Dr. Sarah Stombaugh:
This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight Podcast.

Announcer:
Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here’s your host, obesity medicine physician, and life coach, Dr. Sarah Stombaugh.

Dr. Sarah Stombaugh:
If you have had the experience of feeling like food is always on your mind, you’re always thinking about what is the next meal? Maybe you’re planning your weekend or vacations, always around where should we go for breakfast? Where should we go for lunch? What should we do for dinner? What’s in the pantry right now? Constantly thinking about what you could eat, what you should be eating, maybe negotiating with yourself about food choices that you’re making. If you feel like food chatter just fuels your brain, then today’s episode is for you. Food noise is a term that has become really popularized over the last couple of years as we look at the effect of GLP medications like Zepbound and Wegovy. And it’s left a lot of people wondering if using the GLP medications has eliminated my food noise entirely, was I ever the problem? And that is what we’re going to dive into today.

I’m Dr. Sara Stombaugh, obesity medicine physician, and food noise is such a common thing that people deal with during their weight loss journey. And we are going to talk about what is food noise, how do we know if it’s a problem, and then most importantly, how are we going to address it to make sure that it is not stopping you from achieving your weight loss goals? And I think this question that a lot of people have realized over the last couple of years is if the GLP medication limits the food noise or eliminates rather the food noise, was I ever the problem? And this is such a powerful realization for a lot of people because they take a medication like Zepbound, they take a medication like Wegovy, all of a sudden the food noise is gone and they’re like, oh my gosh, this wasn’t a me problem.

This was a sign of a deeper hormonal issue that my body was not properly regulating. And if I’m able to treat this with a medication, then maybe it means that something else was going on. And I’m here to tell you today that that’s exactly the case for a lot of people. When we think about food noise and we think about what does that represent, what is actually happening in our body that drives us to feel hungry, that drives us to feel full, that drives us to be thinking about food, there’s a lot of different hormones that play a role in the regulation of appetite. We have hormones like ghrelin, for example. This is our hunger hormone. When ghrelin is elevated, we feel more hungry. We have hunger hormones or fullness hormones rather like leptin that make our body feel full. We have hormones like insulin.

This is a popular one. Everyone’s been talking a lot about insulin resistance, which is absolutely true. And what role does that play in how our body experiences hunger? A lot of times insulin resistance will exhibit itself as cravings for sweets, particularly cravings for processed sweets and sometimes even feeling like low blood sugar, which makes those cravings incredibly intense and urgent when they come up. And one of the biggest challenges why long-term weight loss can be incredibly difficult is that our body has metabolic adaptations when we’ve experienced some weight loss in order to help our body regain back to where we came from. So very common experience is that very early in the weight loss journey, someone might be following a specific diet regimen. Let’s say they’re not on any medications in this situation and they’re doing well, they’re losing some weight, they’re in a kind of a good groove, they’re feeling really good about themselves, and now all of a sudden, maybe they’ve lost 10, 20, 30 pounds, their body starts fighting back.

And this is exactly what we see is that when people are experiencing weight loss, a lot of times their body is seeing as a signal as, oh my gosh, is there food scarcity right now? We need to go yell at you, go yell at you very loudly to go seek food that when you eat it, you need to eat more of it. And we see this hormonal dysregulation happening where people start experiencing really intense hunger because they have increased ghrelin levels. They start experiencing decreased satiety because their body is not going to feel full as quickly. Those leptin levels can be altered. Our body is often not signaling these things properly, or rather it is signaling these things properly, but we’re like, “Hey body, just work with me here. Don’t fight with me.” But it feels like we’re fighting our body. It feels like our body is just screaming at us to eat.

We’re thinking about food all of the time and yet we’re trying to lose weight and so those two things do not go hand in hand. So let’s talk about what this is and how do we address this? Now, as I said, many, many people who’ve taken medications like the GLPs have been shocked at how almost instantly their food noise has been eliminated and they feel like all of a sudden they go from thinking about food all of the time to thinking about it much less frequently. They have all this space now where they’re like, “What do I do with my mental energy because I’m not spending so much effort thinking about food?” Now, the goal is not to think about food at all. We do need to think about food, we do need to plan food, but we don’t want it to take a disproportionate amount of our day.

And the GLP medications, especially when given at the right dose, can be a really phenomenal way to support this because they’re supporting some of that underlying metabolic dysregulation that happens when the body is losing weight and when the body is fighting back. So it helps to combat some of that food noise. The good news is though that GLPs are part of the picture, but whether you’re on GLP medications or not, there’s other things that we can do to help support this pathway to reduce food noise. Now, there’s a lot of things that contribute to, for one, when we think about the standard American diet, we think about the types of food that we’re consuming. A lot of foods that are very highly processed do not trigger satiety or the fullness in the same way that whole natural type foods will signal. So if you imagine, for example, going out to get fast food, you get a fast burd cheeseburger or a fast food cheeseburger, you get french fries, you get a soda on the side, that likely is a very calorically dense meal.

So that’s likely something that’s going to contain a thousand or maybe even more calories depending on the sizes of everything that you get. And if you do extra sauces or increase the size, for example. So there’s not a lot of volume, but there’s a lot of calories in that food that you’re consuming. And the way that you feel after that meal, you probably feel full, but you probably would have felt more full if you ate that same amount of calories in a much lower density food. So if you imagine eating lean protein, for example, you imagine eating it with vegetables, you could much easily consume a similar quantity of food or even a much larger quantity of food at a much lower caloric cost. Then if you had something, for example, like chicken mixed into some rice and vegetables and you had those very calorically low density meals, or lower calories, but a very large volume that would get you full, that would keep you full for lasting periods of time, where the fast food meal may just keep you full for a couple of hours or does it really, even if it kept you full for a while, even though you had a thousand calories, it’s not keeping you full for twice as long or for three times as long compared to if you had eaten a smaller meal.

You can imagine this too, if you’re eating chips, for example, and you think about the way they taste, and sometimes it’s like you can just eat them and eat them and eat them. I always think about something like the Pringles commercial, for example. It’s like once you pop the fundant stop, you could very easily eat the entire canister of Pringles consuming many hundreds of calories and not necessarily feel that full afterwards. But if you consumed the exact same amount of calories of vegetables, it would just be these obscene amount of vegetables, you probably wouldn’t actually even be able to consume that much because it would feel like such a large volume of food. So all that to say, foods that are more highly processed do not induce fullness in the same way than a less processed food. So when we think about fruits, when we think about vegetables, when we think about grains in their whole form, when we think about protein, particularly lean proteins, but honestly even non-lean proteins, when we’re building a meal that has these components, it has protein, it has fiber, has even some fats, that will help build a slow digestion with satiety that will last us for many hours.

So the fiber helps slow things down, the protein in particular, but the fats as well create this really lasting satiety that feels very different than when we eat a very calorically dense processed meal. So the type of foods that we’re eating can play a really big role in both how our body experiences fullness and then how long that fullness lasts for. We can also think about what are our day-to-day habits and routines. Certainly if you’re in a habit of eating at the same time every day, your body’s probably going to start to expect that. And so working on how do I make some adjustments in my day-to-day routine, eating for reasons that are hunger, stopping when I’m feeling full, choosing foods that help to create that feeling of fullness can be incredibly important. We also think about the role of other pieces like hydration. Are you adequately hydrating throughout the day?

Are there other things like poor sleep that are playing a role in that hormone signaling mismanagement? We know that getting a poor night of sleep the next day can really increase hunger, it can really decrease that fullness. And so things like getting good sleep can also help with decreasing food noise. So thinking about all these pieces together of getting good sleep, getting good hydration, building meals, planning ahead, not letting yourself get so hungry, making sure that you’re choosing protein, that you’re choosing fiber, these nutrients that feel really energizing in the body and give you that lasting fullness and maybe also with the help of a medication like a GLP. This recipe together is just magic. People realize that we’re treating some of those underlying hormonal dysregulations that happen, and when we can partner it with things like the food piece, like the sleep piece, it starts making a difference in how our body feels day to day, and it feels like we’re working with our body rather than feeling like we’re fighting our body.

So if you have been trying to lose weight and feel like you’re stuck in a cycle, feeling like you’re fighting like your body, my goal is to help you reconnect with your body, to feel like you’re able to think about food, to plan about food in a way that feels really good, that feels really comfortable without being all-consuming. If you were looking for a doctor to support you in that way, I see patients in person in Charlottesville, Virginia and throughout the states of Illinois, Tennessee, and Virginia by telemedicine, and I would love to work with you to support you in your weight loss journey. You can learn more at www.sarahstombaughmd.com. Thank you for joining us for this episode. We’ll see you all in the next one.