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ForumsOff-TopicGLP-1 and your career — need advice Page 2

GLP-1 and your career — need advice

Dr.MetabolicMD Wed, Mar 5, 2025 at 3:59 PM 9 replies 1,523 viewsPage 2 of 2
Dr.PeteFamMed
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Mar 5, 2025 at 5:21 PM#6
BethLabQueen said:
Dr.MetabolicMD said: ...regarding food noise mechanism of action...

Rebound hunger after missed dose of food noise: I missed my injection by 3 days due to a shipping delay and the hunger came ROARING back. Like a switch flipped. It was eye-opening to feel the difference.

This experience actually reinforced my understanding of what the medication does — it's not just "suppressing appetite," it's normalizing dysregulated hunger signaling. When the drug wears off, you feel the full force of what it was managing.

Last edited: Mar 5, 2025 at 6:21 PM
50 20hyun_seoul, jim_asheville, matt_MKE and 47 others
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hank_denver
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Mar 5, 2025 at 5:53 PM#7
Dr.MetabolicMD said:
The food noise came back three weeks after I reduced my dose, well before the weight moved, which tells me something about which effect tracks what.

Central vs peripheral GLP-1R signaling in food noise: elegant studies using brain-penetrant vs peripherally-restricted GLP-1 agonists show that ~80% of the weight loss effect is centrally mediated[1].

The key brain regions: arcuate nucleus (appetite), area postrema (nausea), NTS (satiety), VTA/NAc (reward). Peripheral effects (gastric emptying, insulin secretion) contribute but are secondary for weight loss.

This has implications for next-gen drugs: optimizing brain penetration and CNS receptor occupancy may be more important than systemic exposure.

References:
[1] Secher A, et al. J Clin Invest. 2014;124(10):4473-4488.
49 19raj_cambridge, ingrid_STO, pete_nash and 46 others
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BariatricNurseD
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Mar 5, 2025 at 6:25 PM#8
Dr.PeteFamMed said:
Rebound hunger after missed dose of food noise: I missed my injection by 3 days due to a shipping delay and the hunger came ROARING back.

"Food aversion" side effect of food noise that I wasn't prepared for: I used to LOVE cooking and trying new restaurants. Now certain foods — especially fried foods — literally repulse me.

It's not just reduced appetite; it's an active disgust response. My therapist says this is common and likely related to the reward pathway modulation. It's mostly a positive change, but I do miss enjoying food the way I used to.

48 18josh_phd_bmore, roxy_nash, tony_orlando and 45 others
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mike_mealprep
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Mar 5, 2025 at 6:57 PM#9

A narrower follow-up, since the general answer is now clear:

What did you change at the same time, and can you separate the two now?

47 17mel_PDX, Dr.AddMedPHL, newstart_MO and 44 others
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Dr.MetabolicMD
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Mar 5, 2025 at 9:29 PM#10
BariatricNurseD said:
"Food aversion" side effect of food noise that I wasn't prepared for: I used to LOVE cooking and trying new restaurants.

Phantom hunger vs real hunger on food noise: learning to distinguish between the two has been a revelation. Real hunger: gradual onset, physical stomach sensation, any food sounds good. Phantom hunger: sudden, emotionally triggered, specific food cravings, occurs right after eating.

The GLP-1 agonist suppresses real hunger beautifully. Phantom hunger still pops up but I can now recognize it for what it is — an emotional signal, not a physical need. Mindfulness training helped enormously with this distinction.

31 6GenomicsKate, Dr.ObesityMed, HealthEcon_DC and 28 others
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