Savannah Mendoza, once a frequent spender on food delivery services and fast-food outlets to quell her relentless food cravings, found a new perspective after starting a widely-used medication for weight management and diabetes. She began to perceive her cravings as "food noise," an incessant internal dialogue about food that impedes healthy dietary choices.

This concept of "food noise" has gained traction, particularly in the digital sphere, as an increasing number of individuals on popular weight-loss and diabetes medications have noticed a reduction in these internal food-related thoughts. Semaglutide and tirzepatide, both classified as glucagon-like peptide-1 receptor agonists (GLP-1s), function by signaling the body that it has recently eaten, prompting insulin release and decelerating gastric food transit.

These drugs, marketed under the names Ozempic and Mounjaro for type 2 diabetes, and their counterparts Wegovy and Zepbound for weight reduction, have assisted millions in shedding pounds. Mendoza, now 27, recounts her early twenties as a period of constant preoccupation with food, often fabricating errands as a pretext for drive-thru visits and stealthily indulging in ice cream while preparing her daughter's lunch. "I just thought I was obsessed with food," she reflects from her home in Huntington Beach,

California. With tirzepatide, she experiences a newfound tranquility, liberated from the food noise, attributing part of this to a side effect that leaves her feeling "perpetually bloated and uninterested in eating."

Summer Kessel, a tirzepatide user for over two years, describes her previous self as a "bottomless pit," perpetually famished. "I was constantly contemplating, planning, and scheming for my next meal," recalls the 37-year-old from Tampa, Florida. "I'd have breakfast at home, another at work, followed by lunch, a pre-departure snack, fast food on my way home, and then dinner upon arrival." Post her inaugural weight-loss injection, she experienced a profound "relief," as the internal "noise" concerning food choices, preferences, and calorie counts subsided, allowing her to live without the constant food fixation.

As a registered dietitian with two decades of healthcare experience, Kessel now shares nutritional advice with a substantial social media audience. She asserts that it was only after beginning tirzepatide that she could embody her advice, consuming three balanced meals daily. "I feel the appropriate hunger at mealtimes... I no longer obsessively think about food, focusing instead on what nourishes and satisfies, enhancing my well-being," she explains.

The etiology of food noise is multifaceted, with no definitive prevalence figures, yet most experts concur on its existence, despite only recent awareness. Approximately 15 years ago, Dr. Michael Lowe from Drexel University's Department of Psychological and Brain Sciences in Philadelphia formulated the concept of "hedonic hunger," defining it as an intense craving for food-derived pleasure unrelated to physical hunger.

Lowe's theory and the associated Power of Food Scale are now utilized in clinical trials for weight-loss medications in adults and children, gauging the "desire for palatable foods when not hungry." Lowe posits that this concept closely aligns with the food noise reported by GLP-1 medication users. "Throughout my career, I've studied appetite and its control mechanisms, as well as our innate system signaling the need for caloric replenishment.

However, this doesn't account for the weight gain many have experienced over the past 45 years by consuming more calories than necessary for health," Lowe elaborates.

The growling stomach before dinner signifies homeostatic or "normal" hunger—a bodily reminder that lunchtime calories have been largely expended for energy, according to Lowe. In contrast, hedonic hunger involves the continued desire and consumption of food beyond caloric needs, even post-meal. "I argue that when we eat for caloric needs, pleasure is incidental.

However, when we have a compelling urge to eat despite not being physically hungry, pleasure becomes the primary motivation," he states. Some hedonic hunger is expected due to America's food culture, with fast-food outlets on every main street and a scarcity of supermarkets offering fresh produce in certain areas. "Obtaining food is effortless, and overconsumption of the wrong types is all too common," Lowe notes.

Jackson LeMay from Lilburn, Georgia, endured food noise—"a constant, insatiable itch"—for over a decade, dating back to high school. He recalls hiding food, taking it from the pantry or fridge, and concealing wrappers, as well as eating in secret and fabricating lunch money requests to buy snacks. As an adult, he found social media ads and the constant availability of food delivery facilitated binge eating and made cessation difficult.

The 27-year-old lost 155 pounds through diet, exercise, and Mounjaro, which he continues to use for weight maintenance, and only realized the impact of food noise after starting the medication. "You don't truly recognize the poor relationship with food or the brain's obsession with eating and food-related decisions... because it's ingrained," says LeMay, who also works part-time as a content creator for a telehealth company prescribing weight-loss medications.

Dr. Najaf Asrar, an endocrinologist and obesity medicine specialist in New Jersey, works adjacent to a cookie store, and every time he glances out the window, he's tempted to purchase a box for his family. "Food noise is significantly fueled by our environment and the constant push of food.

There's a psychological component; we didn't used to have entire stores dedicated to desserts," he remarks. "Food noise becomes a pattern through environmental influences." Asrar collaborates with patients using weight-loss medications alongside lifestyle modifications. "I inform my patients that obesity is a chronic condition, but medication doesn't have to be," he states. He's observed that once some patients achieve their target weight, they can retrain their brains, and food noise impacts them less.

While GLP-1 medications may seem a solution for some with overweight and obesity experiencing food noise, they're not the sole option—and may not be suitable for those with food noise and a normal BMI.

"We're beginning to understand that the experience of food noise might be driven by signals from the stomach or body in ways we hadn't fully appreciated," says Dr. Tom Hildebrandt, director of the Center of Excellence in Eating and Weight Disorders at Mount Sinai Health System in New York. He describes food noise as peripheral signals leading to excessive thinking and feeling about food-related cues, which society often attributes to a lack of control. "Perhaps it's not just personal responsibility, but a metabolic condition altering how a person's brain perceives hunger, fullness, and body image issues associated with eating disorders," Hildebrandt suggests.

In an overstimulating environment with abundant food choices, making correct selections is challenging. At the Center of Excellence in Eating and Weight Disorders, Hildebrandt's team addresses food noise through cognitive behavioral therapy sessions, aimed at inoculating against a "toxic food environment and learning to self-regulate a potentially disturbed system due to attempts to manage or restrict food noise." "It's not universally effective, but it works well for many, reducing food noise and enabling a more functional and effective approach to life," he notes.

Physicians at Hildebrandt's center may prescribe antidepressants or Vyvanse, used for binge-eating disorder, before considering GLP-1 medications. "We await scientific confirmation of its effectiveness in reducing food noise before prioritizing it, as we know other pharmacological and psychotherapeutic options to be effective," he adds.

Individuals with food noise might find that GLP-1 medications correct their metabolic signals and diminish brain chatter but introduce a new concern, according to Hildebrandt: a fear that food may harm or adversely affect them. "If you've spoken with GLP-1 users, it's common to feel physically uncomfortable after consuming certain foods or quantities, which is part of its efficacy. However, this learned experience can lead to a different kind of fear of food," Hildebrandt explains.

While Zepbound and Wegovy aren't treatments for food noise, some patients report undeniable effects. Kessel, the Florida dietitian, would be content with Mounjaro "just to quiet the food noise," even without weight loss. Lowe attributes two benefits to these medications: reducing food noise and facilitating greater weight loss than older drugs or lifestyle changes alone.

"This medication targets the underlying physiology of excessive appetite more than normal appetite, altering the chemical composition, especially in brain and hormonal pathways that spark the desire for food when unnecessary, and reducing chronic food thoughts," Lowe says. "It's nearly a magic pill, as it results in substantial weight loss, significantly reduces unpleasant food obsessions, and requires minimal self-control to achieve these benefits." LeMay notes his diet improved immediately after starting Mounjaro, yet he still savors mealtimes. "Before the medication, I lived to eat. Now, I eat to live, nourishing my body, seeking energy, and desiring to feel good," LeMay concludes.