Writing this once so I can stop repeating it across threads. It is about food noise, and it is deliberately narrow — everything I am not confident about is marked as such.
What is actually established
Food noise is the best term this community has produced and it describes something the trials did not measure well: the constant background computation about food that most people with obesity live with and most people without it do not believe exists. GLP-1 agonism reduces the salience of food cues in the reward pathway rather than simply reducing hunger, which is why the reported experience is silence rather than willpower. It is also why its return on dose reduction is the first thing people notice, well before the weight moves.
The condition it depends on
It is worth naming the loss side of it. Food was a source of pleasure and structure, and its removal can leave a gap that people are not prepared for.
What I am not sure about
So the question, as narrowly as I can put it: whether the quiet is the same mechanism as the appetite suppression or a separate one, because they seem to come and go on different schedules. Tell me what I have not thought of.
mike_mod said:Food noise is the best term this community has produced and it describes something the trials did not measure well: the constant background…
Phantom hunger vs real hunger on food noise: learning to distinguish between the two has been a revelation. Real hunger: gradual onset, physical stomach sensation, any food sounds good. Phantom hunger: sudden, emotionally triggered, specific food cravings, occurs right after eating.
The GLP-1 agonist suppresses real hunger beautifully. Phantom hunger still pops up but I can now recognize it for what it is — an emotional signal, not a physical need. Mindfulness training helped enormously with this distinction.
mike_mod said:Food noise is the best term this community has produced and it describes something the trials did not measure well: the constant background…
The GLP-1 and alcohol use disorder connection, relevant to food noise: observational data from Scandinavian registries shows reduced alcohol-related hospitalizations in GLP-1 agonist users[1].
The mechanism is plausible: GLP-1R is expressed in the mesolimbic reward pathway (VTA, nucleus accumbens). Agonism at these receptors may reduce the reinforcing properties of alcohol, similar to the reduction in "food noise."
RCTs for GLP-1 agonists in AUD are now underway. If positive, this would be a paradigm-shifting repurposing of existing medications.
[1] Wang W, et al. Nat Med. 2024;30:574-584.
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Browse GL BiochemPeptideChemSF said:The GLP-1 and alcohol use disorder connection, relevant to food noise: observational data from Scandinavian registries shows reduced alcohol-related…
PeptideChemSF said:...regarding food noise mechanism of action...
To build on this — the mechanism is more complex than "it makes you less hungry." GLP-1 agonists:
- Activate hypothalamic satiety centers (appetite reduction)
- Delay gastric emptying (prolonged fullness)
- Potentiate glucose-dependent insulin secretion
- Suppress glucagon secretion
- Modulate reward pathway dopaminergic signaling
- Reduce hepatic lipogenesis
- Have direct cardiovascular protective effects
It's a multi-target drug with systemic metabolic effects. Understanding the mechanism helps us predict and manage side effects.
Dr.MetabolicMD said:Phantom hunger vs real hunger on food noise: learning to distinguish between the two has been a revelation.
Same experience, arrived at from the opposite direction.