Eating two large meals back-to-back is a tradition we’ve been practicing in the U.S. pretty much since in-laws and the first nationally proclaimed day of Thanksgiving were combined back in 1789. Ever since, each year on the fourth Thursday of November, millions of Americans eat successive 2,500-calorie Thanksgiving meals: first at the home of one side of the family, then the other.
Now, we love our marathon feasts, but anyone who’s survived a double Thanksgiving dinner knows the experience can be taxing. But exactly how much of a toll is this gluttony taking on our insides, and how do we keep ourselves from overindulging in the first place?
To find out, I turned to the experts: Dana Hunnes, senior dietitian at Ronald Reagan UCLA Medical Center and an assistant professor in UCLA’s Fielding School of Public Health; and Tyler Mason, a psychologist and assistant professor of preventive medicine at the Keck School of Medicine of USC.
As you might expect, eating two giant meals in one day places increased demand on your digestive, circulatory and respiratory systems. While you’re unlikely to puke — the volume of food that would need to be consumed to cause vomiting would mean eating well past physical discomfort, according to Hunnes — you’re much more likely to experience pain, bloating and inflammation, as well as fatigue. Constipation and intestinal blockages are also possible.
The bottom line is, you’re going to be uncomfortable for a while.
Both Mason and Hunnes are quick to make it clear that one day of extreme binge-eating a year isn’t likely to cause any serious long-term health consequences, either, but they do state that there are higher risks for people with pre-existing issues. Mason notes, for example, that for people with distorted body image or low self-esteem — who are already at risk for disordered eating — one event could lead to intense feelings of guilt or shame that trigger damaging behaviors like food restricting or purging. And Hunnes says that people with “comorbid conditions” such as diabetes or heart conditions are much more likely to suffer ill effects. (Notably, the day after Thanksgiving sees spikes in hospital/urgent care visits related to heart complaints.)
What’s more, according to Hunnes, Americans typically gain one to three pounds between Thanksgiving and New Year’s Day, and they don’t tend to lose that weight. Over 10 years, that’s 10 to 30 pounds, a significant weight gain with its own possible health ramifications.
In spite of all this, we all know that it’s far easier to overdo it on Thanksgiving than to hold back, so if you do find yourself stuffed fuller than the turkey come Thanksgiving night, don’t panic. If you need to lie down, lie on your left side to reduce discomfort — this puts your stomach below your esophagus, meaning acid is less likely to creep up and give you heartburn. Ideally, you also want to go for a walk about an hour after the meal to help your body begin to absorb nutrients and process what you’ve fed it.
Hunnes recommends eating lighter meals the day after Thanksgiving as well: Think toast with a little peanut butter, light salads and fruits and vegetables — save those turkey-cranberry-stuffing leftover sandwiches for later in the weekend when your digestive system isn’t quite so overworked. You may end up dealing with some constipation, but there’s probably no need to worry unless you still feel full and haven’t made any digestive progress in the next day or so. (Disclaimer: This isn’t a substitute for medical advice! I don’t know you and neither do our experts, so talk to a doctor if you have serious butt discomfort, or any other concerns.)
As far as what you can do to avoid all this discomfort in the first place? Don’t eat quite so much is the obvious, if unhelpful answer. But that’s obviously difficult to do when you’re faced with not one but two — or more! — tables freighted with tradition, expectations and ancient family recipes where you’re pretty sure the main secret ingredient is butter.
The best thing to do then is to go in with a strategy: People tend to save all their Thanksgiving-Day eating for the big feast, but as both Hunnes and Mason note, this is a mistake that usually leads to overeating. Instead, try to pace yourself with smaller meals throughout the day.
Our experts also recommend paying more attention to the food you choose. If there are 10 dishes on the table, go for your top five or six, instead of taking some of all 10, Hunnes suggests, doing what you can to balance starches and fats with fruits and vegetables (admittedly an uphill battle with most traditional Thanksgiving food). You can also practice what Mason calls “mindful eating”: taking time to enjoy the flavors and textures of your food instead of mindlessly filling your plate (and face).
Of course, some people eat through their family stress at Thanksgiving. In general, if you know you’re prone to overeating when stressed (e.g., Aunt Mary asking when you’re going to meet someone nice and settle down for the fourth time in 45 minutes), Mason suggests working on some positive coping skills in advance so you can deal with these kinds of situations as they arise. These skills include recognizing when you’re experiencing negative feelings and accepting them, but not letting those negative feelings dictate your actions, as well as incorporating physical activity into your daily life. (Pro tip: Go for a walk if things get particularly tense — the fresh air and activity will help you digest and defuse.)
Another obvious but helpful piece of advice: Watch how much you drink. While Mason is careful to explain that the research isn’t entirely clear on the causes, he notes that drinking alcohol is often followed by overeating, perhaps because of lowered inhibitions. Pacing yourself with alcohol, especially before and during that crucial first meal, might mean less immediate fun, but it’ll also help you get through the day with less discomfort.
And wouldn’t that be something to be thankful for?