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ForumsOff-TopicI fit into my college jeans and I am not okay (happy tears) — my results so far

I fit into my college jeans and I am not okay (happy tears) — my results so far

VanRx_Mike Sat, Oct 19, 2024 at 4:43 AM 43 replies 2,235 viewsPage 1 of 9
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VanRx_Mike
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Oct 19, 2024 at 4:43 AM#1

Read the primary source rather than the write-up and the two do not agree, so here is what is actually in it.

Food noise is the best term this community has produced and it describes something the trials did not measure well: the constant background computation about food that most people with obesity live with and most people without it do not believe exists. GLP-1 agonism reduces the salience of food cues in the reward pathway rather than simply reducing hunger, which is why the reported experience is silence rather than willpower. It is also why its return on dose reduction is the first thing people notice, well before the weight moves.

Where I think it is weakest: the follow-up is short relative to how long people actually take these drugs, so durability is an assumption here rather than a finding.

So the question, as narrowly as I can put it: whether the quiet is the same mechanism as the appetite suppression or a separate one, because they seem to come and go on different schedules. I would rather have one careful answer than five confident ones.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
34 4Dr.LeslieOBGYN, MikeNYC_runner and 31 others
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BariatricNurseD
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Oct 19, 2024 at 4:48 AM#2
VanRx_Mike said:
Food noise is the best term this community has produced and it describes something the trials did not measure well: the constant background…

The GLP-1 and alcohol use disorder connection, relevant to food noise: observational data from Scandinavian registries shows reduced alcohol-related hospitalizations in GLP-1 agonist users[1].

The mechanism is plausible: GLP-1R is expressed in the mesolimbic reward pathway (VTA, nucleus accumbens). Agonism at these receptors may reduce the reinforcing properties of alcohol, similar to the reduction in "food noise."

RCTs for GLP-1 agonists in AUD are now underway. If positive, this would be a paradigm-shifting repurposing of existing medications.

References:
[1] Wang W, et al. Nat Med. 2024;30:574-584.
33 3roxy_nash, tony_orlando, Dr.NephBHM_UK and 30 others
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sarah.morrison
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Oct 19, 2024 at 4:53 AM#3
VanRx_Mike said:
Food noise is the best term this community has produced and it describes something the trials did not measure well: the constant background…

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.
32 2tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 29 others
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chris_chi24
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Oct 19, 2024 at 4:58 AM#4
sarah.morrison said:
Central vs peripheral GLP-1R signaling in food noise: elegant studies using brain-penetrant vs peripherally-restricted GLP-1 agonists show that ~80%…

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.

Last edited: Oct 19, 2024 at 7:58 AM
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tyler_CSCS
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Oct 19, 2024 at 5:25 AM#5
BariatricNurseD said:
The GLP-1 and alcohol use disorder connection, relevant to food noise: observational data from Scandinavian registries shows reduced alcohol-related…

Can confirm. Same sequence, different timescale. Posting only so the count is not one.

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