When Joel Brown was a chef in the 2010s in Toronto, tasting a brilliant new dish was like hearing a piece of life-altering music. He\u2019d let out a bewildered laugh, rendered speechless by the revelatory flavours and textures. He reacted that way after he tasted a mortadella sandwich on a cornetto with pistachio remoulade. And another time after eating a spoonful of hazelnut gelato. Then again after a bite of focaccia that was \u201c70 per cent oil and 30 per cent bread.\u201d <\/p>\n
But in 2024, just a week after Mr. Brown, now 40, began taking the weight-loss drug Mounjaro, the joy had vanished. Flavours and textures lost their thrill. He struggled to find even a fraction of his past delight at mealtime. <\/p>\n
\u201cIt was like, \u2018I need this many calories to survive today,\u2019\u201d he recalls. \u201cIt was more of a detached, less emotional, more statistical way of eating.\u201d<\/p>\n
After a month on the drug, which he\u2019d been prescribed by a telehealth provider to help him lose weight, he decided to stop. He wondered about the long-term side effects and he wanted to meet with his own doctor to discuss them. <\/p>\n
But more importantly, he was disturbed by how Mounjaro had zapped so much enjoyment from his life. <\/p>\n
Canadians starting GLP-1 medications such as Ozempic, Mounjaro or Wegovy know these drugs will make them consume less food by cutting their cravings and making them feel full sooner but don\u2019t often consider the psychological effects of taking them: how they can strip pleasure from eating, make once-loved dishes taste revolting and leave them desperate for joy in other realms of their lives. <\/p>\n
As they\u2019ve grown in popularity, experts and patients alike are realizing the drugs don\u2019t solve every food-related issue and in some ways introduce new ones \u2013 something that could be addressed with therapy and support, the standard approach for those who undergo bariatric and metabolic surgery. <\/p>\n
Where does the rise of GLP-1s leave the body positivity movement?<\/a><\/p>\n When it comes to weight loss, it\u2019s easy to measure the results of a GLP-1 on a bathroom scale or in the fitting room of a clothing store. But how does one measure the other things lost? The delight in taking the first bite of a French fry, fresh from the deep fryer. The pleasure of sampling dishes shared family-style at a friend\u2019s birthday dinner. The spontaneous joy of grabbing an ice cream cone at the local scoop shop, even if you\u2019re full from lunch. <\/p>\n In A Room of One\u2019s Own, Virginia Woolf famously wrote, \u201cOne cannot think well, love well, sleep well, if one has not dined well.\u201d <\/p>\n For most of us, food is our first and most basic source of pleasure. When is it worth it to give that up? <\/p>\n There\u2019s a big difference between hunger and appetite.<\/p>\n We feel hungry when the levels of nutrients in our blood change and the hormone ghrelin is released by the stomach, signalling to the brain \u2013 specifically our hypothalamus, which controls thirst, hunger and body temperature \u2013 that our energy reserves are low and we need food. Our stomach might start grumbling or we could feel light-headed. After we eat and reach the point of satiety, other hormones, such as insulin, are released and when they hit our hypothalamus, they signal that we should stop eating. This is eating stimulated by our body\u2019s caloric needs. <\/p>\n Appetite, meanwhile, is controlled by the pleasure centres of the brain. When we eat for pleasure and our hypothalamus releases dopamine, it can affect our bodies in many positive ways: improving memory, sleep and blood flow. It can also help reduce stress, as anyone who has taken the edge off a bad day with a pint of Ben & Jerry\u2019s would know.<\/p>\n But food that is ultra-palatable can light up this part of our brain and override the signals telling us to stop eating. Seeing or smelling certain foods (especially those high in fat and sugar) can trigger extra-strong cravings and the release of dopamine in the brain that can make us want to eat these foods \u2013 sometimes to excess. The strong desire for food even when our stomachs are full is known as \u201chedonic hunger.\u201d <\/p>\n Research has shown that people who struggle with overeating and obesity have a hyperactivation of the reward pathways in their brain and experience this hedonic hunger more frequently than the rest of the population. And women have higher rates of hedonic hunger than men. <\/p>\n GLP-1s reduce the activation of those reward pathways as well as the dopamine released, according to studies performed on humans and animals, thus curbing overeating. They can also quiet \u201cfood noise,\u201d a term used to describe thoughts of food that are repetitive, unwanted and distressing. <\/p>\n But with GLP-1s, there can sometimes be too much of a good thing. The drugs can be so effective at blocking food noise and reducing the release of dopamine that they can cause anhedonia: a reduced ability to feel pleasure. <\/p>\n The anhedonia that can result from taking GLP-1s needs to be better measured and addressed, says Emily Dhurandhar, an obesity researcher and the director of research special projects at Texas Tech University Health Sciences Center. These impacts, like so much with GLP-1s, are understudied. Much of what researchers like her understand about this side effect has been informed through anecdotal reports, many of them shared on forums such as Reddit.<\/p>\n How will cheaper versions of Ozempic tip the scales?<\/a><\/p>\n After Mr. Brown, the former chef, left restaurants for a job in sales for a cannabis company, he found himself increasingly behind a desk or the wheel of a car en route to sales calls rather than on his feet, logging thousands of steps a day. He ate restaurant food about 10 times a week and it was catching up to him. <\/p>\n A few years into this new lifestyle, he noticed a dip in his metabolism and started putting on weight. A family history of heart attacks and diabetes had him concerned about his future. He started working out a lot \u2013 more in two years than he had his whole life \u2013 but his weight stayed the same. And that\u2019s why he started on Mounjaro. <\/p>\n He didn\u2019t face any of the common side effects he\u2019d heard about, such as nausea or bloating, but in the weeks that followed the first injection, he experienced a \u201cpsychological shift.\u201d <\/p>\n Food is how we connect with and care for other people. It\u2019s one of the ways we preserve our culture, and the most common way we\u2019re exposed to new ones. Food is nostalgia and comfort. Some of our strongest memories are tied to the look, smell or taste of a dish we had as a child. <\/p>\n For Mr. Brown, food had always been the biggest source of happiness in his life: not just cooking and eating it, but learning the history of different cuisines and seeing how meals brought people together.<\/p>\n And then it all evaporated. <\/p>\n \u201cI would look at a restaurant menu or I go into a grocery store, and it would just be like, that part of me is dead,\u201d he said.<\/p>\n He wanted to limit his caloric intake but didn\u2019t anticipate what the loss of appetite would mean for his psyche. <\/p>\n After stopping the drug, Mr. Brown \u2013 to his great relief \u2013 regained the pleasure he\u2019d lost when eating good food. But he also gained back the 10 pounds he\u2019d shed in just a few months. <\/p>\n He was back where he started and knew he needed help fighting back against the diabetes and heart disease risk in his family. After almost a year and half of consideration, Mr. Brown decided to go back on the drug again this January, but this time after discussing it with his doctor \u2013 including his fears about the return of the anhedonia from last time. He was prescribed the lowest dose of the drug \u2013 lower than what he\u2019d taken in 2024 \u2013 and so far, it\u2019s been a more pleasant experience for him. <\/p>\n For some who have struggled their whole lives with body-image issues, the loss of pleasure in food can seem a worthwhile trade-off for weight loss.<\/p>\n Heidi MacKay, a 53-year-old in Vancouver, can\u2019t remember a time in life when food wasn\u2019t the enemy. At birthday parties, when the kids around her giddily wolfed down slices of birthday cake, she felt shame for doing the same. When she was still in elementary school, her parents enrolled her in Weight Watchers. <\/p>\n She had an intense sweet tooth and loved bringing candy or cookies to bed to nibble on at the end of a long, tiring day. The fries and coleslaw from the local chain White Spot were her \u201cfavourite thing in the whole world.\u201d But after she was done the negative feelings kicked in. <\/p>\n She almost exclusively ordered delivery or takeout from restaurants, so unbearable was the feeling of being watched and judged for her body and her perceived lack of self-control. <\/p>\n She was always curious about the relationship people who weren\u2019t fat had with food. Did they just sit down and eat it without any of the baggage? Did they crave something, give in to the indulgence and then feel fine after? <\/p>\n When Ms. MacKay learned the term \u201cfood noise\u201d in conversations about GLP-1s, she immediately connected with it. She was intrigued by the idea of the volume being turned down on her persistent thoughts about eating. <\/p>\n On Mounjaro, which she was prescribed to treat diabetes, it felt like the dial was turned down to zero during her first year on the drug. For the first five days after her weekly injection, she had no feelings of hunger and had to force herself to eat. In those initial weeks she was also struck by an anxiety so debilitating she messaged her endocrinologist with worry, asking if it was something he\u2019d seen in other patients. The doctor replied curtly, saying he\u2019d never heard of that. <\/p>\n Two months into starting the drug, she ate a quesadilla with cheese, sour cream and salsa and spent the weekend feeling like she needed to go to the ER, that\u2019s how intense the nausea, vomiting, constipation, diarrhea and stomach pain were. She felt similarly ill another time when she ordered a veggie burger with fries and coleslaw from her beloved White Spot. <\/p>\n She messaged the clinic again, seeking treatment for the digestive issues but was told that as a diabetes clinic, they could not prescribe her anything. But she was shedding pounds rapidly, so she stayed on Mounjaro. <\/p>\n In that first year, she would start each day with coffee with artificial sweetener and coffee creamer, followed by oat or soy milk blended with protein powder and ice for breakfast (adding in extra shakes like this if she felt she wasn\u2019t getting enough protein for the day). For lunch she\u2019d eat something like half a vegetarian sandwich from Subway. Dinner would often be plant-based chili and salad.<\/p>\n There was \u201cjust no food joy anymore,\u201d she said. <\/p>\n Throughout her life, Ms. MacKay had seen dietitians, counsellors and therapists about her weight, but all were focused on helping her drop pounds, rather than addressing her mental health and the impact being fat and bullied had on her self-esteem. <\/p>\n Dozens of online-pharmacy ads, including for weight-loss drugs, appear to violate federal rules<\/a><\/p>\n People on these drugs \u201cmay have some need for psychological support and for coping mechanisms related to that loss of joy, that loss of pleasure,\u201d says Ms. Dhurandhar, the obesity researcher at Texas Tech. She pointed to the holistic approach taken with metabolic and bariatric surgery patients as a model worth replicating. <\/p>\n Canadian guidelines recommend a comprehensive psychosocial assessment of patients before surgery to identify any mental health issues. Psychiatrists and psychologists are often part of care teams alongside surgeons and nurses and therapy is a common part of post-op care.<\/p>\n Preliminary research on the impact of GLP-1s on depression and mood disorders is mixed: Some studies suggest the drugs can alleviate symptoms; others suggest a side effect is heightened risk of depression and suicidality. <\/p>\n A study published last July by a team of researchers at Tulane University in New Orleans found people taking GLP-1s were significantly more likely to develop psychiatric disorders compared with those who had undergone metabolic and bariatric surgery. <\/p>\n Researchers followed a group of 33,600 patients who had undergone weight-loss surgery and the same number who were taking weekly injections of GLP-1s and found that over a five-year period, the ones who had undergone surgery had an 18 per cent reduced risk of anxiety disorders, 17 per cent reduced risk of substance abuse and 54 per cent reduced risk of cognitive deficits compared to their counterparts on GLP-1s. However, they had a 163 per cent higher risk of developing eating disorders. <\/p>\n \u201cThe data supports embedding psychiatric screening and support within both surgical and medical obesity programs to help reduce the potential mental health burden after treatment,\u201d said Shauna Levy, one of the study\u2019s co-authors, in a release. <\/p>\n Because so many social gatherings revolve around food, being restricted in what you can comfortably eat on a GLP-1 can lead to isolation for patients. That might mean skipping out on holiday feasting, ducking out early at work parties or staying at home when friends are gathering at a restaurant for brunch. <\/p>\n Last summer, Ms. MacKay went out with her husband and friend to an expensive restaurant in Vancouver. Her companions ordered extravagantly, while Heidi only got edamame and a non-alcoholic beer. <\/p>\n \u201cI felt sad that they were eating this beautiful food and I was just so turned off,\u201d she said. <\/p>\n So much of the therapy that happens after metabolic and bariatric surgery is about helping patients find new social settings for \u201cconnection, support and enjoyment,\u201d says Sanjeev Sockalingam, scientific director of Obesity Canada. <\/p>\n Many people who have struggled with overeating have strong negative internal narratives and part of therapy is rewriting those, often through cognitive behavioural therapy. <\/p>\n Sometimes patients struggle with defeatist thinking around not being able to maintain their weight loss; other times it\u2019s coming to terms with not being able to enjoy a certain kind of food anymore, he says. <\/p>\n In therapy, those who have pursued weight-loss interventions are encouraged to schedule pleasurable activities in their lives. While many think of exercise, Dr. Sockalingam recommends finding hobbies that are unrelated to the body, such as creative pursuits or classes at a local community centre. <\/p>\n Health Canada approves first generic Ozempic, made by India\u2019s Dr. Reddy\u2019s<\/a><\/p>\n Lorraine Stover decided to give Ozempic a try last fall in an effort to improve her mobility and relieve her joint pain. She\u2019d heard anecdotally that a side effect of taking a GLP-1 was anhedonia \u2013 specifically related to food \u2013 and it made her nervous about starting the drug. <\/p>\n When her eyes opened in the morning, her first thought was what she wanted to make herself for breakfast. If she was at Costco and saw wagyu steaks on sale, she\u2019d buy a large pack and then plan a dinner party around them. Living in Douro-Dummer, a rural township between Toronto and Ottawa, she was far from city amenities and most of her social activity revolved around inviting friends over for food \u2013 and lots of it. <\/p>\n When having overnight guests a few months ago, she whipped up seafood pasta and served it alongside homemade bread, a shrimp ring, cheese balls, miniature naans with dips and cookies for dessert. The next morning she made French toast, sausages and eggs. <\/p>\n \u201cFood is entertainment and fun and warmth and love and cozy and safety for me,\u201d she explained. <\/p>\n She still entertained over the holidays, but just ate smaller portions than she typically would and had the new-found restraint to not sit in front of the TV with a bowl of reheated leftovers in the evenings. If she overindulged, she faced pretty immediate consequences: A few too many decadent appetizers or one too many glasses of wine would result in painful, middle-of-the-night indigestion. <\/p>\n The original plan was to start off on the lowest dose of the drug \u2013 0.25 mg weekly \u2013 as many patients do, and then double it after a month. But after discussing it with her doctor, Ms. Stover has decided to stick with that initial low dose, even if it means slower results.<\/p>\n With a higher dose, she wonders if she\u2019d lose her desire to entertain. Maybe, she mused with mild horror, she might replace dinner parties with going out for bike rides with friends and eating granola bars. <\/p>\n \u201cIs that the new me? I can never see that as being fun,\u201d she said. \u201cI think it would take away part of my personality that I really like.\u201d<\/p>\n Powering through a life where there was no pleasure in eating proved worth it for Ms. MacKay. This winter, after nearly a year and a half on Mounjaro, something about the way her body metabolized the drug changed. She was able to find joy in food again. <\/p>\n On a recent brunch with family she ordered a plate of French toast, something unthinkable six months earlier, but restricted herself to eating only one-third of the portion and felt good about it. In March she went out on an errand for work, grabbed half a panini and ate it in public. Before the drug, that\u2019s something she never would have done. <\/p>\n \u201cThe feeling of walking down the street and having sauce dripping down my chin and not caring \u2013 it was such a joyful feeling,\u201d she said.<\/p>\n Health & Wellness Newsletter<\/p>\n Keep up to date on the latest nutrition news and dietary advice, fitness tips and wellness trends<\/p>\n Unsubscribe any time. By signing up, you will be subject to our\u00a0Terms and Conditions<\/a>.\u00a0See our\u00a0Privacy Policy<\/a>.\u00a0Learn more<\/p>\n Already have account?\u00a0Log In<\/p>\n","protected":false},"excerpt":{"rendered":"When Joel Brown was a chef in the 2010s in Toronto, tasting a brilliant new dish was like…\n","protected":false},"author":2,"featured_media":641380,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[21366,64,63,137,180700,490,21359,21369,40077],"class_list":["post-641379","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-appwebview","tag-au","tag-australia","tag-health","tag-lc-g","tag-medication","tag-nopolly","tag-yesapplenews","tag-yessnap"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/641379","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=641379"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/641379\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/641380"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=641379"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=641379"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=641379"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}