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Drugs to help quiet ‘food noise’

Researchers are continuing to investigate how semaglutide works, how it may influence aspects of the brain like food noise and the potential it has for other uses, like treating addiction

Published: Tue 4 Jul 2023, 10:00 PM

Updated: Tue 4 Jul 2023, 10:01 PM

  • By
  • Dani Blum

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Kaitlin Brito for The New York Times

Kaitlin Brito for The New York Times

Until she started taking the weight loss drug Wegovy, Staci Klemmer’s days revolved around food. When she woke up, she plotted out what she would eat; as soon as she had lunch, she thought about dinner. After leaving work as a high school teacher in Bucks County, Pennsylvania, she would often drive to Taco Bell or McDonald’s to quell what she called a “24/7 chatter” in the back of her mind. Even when she was full, she wanted to eat.

Almost immediately after Klemmer’s first dose of medication in February, she was hit with side effects: acid reflux, constipation, queasiness, fatigue. But, she said, it was like a switch flipped in her brain — the “food noise” went silent.

“I don’t think about tacos all the time anymore,” Klemmer, 57, said. “I don’t have cravings anymore. At all. It’s the weirdest thing.”

Dr Andrew Kraftson, a clinical associate professor at Michigan Medicine, said that over his 13 years as an obesity medicine specialist, people he treated would often say they couldn’t stop thinking about food. So when he started prescribing Wegovy and Ozempic, a diabetes medication that contains the same compound, and patients began to use the term food noise, saying it had disappeared, he knew exactly what they meant.

As interest has intensified around Ozempic and other injectable diabetes medications like Mounjaro, which works in similar ways, that term has gained traction. Videos related to the subject “food noise explained” have been viewed 1.8 billion times on TikTok. And some of the people who have managed to get their hands on these medications — despite persistent shortages and list prices that can near or surpass $1,000 — have shared stories on social media about their experiences.

Wendy Gantt, 56, said she first heard the term food noise on TikTok, where she had also learned about Mounjaro. She found a telehealth platform and received a prescription within a few hours. She can remember the first day she started taking the drug last summer. “It was like a sense of freedom from that loop of, ‘What am I going to eat? I’m never full; there’s not enough. What can I snack on?’” she said. “It’s like someone took an eraser to it.”

For some, the shortages of these medications have provided a test case, a way to see their lives with and without food noise. Kelsey Ryan, 35, an insurance broker in Canandaigua, New York, hasn’t been able to fill her Ozempic prescription for the past few weeks, and the noise has crept back in. It’s not just the pull of soft-serve each day, she said. Food noise, to Ryan, also means a range of other food-related thoughts: internal negotiations about whether to eat in front of other people, wondering if they’ll judge her for eating fried chicken or if ordering a salad makes it look like she’s trying too hard. Ozempic is more of a way to silence the food noise than anything else, she said.

“It’s a tool,” she said. “It’s not like a magic drug that’s giving people an easy way out.”

There is no clinical definition for food noise, but the experts and patients interviewed for this article generally agreed it was shorthand for constant rumination about food. Some researchers associate the concept with “hedonic hunger,” an intense preoccupation with eating food for the purpose of pleasure, and noted that it could also be a component of binge eating disorder, which is common but often misunderstood.

Obesity medicine specialists have tried to better understand why a person may ruminate about food for some time, said Dr. Robert Gabbay, chief scientific and medical officer of the American Diabetes Association. “It just seems to be that some people are a little more wired this way,” he said. Obsessive rumination about food is most likely a result of genetic factors as well as environmental exposure and learned habits, said Dr. Janice Jin Hwang, chief of the division of endocrinology and metabolism at the University of North Carolina School of Medicine.

Why some people can shake off the impulse to eat, and other people stay mired in thoughts about food, is “the million-dollar question,” Hwang said.

The active ingredient in Ozempic and Wegovy is semaglutide, a compound that affects the areas in the brain that regulate appetite, Gabbay said; it also prompts the stomach to empty more slowly, making people taking the medication feel fuller faster and for longer. That satiation itself could blunt food noise, he said.

There’s another theoretical framework for why Ozempic might quash food noise: Semaglutide activates receptors for a hormone called GLP-1. Studies in animals have shown those receptors are found in cells in regions of the brain that are particularly important for motivation and reward, pointing to one potential way semaglutide could influence cravings and desires. It’s possible, although not proven, that the same happens in humans, Hwang said, which could explain why people taking the medication sometimes report that the food (and, in some cases, alcohol) they used to crave no longer gives them joy.

Researchers are continuing to investigate how semaglutide works, how it may influence aspects of the brain like food noise and the potential it has for other uses, like treating addiction.

Klemmer said she worried about the potential long-term side effects of a medication she might be on for the rest of her life. But she thinks the trade-off — the end of food noise — is worth it. “It’s worth every bad side effect that I’d have to go through to have what I feel now,” she said: “not caring about food.”

This article originally appeared in The New York Times.



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