people taking GLP-1s had a lot to say about it<\/a>. For as long as they could remember, users of the drugs said, they had been plagued by food noise. But they thought it was just a normal part of life. They thought everyone had it.<\/p>\nUntil they took one of the new drugs.<\/p>\n
Suddenly, food noise was silenced.<\/p>\n
And that effect is leading to new questions about the drugs. If researchers can clarify the source of this inner buzz and what makes it go away, that could lead to a clearer understanding of what causes obesity in the first place.<\/p>\n
\u2018You Don\u2019t Want the Salad\u2019<\/p>\n
People who struggle with their weight describe relentless thoughts of food.<\/p>\n
Lena Smith Parker, 53, of Hamden, Conn., spent decades dieting and regaining weight. All the while, she said, she was plagued by internal voices urging her to eat and shaming her for eating.<\/p>\n
One, she said, is like a relentless auctioneer. \u201cYou know there\u2019s cake in the kitchen. Hey, there\u2019s cake in the kitchen. Don\u2019t you want the cake in the kitchen?\u201d<\/p>\n
Another, she said, is like \u201ca really bad used-car salesman.\u201d<\/p>\n
\u201cYou don\u2019t want the salad. You don\u2019t want the carrots,\u201d the voice says. \u201cYou want the cake.\u201d<\/p>\n
Then, there\u2019s the bully. \u201cYou are so fat. I can\u2019t stand you.\u201d<\/p>\n
Finally, there\u2019s the advance planner. \u201cCan I get to the store next Tuesday to get the special cupcakes so I can eat them in the car before I get home?\u201d it asks.<\/p>\n
But why would people like Ms. Parker have such thoughts?<\/p>\n
Researchers suspect the answer lies in an elusive concept called the set point.<\/p>\n
The idea arose from studies in the 1940s. Researchers discovered that if they got rodents to gain or lose weight, the animals would quickly return to their starting weight when the study ended. The same thing seemed to happen with people.<\/p>\n
That led to the concept that became known as the set point. It says that each person has a weight their body naturally gravitates toward \u2014 their set point. It can change over a person\u2019s lifetime. For some, the set point may malfunction, reaching such a high level that a person\u2019s health is affected by excess weight.<\/p>\n
\u201cObesity results from the initial elevation of the set point to an abnormal level,\u201d said Dr. Lee Kaplan, director of the Obesity and Metabolism Institute in Boston. Dr. Kaplan consults for a number of pharmaceutical companies.<\/p>\n
Any time a person tries to get their weight much below their set point, researchers have observed, food noise will kick in. That may be part of a physiological process. When weight is lost, the body\u2019s metabolism slows so a person needs less food than would be expected to maintain their weight. At the same time, the researchers have noticed, food noise kicks in, compelling a person to eat more calories than the body can handle without storing some as fat. That\u2019s why diets almost always fail in the long run.<\/p>\n
And food noise is not restricted to people with obesity, researchers stress. Anyone can have it if their weight falls below the body\u2019s preferred set point.<\/p>\n
Dr. Jules Hirsch at Rockefeller University and his colleagues Dr. Rudolph Leibel and Dr. Michael Rosenbaum at Columbia saw that effect decades ago when they studied the metabolic and behavioral changes that occurred when people lost weight.<\/p>\n
Their subjects lived at the Rockefeller hospital and stayed on a low-calorie diet until they lost at least 10 percent of their weight. Some studies involved people with obesity but others involved people of normal weight.<\/p>\n
But although the participants\u2019 weights were lower when they left the hospital, they had the physiological signs of starving people. Their metabolisms were low, and they dreamed and fantasized about food. And they binged when they were no longer subjected to an enforced diet. It was a condition so extreme it became called \u201csemi-starvation neurosis.\u201d<\/p>\n
The situation was, Dr. Leibel said, \u201ca perfect storm for weight regain.\u201d<\/p>\n
\u2018My Brain Is Empty\u2019<\/p>\n
Ms. Smith Parker thought that food noise was normal, that everyone had it.<\/p>\n
Then, she went to a weight-loss clinic at Yale run by Dr. Ania Jastreboff who enrolled her in a clinical trial of tirzepatide, one of the new obesity drugs that was marketed as Zepbound.<\/p>\n
Suddenly, the food noise was gone.<\/p>\n
When the study ended, however, she no longer had access to the drug because it was not yet approved by the Food and Drug Administration.<\/p>\n
\u201cThe food noise came roaring back with a vengeance,\u201d Ms. Smith Parker said. \u201cI gained back 40 pounds pretty much by eating spaghetti nonstop, and chocolate cupcakes.\u201d<\/p>\n
So Dr. Jastreboff prescribed Wegovy \u2014 which was approved \u2014 for Ms. Smith Parker, and those voices in her head telling her to eat were gone.<\/p>\n
\u201cI was like, Wait. My brain is empty,\u201d Ms. Smith Parker said.<\/p>\n
Dr. Jastreboff, who conducts clinical trials for makers of obesity drugs and is on multiple scientific advisory boards for pharmaceutical companies, thinks there\u2019s an explanation for what happened to Ms. Smith Parker and her other patients. The new obesity drugs seem to be resetting the set point at a lower level. As a result, people still can get hungry, but she says they no longer have a running internal dialogue about food that drives them to continue eating.<\/p>\n
But Dr. Jastreboff and other researchers say the drugs only change the set point while people are taking them. The original set point seems to return if people stop taking the drugs. So does food noise, followed by increased eating and regained weight.<\/p>\n
Dr. Leibel, who consults for makers of obesity drugs, likens the effects of the drugs on food noise to the effects of aspirin on a fever. Aspirin, he noted, \u201cwill suppress a fever without curing the underlying cause.\u201d<\/p>\n
But if the new obesity drugs reset the set point, how do they do it?<\/p>\n
\u201cWhat\u2019s the thing that\u2019s set and what\u2019s reading that as set?\u201d asked Dr. Daniel Drucker, a University of Toronto researcher who helped develop the new obesity drugs decades ago.<\/p>\n
And how exactly are the GLP-1s and similar drugs affecting set points?<\/p>\n
\u201cThat\u2019s the million or billion dollar question,\u201d he added.<\/p>\n
Understanding the mechanism might help explain why the disease of obesity is characterized by a set point that is so high and perhaps suggest new ways of lowering it.<\/p>\n
For people like Oprah Winfrey, life without food noise has been remarkable. In a book she published this year and co-wrote with Dr. Jastreboff, she said until hers was silenced by one of the obesity drugs she thought everyone had food noise, that it was normal.<\/p>\n
\u201cThe single biggest surprise of taking the medications was waking up and not thinking about the very first thing I wanted to eat \u2026 or the healthier thing I should have wanted \u2026 or the bargain I could make with myself so I could eat first thing,\u201d she wrote.<\/p>\n
Dr. Drucker said there was a lesson here about food noise for those who do not experience it.<\/p>\n
\u201cPeople who are not struggling with their weight can be very judgmental,\u201d he said. \u201cThey never had their brains driving their behavior.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Before the new obesity drugs came on the market, almost no one used the term food noise. Researchers…\n","protected":false},"author":2,"featured_media":610329,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[3615,299,176491,97,986,1728,3587],"class_list":{"0":"post-610328","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-brain","9":"tag-food","10":"tag-glp-1-ras-drug","11":"tag-health","12":"tag-obesity","13":"tag-research","14":"tag-weight"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/610328","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=610328"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/610328\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/610329"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=610328"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=610328"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=610328"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}