the luxury of having enough food, he said.
"I think to step back, rather than focus just on yourself, look at where you are in the world," he said. "It may help you appreciate. Most of us have a very fortunate and blessed situation."
Contact Leah Hunter at [email protected] or 423-757-6673.
Contributed Photo / Dr. Jon Cohen, a psychiatrist, said people may mistake other sources of anxiety, like traveling long distances via airplane, for food anxiety.
Staff File Photo / Dr. Rishabh Shah, a general and bariatric surgeon with CHI Memorial Hospital, said people should practice healthy eating habits, including the Rule of 20s, during the holidays. The rule calls for chewing each bite 20 times, putting your fork down for 20 seconds in between each bite and not eating after 20 minutes.