What is ‘food noise’ and why are we hearing about it amid the rise of GLP-1 meds?

Before Brenda Rogers started taking Ozempic in the spring of 2023, she didn’t realize how much “food noise” was sapping her mental energy. “You’re just constantly thinking about food and not having enough, having too much, ‘what am I gonna eat? Oh, don’t add in the carbs because carbs aren’t good, that’s gonna make me more fat, don’t have fat because that’s going to make you fat,’“ said the 52-year-old online business manager in Vancouver. “It’s exhausting thinking that way.” The term “food noise” has emerged alongside the popularity of glucagon-like peptide-1receptor agonists—known as GLP-1 medications—that treat Type 2 diabetes and obesity, said Dr. Sanjeev Sockalingam, scientific director of Obesity Canada and chief medical officer at the Centre for Addiction and Mental Health in Toronto.Those medications include Ozempic and Wegovy—manufactured by Novo Nordisk—and Mounjaro and Zepbound—manufactured by Eli Lilly. “Food noise is not a formal diagnosis, but it is a manifestation of people’s relationship with food in the context of someone who might be living with obesity being a chronic disease,” said Dr. Sockalingam, who is also a professor of psychiatry at the University of Toronto. “It really has emerged from the patients and people we treat.”What is food noise?Although there’s no formal definition, Dr. Sockalingam said people describe it as a distressing “insatiable, pervasive preoccupation with food or thinking about food.” Russell de Souza, a registered dietitian and an associate professor at the Centre for Metabolism, Obesity and Diabetes Research at McMaster University in Hamilton, said the thoughts can be so intrusive they’re “overwhelming” for people. “It gets hard for them to think about other things that they have to do. And they just become preoccupied with food to the point where it’s distracting,” de Souza said. Dr. Sockalingam said people often feel a sense of freedom after treatment, either through GLP-1 medications, psychological interventions, or both. “(Treatment) does liberate many patients who’ve been struggling and really preoccupied and almost captive to this kind of thoughts of food,” he said. Why are we hearing about food noise now?Before GLP-1 medications became available, healthcare providers didn’t have effective treatments for obesity that address the interaction between the brain and gut, Dr. Sockalingam said. As people have become aware of GLP-1 medications, there have been more conversations about obesity and decreased stigma around it, so people are feeling more comfortable talking about their feelings and experiences.“We have to understand that gaining weight is not a personal failure—it’s a chronic disease,” said de Souza. How do medications like Ozempic stop food noise?GLP-1 medications act like the GLP-1 hormone that controls feelings of hunger and fullness. They act on receptors in both the brain and the gut. The hypothalamus in the brain regulates hunger and appetite and gets signals about when to stop eating, said de Souza.“Sometimes that signal is not as strong in some people as others, and it may not last as long,” he said. GLP-1 medications work on those receptors in the hypothalamus to decrease hunger and also slow the emptying of the stomach, so people feel full faster.As people feel more full, they can often focus on other things besides food and quiet the food noise, Dr. Sockalingam said. Ozempic and other GLP-1 medications also work on the brain’s dopamine-driven reward circuits, which can be hyperactive in some people and cause excessive cravings. “As we consume things that bring us pleasure, dopamine then conditions us to really want or crave it. And so we have seen cravings decrease with GLP-1 receptor agonists,” he said. Is medication the only way to deal with food noise?No—cognitive behavioural therapy (CBT) can also help, Dr. Sockalingam said. CBT works with the prefrontal cortex of the brain, which is responsible for decision-making, to change the way people respond to the intense cravings and reduce them. It can include coping mechanisms “like how you might distract yourself, how you might introduce new behaviours, how you might change your thinking so that you might not be as preoccupied and focused on food,” he said. De Souza said eating high-fibre, high-protein food that keeps people full longer may also help to quiet food noise. Oat bran, fruits, vegetables, fish, chickpeas, lentils, beans and peas are all filling foods, he said. But not overly restricting food that you like is also important, de Souza said. “When you restrict foods that you like a lot, that technique can actually backfire sometimes and you can just crave that food that you’ve been missing so long,” he said. “It can create more food noise than it takes away.”

What is ‘food noise’ and why are we hearing about it amid the rise of GLP-1 meds?

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