Celebrating Shavuot on Mounjaro

Shavuot, seven weeks after Passover, celebrates the giving of the Torah. Many families mark it with dairy meals of blintzes, cheesecake, kugel, quiche, and cheese bourekas. Many also stay up all night for Tikkun Leil Shavuot, learning together with coffee and snacks, followed by morning services, sometimes at sunrise. Outside Israel, many communities observe two days of the holiday, with Yizkor on the second. Customs vary by community and family.

If you take Mounjaro or compounded tirzepatide, a night without sleep, a lot of coffee and cookies, and a rich dairy feast on a smaller appetite can leave you feeling rough. Here is how to plan.

Plan your dose around the holiday

In SURMOUNT-1, a 72-week trial of tirzepatide, the same active ingredient as Mounjaro, in adults with obesity or overweight who did not have diabetes, the most common adverse events with tirzepatide were gastrointestinal, and most were mild to moderate in severity, occurring primarily during dose escalation.

That makes the timing of increases the most useful thing to plan. If a dose increase would fall in the week of Shavuot, ask your provider whether to hold it until afterward. The Mounjaro label allows the day of weekly administration to be changed as long as the two doses are at least 3 days (72 hours) apart, but ask your provider before you change it. If you are still early in treatment, our guide on the starting dose of tirzepatide covers what the first weeks usually look like.

The dairy feast

Dairy brings real protein, which is a plus on Mounjaro: cheese, yogurt, cottage cheese, and eggs in quiche or kugel all help. The challenge is richness. Start with savory dishes, such as a slice of quiche, a cheese boureka, or a salad with feta, then have a small piece of cheesecake or one blintz for dessert. Eat slowly and stop at the first sign of fullness. Our guide on what to eat after an injection has ideas for foods that tend to sit well.

Rich dairy and a sensitive stomach

Some people do not digest lactose well, and heavy cream sauces and cheesecake on top of the digestive side effects of these medications can be a lot. In the placebo-controlled trials for Mounjaro in adults with type 2 diabetes, nausea was reported by 12% to 18% of adults across the three doses, compared with 4% on placebo. If dairy tends to bother you, choose aged cheeses and yogurt, which many people tolerate better, and keep portions small. If you switched from semaglutide, our guide comparing tirzepatide and semaglutide side effects covers how they differ.

The all-night study session

A night of learning usually comes with coffee, cookies, cake, and sugary snacks. On a small appetite, those can crowd out anything nourishing. Bring protein snacks you can share, such as cheese, nuts, yogurt cups, or hard-boiled eggs, and drink water alongside the coffee. Coffee on an empty stomach can make nausea worse, so have it with food.

Low blood sugar overnight

The prescribing information for Mounjaro says people who take it with insulin or an insulin secretagogue, such as a sulfonylurea, may have an increased risk of hypoglycemia, including severe hypoglycemia. A long night awake, irregular snacks, and an early-morning service can change your usual pattern. If that is you, ask your diabetes care team how to plan the night, keep glucose tablets with you, and tell a study partner the signs: shakiness, sweating, a fast heartbeat, sudden hunger, irritability, or confusion. Never change those medications on your own.

The sunrise service and after

After a night without sleep, standing for services can leave you lightheaded. Sit when you can, and stand up slowly. Eat something small with protein before you sleep, rather than going to bed on a stomach full of only coffee and cookies.

Two days of holiday meals

Two days of festive meals mean several rich meals close together. Make sure each one includes protein, and keep portions modest. Some of the weight lost on these medications is muscle, and protein helps protect it. Our guide on getting the most out of your GLP-1 treatment covers why protein and resistance exercise matter.

Wine for kiddush

A sip for kiddush is part of the meal. For more than that, have wine with food, alternate with water, and know that some people find alcohol affects them differently on these medications. Alcohol can lower blood sugar, sometimes hours later, especially for people who take insulin or a sulfonylurea.

Never skip a dose for the holiday

It can be tempting to skip an injection so you can enjoy more of the cheesecake. Do not. The Mounjaro label says to take a missed dose as soon as possible within 4 days (96 hours), and to skip it and take the next dose on your regular day if more than 4 days have passed.

Keep simple notes

Write down how you felt after the night of study and the dairy meals, and any blood sugar readings, so next year is easier to plan. Watch for persistent fatigue, feeling cold, hair shedding, dizziness when you stand, losing strength, and losing weight faster than you and your provider intended. Our guide on tracking your progress covers ways to record more than your weight.

Consider this scenario: a man on Mounjaro who also takes insulin steps up his dose the week of Shavuot. He stays up all night learning, living on coffee and cookies, then sits down after the morning service to cheese blintzes, a large slice of cheesecake, and kugel. Within an hour he is nauseated, and later that morning he feels shaky and sweaty. Holding the dose increase, bringing cheese and nuts to the study session, eating something savory first, and keeping dessert small would very likely have made the holiday easier.

The short version

For Shavuot on Mounjaro, ask your provider about holding a dose increase, start dairy meals with savory dishes, and keep cheesecake and blintzes to a small serving. Bring protein snacks to the all-night study session, drink water alongside coffee, and carry glucose tablets if you take insulin or a sulfonylurea. Sit during services after a night awake, eat a little before sleeping, and never skip a dose for the holiday.

If you want a provider who will help you plan treatment around the holidays you celebrate, TrimRx includes ongoing provider access alongside treatment.

This information is for educational purposes and is not medical advice. Consult with a healthcare provider before starting any medication. Individual results may vary.