How to Quiet the Food Noise
Food Noise refers to the obsessive, intrusive thoughts about food throughout the day that some people experience. This food noise can be worse for patients with overweight or obesity. For some, these thoughts can become a daily activity and lead to their lives revolving around food. A few examples cited include thinking about foods all the time (particularly highly palatable and energy dense foods), feeling tempted to check food delivery applications multiple times a day, and thinking about the next meal you will consume (Hyashi et al). Making lifestyle changes and modifying diet is an emotional process for many of my patients. The bias against obesity, diet culture, increased ghrelin (hunger hormone) can all lead to a lot of anxiety around food and eating.
So, what can be done to reduce this food noise? There are both behavioral modifications and medications that can help. The longer I work with weight management, the less strict I’ve become with rules. I have noticed that when dietary guidelines are very rigid or restrictive, it becomes unsustainable. These rigid rules also lead to increased stress and anxiety around food. This is why I always describe my nutrition counseling as a guideline, a jumping off point. There are certain modifications that we know can help, increasing your protein and fiber intake, reducing your processed food intake. However, I do not ban foods. Everybody has their trigger foods, those foods you just can’t resist. Let’s say your trigger food is cookies. It’s not realistic to say you will never eat a cookie again. Saying you are not allowed to eat cookies is probably going to make you crave cookies, and it becomes a battle of willpower, then you eat the cookies, and feel guilty about it, causing more stress. A better approach would be, don’t keep cookies in the house, it will be too tempting, but allow yourself to eat a cookie every once in a while, long term, this will be more successful. Our goal is to get as close to food neutrality as possible. Food is not good or bad, it’s just food. This can help to quiet some of those intrusive thoughts.
The second very important component is medication. The American Association of Clinical Endocrinology (AACE) declared Obesity as a disease in 2012. The American Medical Association (AMA) adopted a similar stance in 2014. More recently, in 2017, AACE has opted to redefine the disease, and to use the term Adiposity-Based chronic disease. The idea is that this more accurately describes a clinical condition of excess adiposity (fat) and the complications related to it. I personally often just use the term weight as I know that the word “obesity” is a loaded word for many.
Regardless of what you call it, the important point is that weight is not a behavioral or willpower issue, rather a medical condition driven by genetics, stress, disease, medication and many other factors. The issue of food noise is real, some patients have more ghrelin, the hunger hormone, and these disruptive thoughts benefit from medical treatment. The GLP1 and GLP1/GIP agonists, including Ozempic, Wegovy, Zepbound and Mounjaro work on the hunger center in the hypothalamus in the brain. They shut down the signal, this can translate to decreased appetite, filling up faster. But the effect most patients consistently talk about is the reduction of cravings, of “food noise”. Patients describe food is simply off their minds. I have heard patients describe it as liberating, they feel more at ease and have more time in the day to dedicate to other activities.
Medications are not magic, ideally, they just make it easier to do everything else. Losing weight shouldn’t have to feel impossible, or like torture. Taking weight loss medication is not the easy way out, rather, along with lifestyle modification, it is an integral part in weight management and the treatment of chronic disease.