I didn't use any oil to brown the sausage and didn't miss it. I rinsed it really well with insty-hot water in the sink in a strainer to get rid of any excess fat. I also used fat free half & half instead of cream. This recipe was DELICIOUS, and I didn't miss any of the excess fat. We will definitely eat this again and again. Also, I got impatient waiting for the sauce to thicken, so I sprinkled in a little flour and cornstarch. I almost overdid it, so it was probably unnecessary. This dish is even yummy served leftover and cold the next day! I love all of the garlic. I skipped the hot pepper flakes in hopes the kids would eat it (and my Italian sausage was the mild version), but they still found it too spicy to eat. They are six, four, and one, so that's not too surprising.
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