The food noise has gone. But what was it trying to tell you?
One of the things I hear often from women taking GLP-1 medications such as Wegovy or Mounjaro is just how quiet their brain suddenly feels around food.
They are no longer thinking about what they are going to eat next while they are still eating breakfast, they can walk past the biscuits without having an internal debate about whether they should have one, and they feel full sooner, cravings can reduce, and food simply seems to occupy less space in their head.
For clients who have spent years thinking about food, trying not to think about food, dieting, overeating, feeling guilty about eating and then promising themselves they will be better tomorrow, that ‘quiet’ can be enormously liberating.
Image: Unsplash
The Evidence
Research into semaglutide has found reductions in hunger and food cravings, improvements in feelings of fullness and satiety and greater perceived control over eating. In one randomised controlled trial, participants taking semaglutide also ate significantly less at a meal when compared with those taking a placebo, while more recent research suggests some of these effects on appetite, food preoccupation and food reward can continue during longer term treatment, although not every subjective effect appears to remain as strong over time.
So, for some GLP-1 medications can be incredibly helpful but, what interests me more is something we are talking about much less.
What was creating all that noise in the first place?
What do we mean by food noise?
Food noise is a relatively new term in both popular culture and scientific research, even though the experience it describes is certainly not new.
It generally refers to persistent or intrusive thoughts about food. That might mean thinking frequently about what you are going to eat, planning meals, experiencing cravings, feeling particularly responsive to the sight or smell of food or spending a considerable amount of mental energy trying to control what you eat.
It is something we often see in people with a diagnosed eating disorder, but I believe the experience is much more widespread than that. Many women have spent years, often since their teens, dieting, restricting, worrying about food or feeling that they need to control what they eat, without ever having had a formal eating disorder diagnosis. For some, food noise may be part of a much longer history of disordered eating or a difficult relationship with food that has simply become normalised over time.
A 2025 paper published in Nutrition & Diabetes looked at how food noise should be defined and measured and highlighted something important. We are using the term a lot, but we still do not fully understand whether everyone describing food noise is actually experiencing the same thing, or what biological, psychological and environmental factors are driving it.
And this is where I think the conversation becomes much more interesting, because two women can both tell me that they think about food all day, while the reasons behind those thoughts can be completely different.
One may have spent thirty years restricting food and dieting, which can make food increasingly psychologically important, another may be eating meals that simply are not satisfying her physically, whilst someone else may be using food to soothe herself after a relentlessly stressful day.
There may be poor sleep, changing hormones, insulin resistance, highly palatable food, emotional eating, binge eating, years of weight cycling or a complicated relationship with her body sitting somewhere in the picture too. So there is rarely just one explanation, and is why each woman must be treated individually and not with a blanket approach.
Midlife can add another layer
This is particularly relevant for the women I work with because midlife can be a period when several things change at once.
Sleep can become more disrupted, stress may be high, hormonal changes can affect body composition and where we store fat, and muscle mass becomes increasingly important. Some women notice changes in appetite, energy or blood sugar regulation, while many are also juggling work, ageing parents, teenagers, relationships and very little time for themselves.
Then their body begins to look different too. For a woman who has spent decades absorbing the message that a smaller body is a better body, that can be incredibly difficult.
Then suddenly there is a medication available that can make eating less feel considerably easier, quieten some of that food noise and, for many women, lead to significant weight loss at the same time.
For some women, using it may be an entirely appropriate decision and may bring significant health benefits. GLP-1 based medications have good evidence behind them for weight management in appropriate people and can improve important markers of metabolic health.
But I do think we need to separate two different questions.
Is this medication helping me?
Do I understand what has been influencing my health, eating and relationship with food in the first place?
Quieting the noise is not necessarily the same as understanding it
Imagine you have always struggled with overwhelming food cravings in the afternoon. You start taking a GLP-1 medication and within a few weeks those cravings largely disappear. But perhaps nobody ever asked why 4pm was so difficult before.
Maybe breakfast was a coffee, lunch was a small salad because you were trying to lose weight and by mid-afternoon your body was understandably asking for energy.
Perhaps 4pm was the first moment in your day when you stopped working and food had become associated with relief, or you were exhausted because you had been awake since 3am with menopausal insomnia.
Maybe you had spent years moving between dieting and overeating and had stopped trusting your body's hunger signals altogether.
The medication may change the experience of the craving, but those are still useful things to understand about yourself. Not because we need to search endlessly for a hidden cause behind every symptom, but because your appetite exists as part of a much bigger health picture.
But isn't food noise biological?
Absolutely, it can be.
This is another reason I would be very cautious about suggesting that people should simply learn to control their thoughts about food.
GLP-1 is a hormone involved in appetite and energy regulation, and GLP-1 medications act on biological pathways involved in hunger, satiety and food reward, and randomised trials of semaglutide have demonstrated reductions in hunger, cravings and energy intake, so there is clearly biology involved.
That does not make psychological or behavioural factors irrelevant. It simply means the old argument about whether eating behaviour is biological or psychological was never particularly useful, because it can be both.
Add perimenopause, sleep, stress, genetics, environment, learned behaviour, emotions, food availability and previous dieting experiences and you begin to see why I prefer looking at someone's whole health picture rather than reducing everything to appetite or willpower.
What happens if or when the medication stops?
This is where understanding your own picture may become particularly valuable.
GLP-1 medications may need to be used for the longer term for some people, just as medications are used long term for many other chronic health conditions. There should not be an assumption that everybody is eventually going to stop. We do, however, know that weight regain is common after treatment is withdrawn.
We also know that appetite, food noise and weight can begin to change again when GLP-1 medication is stopped, which I explore in more detail in the next article in this series: What happens when you stop taking a GLP-1?
That does not mean taking the medication was pointless and it certainly does not mean somebody has failed if weight returns, but it tells us something much more useful.
The biology that influences appetite and body weight does not necessarily disappear just because somebody has spent a year eating differently, and this raises an interesting question for anyone using these medications privately for weight loss.
Now that food feels quieter, what might this give you the space to understand about yourself?
If food is taking up far less space in your head, this could be a wonderful opportunity to understand your body better rather than thinking about your medication as the entire solution.
Are you eating enough protein and giving yourself the best chance of maintaining muscle?
Are you getting enough fibre too?
What is happening with your sleep?
How is your digestion?
Are you nourishing yourself well despite having a much smaller appetite?
Have you spent years dieting and would it help to rebuild a more trusting relationship with food?
Were there particular emotions or situations that previously drove you towards food?
What is happening with your blood sugar, hormones and metabolic health?
How do you cope with stress now that food, or comfort eating, is no longer an issue (if you are on a GLP1)?
These questions are not an argument against medication. They are, however, an argument for not reducing health to a number on the scales, and they are exactly the kind of conversations we have with clients every day.
GLP-1 medications can be part of the answer without being the whole answer
There are women for whom these medications will be genuinely transformative. There are also women who will decide that they are not right for them, and others who may use them for a period and later choose or need to stop.
This is not a one size fits all conversation.
What I would like to see is far less judgement on both sides. Women should not be made to feel that using medication is somehow cheating. Equally, we should not reach a point where every woman whose body changes in midlife feels that she needs an injection to fix it. There is a much more thoughtful conversation somewhere in the middle.
If a GLP-1 medication has turned down your food noise, enjoy the quiet, but perhaps use some of that quiet to become curious too, because understanding why you feel, eat and function the way you do has value whether you stay on the medication for years, eventually stop it, or never take it at all.
And that, for me, is what looking at the whole health picture is really about.
