Claudia Connell: Food noise affects appetite; some manage it, others struggle

HOW do you like to unwind at night, before switching off the bedroom lamp and going to sleep? A couple of chapters of a thrilling novel perhaps? Maybe a spot of meditation? Until five weeks ago my relaxation method of choice was to scroll mindlessly through Instagram looking at pictures of food.

I’d look at a page that recommended brunch spots, which, in turn, would take me to another page for the best pasta recipes, then on to an account dedicated to quick and simple suppers. Before you knew it, I’d fallen so deep into a food-filled rabbit hole that I would still be scrolling two hours later.

I’ve been doing this for years, but it was only very recently that I learned my behaviour was a symptom of something called ‘food noise’.

The extraordinary boom in the popularity of weight-loss injections has meant that, suddenly, we’ve had to learn a whole new language. Today, words like ‘Ozempic,’ ‘Wegovy,’ and ‘Mounjaro’ have become part of our food and diet lexicon, and so, too, has the phrase ‘food noise’.

But what exactly is it?

Although not a scientific term, in the context of so-called ‘skinny jabs’, ‘food noise’ refers to the internal chatter people, like me, experience relating to food and hunger. Some lucky souls never ‘hear’ it, but for others, it’s a near-constant thinking about food – planning the next meal, imagining its taste, wanting to eat it, or just looking at images of it online.

The revelation for those of us taking drugs like Ozempic is that as well as decreasing appetite, it either hugely reduces ‘food noise’ or silences it altogether.

In my case, I’ve been taking Mounjaro since mid-October. I’ve dropped 10lb, never feel hungry, and as absolutely unthinkable as it would have seemed five weeks ago, never think about food.

I don’t drool at the thought of a pepperoni pizza, I don’t ‘browse’ delivery apps like Uber Eats and Deliveroo to see what’s on offer, and I no longer spend hours looking at cookery sites.

When I do eat, my body craves healthy and wholesome food. This time last year I would have been watching Strictly with a 12in pizza and a huge measure of Baileys, followed by a carton of Ben & Jerry’s ice cream.

Last Saturday, I watched while eating raw carrots and homemade tzatziki. I haven’t had an alcoholic drink since I started injecting, and the very thought of booze or anything sugary makes me feel queasy. For me, Mounjaro is nothing short of a miracle, with the cancelling of my food noise being the most staggering side-effect.

On a basic level, we need food noise in order to survive – it is a message that goes from our gut to our brain, telling us we are hungry and must take in some fuel.

Yet sometimes, so incessant and intrusive can such messages become, the thoughts and cravings for food can make people ill.

Dr Joanna Silver, a psychologist who specialises in treating people with eating disorders, says ‘food noise can become so unrelenting that it can impact day-to-day living’.

She adds: There are people who can’t work because they are unable to focus. Intense food noise can also interfere with and ruin personal relationships because the person can’t be present in the moment. It can destroy social lives because the noise makes it hard to function or think straight.

‘For some, it’s utterly exhausting, like having a radio playing in your head, and can be really damaging to mental health.’

But why does that noise vary so dramatically in people? Why are some able to tune it out while others feel overwhelmed?

Professor Giles Yeo is a geneticist at Cambridge University and an expert in obesity and the brain’s control of food intake and body weight.

He says: ‘Food noise is a manifestation of appetite, and appetite is rather complex. I like to conceptualise it as a triangle.

‘Appetite sits in the centre, and the three points are hunger, fullness and reward. All three talk to each other but use different parts of the brain. If you tug on any points of that triangle, you’re going to change its shape.

‘If you are really hungry, then the simplest foods – bread, rice, cheese – are going to taste delicious and will be enough to trigger the reward element in the brain.

‘But if you’re really full, then the food will need to have a seriously high reward element for you to want it, and that’s going to be something sugary or fatty. This is a phenomenon known as the “dessert stomach”.’

The fuller we are, the more ‘picky’ our brain becomes. After a main course, you wouldn’t feel like eating a plate of fish or chicken again, but you might order a chocolate mousse. That’s because we’re hardwired to crave food that’s dense in calories – it’s an evolutionary instinct that no doubt helped our ancestors to survive many thousands of years ago.

‘Food noise is largely associated with hunger and the reward element,’ continues Professor Yeo. ‘People who love their food are going to experience a very different sort of noise to those who simply regard it as fuel for their bodies.

‘To give you an example, I love food. I can tell you what I’m going to be having for my dinner for the rest of the week. It’s all planned in my head: I’ve bought the ingredients, I know how I’m going to cook it, and I can visualise it on the plate. That’s food noise.

‘I’m going to Montreal soon, and I’ve already been online researching all the restaurants near my hotel and looking at their menus and reviews. That’s food noise.

‘My wife, on the other hand, thinks I’m crazy. She can’t think about food unless she’s hungry. In my case, my food noise takes me to the planning stage, but in some people, because of their biology, they will be driven beyond that to actually eat.’

I’m with Professor Yeo on that one. I can’t imagine turning up to a restaurant without first having looked online at the menu, then looked at pictures of the dishes on Instagram and pretty much decided what I’m going to eat before I’ve even sat down. In my 20s I used to share a flat with a friend who could unwrap a Yorkie bar, eat two squares and put the rest in the fridge for a few days.

I didn’t understand it. Why wasn’t the uneaten chocolate calling her name? Why wasn’t the very thought of it torturing her to the extent she had to sprint to the fridge and scoff it down?

The answer was: because she didn’t experience food noise in the way that I did.

Earlier this year, WeightWatchers and the Stop Obesity Alliance conducted a study to better understand food noise and its impact on those who have weight struggles. It showed that 57 per cent of people who were either overweight or obese experienced continued and disruptive thoughts about food.

Of those questioned, 67 per cent of obese participants said they wished they didn’t think about food as often as they did, compared to 48 per cent of those who fell into a healthy weight range.

Similar numbers of obese respondents said they had to constantly fight the urge to eat even when not hungry and that the food noise made it difficult to stick to a weight loss plan.

By contrast, the same study revealed that when it came to obese people using skinny jabs, 69 per cent said they no longer obsessed over their next meal or snack, while 58 per cent said they had improved focus.

Drugs such as Ozempic (semaglutide) work by mimicking our natural GLP1 hormone, which is what makes our stomachs feel full after eating. In its natural form, however, it lasts for a short period of time – not much more than ten minutes. Introduce Ozempic into the mix and the user will feel fuller for far longer.

But GLP1 doesn’t just communicate with the gut. When released after eating, it also latches onto the vagus nerve, which sends a signal to our brain that we are full and means we stop thinking about food. Ozempic and similar drugs are believed to work longer in the brain, too. ‘In other words, the drug reduces the chance of food noise percolating up into your executive consciousness,’ says Professor Yeo.

The reason this silencing of food noise is such good news for obese people is that studies have shown some have what Professor Yeo calls a ‘hungry brain’.

He explains: ‘My colleagues have conducted brain imaging where you could argue that you can actually see how food noise varies in individuals. People are put into a scanner and shown a variety of food and non-food images.

‘The food pictures will include hyper palatable foods as well as things like broccoli. Participants will be of all weights and in various states of hunger.

‘The scanner allows us to see whether the reward part of their brain lights up more or less under certain circumstances. And what we’ve found is that many obese people will have the brain of a hungry person even though they have just eaten.’

Essentially, some people’s neuro pathways are wired in such a way that, without drugs, they face an uphill battle to control their weight and obsessive thoughts about food.

‘If you don’t have food noise because of your genetics and biology, then it’s going to be much easier to keep your weight down,’ says Professor Yeo.

‘There are going to be a vast proportion of people with obesity who are wired differently. In the past, the prevailing view has always been that people are fat because they have no willpower, but now we know that isn’t true.

‘Ozempic changes one hormone in the body, Mounjaro changes two – and that can lead to incredible outcomes, so what that tells us is that, for people with obesity, it’s a hormonal deficiency that needs to be fixed.’

Dr Silver agrees that problematic food noise is certainly nothing to do with greed or lack of willpower.

She says: ‘Very often, some people who struggle with excessive food noise have too much willpower because they are attempting to stick to rules that may be unsustainable and that, in turn, increases the volume of the noise. The more you tell yourself you can’t eat something, the louder the noise gets.’

Intrusive food noise doesn’t just focus on what a person wants to eat – it’s just as likely to be about what they have consumed. Someone might eat to silence food noise only to find the noise and then take a different turn.

‘People will often have ruminations about what they’ve eaten,’ says Dr Silver. ‘Those thoughts will be telling them that they’ve eaten too much, they’re greedy, a pig and have ruined a diet . . . and on and on it goes.’

The big question is whether, after coming off Mounjaro, my food noise chatter will simply return and be as disruptive and damaging as it was before. Will I, once again, start randomly looking at photos of macaroni cheese at 2am?

‘It’s an interesting one,’ says Professor Yeo. ‘We know that when the drug is in use, you’ll feel full, and when it isn’t, you won’t.

‘But it also changes how people think and feel about food. Because we’re human, after certain periods of time, learned behaviours become habitual. So, will those habits stick?

‘It’s only been a few years that people have been taking these drugs for weight loss in such huge numbers. We’ll just have to see.’