'Food Noise' is a terrible name for what people with obesity deal with

I've been thinking about what a terrible descriptor 'food noise' is. It makes it sound kind of trivial and is decidedly non-clinical. A friend of mine on TikTok suggested something like 'food-focused anxiety,' which is a more apt description of the issue. Anxiety is recognized as a mental health disorder when it is chronic, intense, and disproportionate, and interferes with daily functioning. For those of us who have struggled with food noise, that seems to fit.

One of the things that people who don't struggle with this fail to understand is just how powerful it is, and how difficult, if not impossible, it is to overcome without pharmacological intervention.

Appetite regulation occurs in the hypothalamus. That's the part of the brain that concerns itself with survival (hunger, temperature regulation, etc.). Hunger is an instinctual drive controlled by ghrelin (the hunger hormone), leptin (the satiety hormone), and GLP-1 (the hormone for satiety and blood sugar regulation). Leptin is particularly important as it is key for the brain to know how much fat (energy) is being stored in the body. It is believed that food noise, or food-focused anxiety, is caused by dysregulation with this part of the gut-brain communication.

Because this happens in the hypothalamus, it is difficult, if not impossible, for our executive function (in the prefrontal cortex) to override this drive on a long-term basis. In people with obesity, metabolic disorder, and leptin resistance, metabolic signals can overpower the cognitive control associated with executive function.

This is one reason why people who cease treatments often begin to regain weight. Long-term successful maintenance of weight loss is considered to be 2-5 years, while the period of 1-2 years is considered a critical maintenance window. In studies, people who maintained their weight loss for at least a year are more likely to sustain it long term.