Weight Loss Injections and “Food Noise”

With all the buzz about weight loss injections recently, I’ve been hearing the term “food noise” a lot. As an eating disorder counsellor, I often work with people who experience some kind of food noise – incessant thoughts about food, cravings, anxieties about eating, food rules, and more. Many people discuss taking weight loss injections, such as Ozempic, Wegovy, and Mounjaro, to help reduce food noise. But is this the best approach to tackling food noise, and at what risk?

I appreciate that many people feel they need weight loss drugs desperately, and they have every right to take them. The problem is that many people don’t qualify for weight loss injections through the NHS and seek them elsewhere. This can lead to numerous problems and risks, which I discussed in a previous blog post.

I stand against harmful diet culture and the idealisation of thinness in our society but I do not judge people who choose to take weight loss drugs or pursue other weight loss interventions, given the cultural pressures we face. As a counsellor, my main mission is to help people improve their relationships with food and their bodies and to build self-acceptance.
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What is Food Noise?

Amidst all this talk about food noise, no one seems to define it clearly. Perhaps because there’s an assumption that we all just understand? This assumption in itself speaks volumes.

From my perspective, here’s what I believe it may involve:
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• Worries and anxieties about food and eating
• Constantly thinking about food
• Internal conflicts over what to eat or what not to eat (like an angel and devil on your shoulders)
• Rules about food and eating
• Thoughts about calories or other measures
• Difficulty concentrating due to thoughts about food or eating
• Inability to ignore hunger signals, e.g., stomach rumbling
• Concerns about weight gain
• Feeling guilty after eating
• Thinking of ways to compensate for eating
• Sensory and texture rules and anxieties about food
• Pressure to eat “normally”
• Conflict between different parts of oneself with conflicting narratives

There’s likely even more to it as food noise manifests in various ways, as I’ve learned from my work.

In more official terms, one paper defined food noise as:

“Heightened and/or persistent manifestations of food cue reactivity, often leading to food-related intrusive thoughts and maladaptive eating behaviours.”

This means hunger and thoughts about wanting to eat, which can lead to distressing thoughts and, potentially, disordered eating behaviours. “Maladaptive eating behaviours” refer to disordered eating stemming from food noise or distressing thoughts about food, such as binge eating, diet cycling, restriction, purging, and more. In my experience, this all contributes to eating distress, often accompanying disordered eating. Therefore, food noise may be part of a difficult relationship with food, which for some may be disordered eating or an eating disorder.
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​Hunger and Food Noise

The foundation of food noise for most people seems to be hunger. For those who don’t diet or struggle with food, when they feel hungry and think about food, they just eat. Done. But for those who struggle with eating, it’s not so simple. Hunger or thoughts about food trigger a counter-response, sparking inner conflicts. This can feel like parts arguing or bargaining internally. One part might say, “go and get the biscuits,” while another argues “no, you can’t have biscuits!” And there might be a harsh inner critic part resembling a bully, spouting names and putting you down.

Food noise may begin with hunger, but it’s the struggle against it that becomes the real issue. This struggle often ties into dieting, restriction, or food deprivation, frequently in pursuit of weight loss or to avoid weight gain. This resistance can stem from fear of overeating, feeling out of control, or an inability to stop eating. For some individuals, food can feel addictive due to rules and restrictions against certain foods, and this deprivation drives feelings of addiction and cravings.
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The push/pull of thoughts about food often leads to cycles – sometimes termed diet cycles, binge cycles, or shame cycles. These involve patterns of thoughts and behaviours that typically result in frustration and getting trapped in cycles of disordered eating. You can read more about diet/binge cycles here.
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Weight Loss Injections and Food Noise

Weight loss injections, such as Ozempic, Wegovy, and Mounjaro, are essentially appetite suppressants. They reduce feelings of hunger in some individuals (not all) for a limited time (which is not indefinite). They can have side effects like nausea, which may further reduce the desire to eat. Like many other diet drugs and supplements, they encourage restriction, which can be part of eating disorder behaviours. If considering weight loss injections, it’s crucial to go through a safe, specialist route.

​For those deemed not eligible, it’s not advised to source your own due to the risks involved in this but instead, access other support such as therapy or dietary support from a qualified professional. Also, if you are recommended weight loss injections, it is always your choice so don’t feel pressured into it and be sure to do your homework and read up on them. Whether taking weight loss injections or not, it will be beneficial to work on your relationship with food as this can help address the psychological aspects of food noise and your relationship with eating.
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Where Does Food Noise Come From?

Our thoughts and feelings about food and eating develop from a complex interplay of influences through the lifespan, including:
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• Narratives about food during upbringing
• Genetics
• Childhood development and attachment to caregivers
• Family, peer, and cultural influences
• Trauma and abuse, including appearance-related bullying
• Systemic inequalities
• Diet culture
• Neurodivergence
• Weight stigma and fatphobia
• TV, film, and media influences

Our eating habits are shaped long before birth, forming a complex journey in establishing our relationships with food. Social and cultural factors, particularly diet culture and weight stigma, promote the misconception that being thinner equates to being happier and healthier (which is untrue!). With such societal emphasis on “obesity,” it’s understandable why people are keen to try weight loss injections. However, it’s crucial to debunk the myths and misinformation surrounding “obesity,” BMI, and weight (I recommend Aubrey Gordon for more on this).

Unpacking food noise involves considering many factors, which I frequently explore with my clients. We delve into their childhood experiences with food and eating, the impact of media and diet culture, their developmental relationships, the origins of food rules and “shoulds,” and their perceptions of body size and weight. Therapy is a great avenue for this exploration, but also learning about anti-diet and “health at every size” approaches can also be beneficial. These issues often stem from a fear of weight gain or an inability to lose weight, making a size-acceptance approach a valuable exploration. Separating “health” from weight loss is crucial, given the multifaceted aspects of health (e.g., mental health, sleep, stress) without focussing on body size.
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Are Weight Loss Injections the Best Solution for Tackling Food Noise?

​Personally, I would say no. While they may temporarily lessen food noise for some, it’s only a short-term fix, with a high chance it will return when stopping the injections. These weight loss injections, like other diet pills, suppress appetite as part of restrictive eating. Any pre-existing disordered eating/eating anxieties may get worse in the long run. Ultimately, weight loss injections mask the issue without addressing the underlying problems.
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Weight Loss Injections and Eating Disorders

Eating disorders can sometimes go unnoticed and undiagnosed, creating a grey area where individuals grappling with disordered eating may opt for weight loss injections. Medical professionals who fail to recognise underlying eating disorders may recommend these injections. Binge eating disorder, one of the most prevalent eating disorders, is often misinterpreted as mere overeating or lack of willpower. Consequently, individuals who binge eat may be subjected to diets or weight loss interventions, including weight loss injections, which can worsen their conditions and impede appropriate help and support.
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According to the eating disorder charity BEAT, weight loss injections can be “very dangerous” for those with eating disorders or individuals already vulnerable to disordered eating. On a broader societal scale, weight loss injections perpetuate the pursuit of the thin ideal and weight stigma, thereby encouraging disordered eating and eating disorders.
 

Ways to Address Food Noise

Whether opting for weight loss injections or not, it’s advisable to explore your food noise and understand its roots to work towards a sustainable improvement in your relationship with food:
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• Counselling/Therapy - find out more about counselling here
• Reading and learning – see my resources page here
• Understanding diet cycles and binge eating – read more here 
• Minimising the impact of diet culture, e.g., consider changing up your social media feed
• Work on challenging the negative critical thoughts about eating and your body
• Explore your relationship with exercise/movement if you can – exercise does not have to feel like punishment!
• If wanting to improve “health,” try to separate this from weight, while recognising that “good health” is not accessible to everyone
• Work on self-acceptance as you are now
• Build on self-care practices (this can be any kind of self-care that works for you - not just having a bath!)
• Utilise creative practices if you are so inclined e.g., writing or drawing - I have some therapeutic writing exercises here

If you’re considering counselling for food noise or any other food-related concerns, please get in touch. I offer a free 15-minute initial call to explore how I can assist you.

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