‘Food noise’ fad sparks new warnings over controversial weight loss drugs

If you’ve heard the term “food noise” a lot lately, you are a not alone.

The evolution of controversial new weight loss drugs is shining a spotlight on a crippling, little-understood food phenomenon linked to many dieters’ battle with the bulge.

But health experts warn there is still a major issue too few people are talking about.

Adelaide bariatric GP Zanna Murfitt says global interest in the injectable medications has popularised the notion of “food noise” and how it can affect a person’s waistline.

“In a sense, the concept of food noise has become a lot more ‘sexy’ due to the evolution of these new medications that we can use for weight,” the director and co-founder of Adelaide weight management and wellness clinic Re: You Health said.

“Food noise is more than just thinking about food. It refers to the constant, intrusive thoughts about food that can really dominate our headspace, which can lead to food cravings and subsequent unhealthy eating habits or patterns.

“For people who experience true food noise, it is almost like a constant internal dialogue where these thoughts make it extremely difficult to focus on anything else other than food and eating … it’s that distinction between normal thoughts around food and eating and having these intrusive, constant thoughts that can really affect people day-to-day and can be quite debilitating.”

Dr Murfitt says weight-loss drugs have helped validate this experience and some patients had been told of how food noise had been dulled.

Dr Zanna Murfitt at her practice in Adelaide CBD. Picture: Ben Clark

“(There is a)misperception that we should be able to silence these thoughts, that people just don’t have enough willpower … that’s been a longstanding problem,” she said.

Dr Murfitt says genetic and other epigenetic factors can play a role in a person’s propensity for food noise. There is a correlation, too, between ADHD and food noise.

“We know that ADHD and eating disorders often coexist (and) believe ADHD symptoms such as impulsivity and inattention can play a role in conditions such as binge eating disorder,” she says.

But Dr Murfitt cautions against viewing weight-loss drugs – which include GLP-1 agonists such as semaglutide, branded as Wegovy, and tirzepatide, branded as Mounjaro – as a magic bullet.

“We mustn’t forget that the foundation to any effective weight-loss strategy is lifestyle measures … this is kind of obvious but I think we’ve lost sight of it with (the hype) over these medications.”

GLP-1 drugs are prescription medicines that initially emerged as a diabetes treatment but – after gaining popularity as off-label weight-loss drugs – have now been approved in some forms as an obesity treatment as well.

Dr Murfitt says it is frustrating to meet new patients who haven’t been given appropriate support following a weight-loss medication prescription.

She also laments the rise of “online prescribing services where there’s no face-to-face contact with patients”.

Jack Mosley with his parents Picture: Supplied

“I’ll see patients for the first time who will say things such as ... I’m only eating one meal a day … (but) they’ve lost half their muscle mass in the process, which can have disastrous effects,” she says.

“Yes, (these medications) are supposed to make people feel less hungry and more full but we’re still meant to be eating regular, nutritious meals and doing some resistance exercise to make sure the weight that is being lost is coming from fat mass, not muscle mass.”

It is this point that Jack Mosley, the doctor son of the late Michael Mosley who advocated for intermittent fasting and low-carbohydrate eating in his “Fast 800” diet, is also focused on.

He warns too many users are adopting a “nutrient-poor” quality diet and risk extreme muscle loss as well as malnutrition.

“It is clear to me these drugs are best taken to complement positive diet and lifestyle changes; there is a shocking scarcity (of information) about what to eat to ensure you get the most out of your minimised food intake,” says Dr Mosley, who has just authored a book on the topic, Food Noise.

“Thousands are joining unsupervised online support groups ... and are looking to each other for nutritional and dosage advice.”

Nutrition scientist and researcher Emma Beckett also worries people’s health and wellbeing is being overlooked in the race to get thin.

“What I am concerned about is we’re seeing a lot of people who are saying, ‘I’m just taking the drug’ (with no other lifestyle changes),” she says.

“(This approach) is really risky. We’re going to see slim people who are malnourished and they’re not necessarily going to get identified until they’ve done damage to bones and organs.

“If people are on these medications and their appetite is so suppressed that they’re skipping meals and not interested in eating at all, they should be having conversations with their doctors about reducing their doses.”

Dr Beckett, who has a PhD in nutritional biochemistry as well as qualifications in nutrition and dietetics, herself tried for several months a weight-loss jab.

She says while it wasn’t for her – reducing her ability to enjoy food – the drugs should be regarded as part of a host of weight-loss management tools.

She urges informed and reasoned discussion and says neither “fat-shaming” nor stigma related to weight-loss medication is helpful.

“We’ve never been this collectively fascinated with a medication before … I mean, no one’s ever asked me if I’m on blood pressure medication,” she says.

“I wouldn’t want to leave people thinking that medication is the only way but similarly the conversation I’d love to see more people having is, ‘how do we use these drugs well?’ (We need) proper conversations about eating well and eating for health regardless of body size.”

Adelaide-based accredited practising dietitian Tania Ferraretto agrees the focus needs to be on healthy eating and lifestyle.

“There is a real risk of people getting too hung up on their weight and what they look like rather than paying attention to how to keep healthy. What you weigh doesn’t necessarily equate to how healthy you are,” she says, urging long-term behavioural changes.

“With or without medication, people need to learn strategies and form good behaviours.”

Kylie Abbott is a mum of three boys and nutrition scientist and researcher who recently started using weight-loss medication. Picture: Supplied

Being healthy is the priority

As a nutrition scientist, it’s not surprising Kylie Abbott’s approach to using a weight-loss drug is analytical.

The mum of three has been using an injectable GLP-1 medication for the past four months, after “life caught up with me”.

“I was 40, had type 2 diabetes on both sides of my family. I’d always had really good blood pressure and good blood sugars but they started to be not as good as they’d always been,” she said. “So, I decided to ask my doctor about (the weight-loss medication).”

Ms Abbott, who has ADHD and autism, said being healthy remained her priority.

“I’m aware of (the risk) of the loss of bone mass and muscle mass that can happen ... and am able to be very proactive. I know metabolic health is one side of healthy ageing but we also want good muscles and good bones,” she said.

“So, I might have a yoghurt for morning tea with some nuts because that gives me the protein and the dairy for my bone health and my muscle health.”

She said a more open, “stigma-free, risk-based discussion” around weight-loss drugs was needed.

“We should be viewing these medications as a tool … not every tool is going to work for everyone; our bodies are really complex.”

Expert weight-loss tips

PEOPLE struggling with food noise should definitely go and see a dietitian, for help in coming up with strategies.

PLAN meals so that you are not distracted by that thought of what you might have.

EAT regularly.

PRACTISE intuitive eating, which is respecting the signals in your body and knowing which signals to pay attention to and which ones to ignore.

TRY not to get too hung up on weight and what you look like but instead pay attention to how to keep healthy. Weight doesn’t necessarily equate to how healthy you are. - Dr Emma Beckett, nutrition scientist &researcheR

Editorial note: This article is for general interest and informational purposes only. It does not constitute medical advice.

Originally published as ‘Food noise’ fad sparks new warnings over controversial weight loss drugs