Reader Question: What is Food Noise?

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I received this question from reader Martin:

I keep hearing about how these new diet drugs ending “food noise.” Can you write about this, it seems sus but I’m not sure how.

There has been a lot of talk about (and from the manufacturers of) the GLP-1 agonist weight loss drugs like Zepbound and Wegovy about “food noise.”  While certainly there are some people who have intrusive food thoughts in a way that is harmful/pathological, for the most part, the marketing of this idea by weight loss drug makers seems to be a concerning rebranding of the concept of normal hunger and/or a way for the weight loss industry to profit from the broken relationships with food that are a common outcome of intentional weight loss attempts.

For the latter idea, the concept seems to be used to convince the target market for these drugs (most of whom have spent years, if not most of their lives, being told they need to “eat less”, typically by people with no information about how much they eat, and attempting intentional weight loss by putting their bodies into restriction at the behest and to the great profit of) the weight loss industry,) that the resulting hunger and disrupted relationship with food is something that can be solved by…wait for it…the weight loss industry.

The only study I could find on it (What Is Food Noise? A Conceptual Model of Food Cue Reactivity, Hayashi et al, 2023) was written almost entirely in the context of GLP-1 agonist drugs. They say “For the sake of a definition, food noise could be described as heightened and/or persistent manifestations of food cue reactivity, often leading to food-related intrusive thoughts and maladaptive eating behaviors.” To be clear this is a definition that they created (well, kind of created – terms like “for the sake of” and “could be described” are not what you want to see in clear definitions of concepts that are being used as the reason to prescribe medications with serious side effects,) there is basically no literature or standard definition of this.  

From a real-world application, this is a comment that I saw on a public post about a workshop that was being put on about these drugs:

“The thing about [the weight loss drug] that really helped me is that it turned the signal off in my brain that said I need food… it made my tummy feel full and it told my brain you don’t need it… It’s magic. I don’t know how it works.”

Fun fact, they don’t know how it works either. In a piece called The Science Behind Ozempic Was Wrong, Sarah Zhang of the Atlantic writes “at the same time that they have become massive successes, the original science that underpinned their development has fallen apart… By indiscriminately flooding the body with long-lasting molecules, the injections likely allow engineered GLP-1 drugs to penetrate parts of the body that the natural gut hormone cannot—namely, deep in the brain.”

So the way they thought it was going to work was by mimicking the GLP-1 agonist that spends a brief time in the gut. What they are now learning is that it works in the brain where it hangs around a lot longer, though they aren’t entirely sure how or to what extent.

Beyond the fact that these drugs in the high doses prescribed for weight loss may impact our brains in unknown ways with unknown long-term effects, the fact that the weight loss industry and the diet culture and weight stigma that it perpetuates has harmed us so badly that the world is excited about a drug that causes people to lose touch with survival signals sent out by the brain is deeply concerning to me.

In the study I mentioned, they focus on blaming “food noise” on factors including things like the food environment and social media. What they fail to even mention is the way in which intentional weight loss attempts (from crash diets to “lifestyle changes” to “professional weight management”) can predispose us to “food noise.”  

Let’s look at the cycle here:

The weight loss industry (including the healthcare industry) claimed (and many still claim) that if we’re fat, that’s proof that we eat too much and don’t exercise enough. This led to all of us being told to eat less and exercise more (in dozens if not hundreds of weight loss intervention iterations) typically no matter what we were eating or how much we were exercising.

Giving our bodies less fuel than they need in the hopes that they consume themselves and make themselves smaller (aka intentional weight loss interventions,) especially when this is accompanied by increases in exercise, can trigger our bodies' many famine responses.

One solution to this is to get off the diet roller coaster and permanently fix our relationship with food. That works well for many people, but doesn’t make any money for the weight loss industry.

Cue Novo Nordisk, Eli Lilly, and the coming copycats rebranding this as “food noise” and creating a new solution to tinker with our brains and guts to trick us into not feeling hunger, at least temporarily.

We know from their own research that when people go off of these drugs they regain the weight very quickly. We know that the drug companies’ (obscenely profitable) “solution” is that everyone has to stay on these drugs for the rest of their lives. We also know that their own research finds that weight is going back up at the end of two years even for those who manage to stay on the drugs.

Big Pharma is betting on a solution that interferes with our brains in ways that they don’t understand, without any long-term research to suggest that this will lead to sustained weight loss let alone anything resembling improved health. To me it’s incredibly scary given the lack of ability to provide informed consent even if a practitioner wanted to, and the issue that some providers don’t seem to want to.

I think it’s important to remember that these drugs are approved on a skewed risk/benefit analysis utilizing research (much of it from the weight loss industry) that can vastly overestimate the supposed “harms” of simply existing in a higher-weight body, which means that the FDA and the healthcare system jump at anything that suggests like it might create short-term weight loss, historically without worrying about the long-term consequences to the people on the receiving end of the interventions – that is the history of weight loss drugs and, I am very concerned that it is the present as well.

After approval, it’s all marketing. The rebranding of both normal hunger and the outcomes of intentional weight loss attempts as “food noise” (simultaneously co-opting and diluting the actual pathology that some people experience) is part of the weight loss Pharma industry’s ceaseless marketing machine based on convincing fat people with we are simultaneously too much, and nothing, without them.

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.