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What Triggers Food Noise and Cravings · Meaningful Medicine with Novant Health

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  Joey Wahler (Host): It can be a major obstacle when fighting weight issues.
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  So, we're discussing food noise.
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  Our guests are Dr.
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  Rhonda Mough, an internist specializing in obesity medicine, and joined by
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  Jamie Hamm, a family nurse practitioner.
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  This is Meaningful Medicine, a Novant Health podcast, bringing you
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  access to leading doctors who answer questions they wish you would ask.
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  From routine care to rare conditions, our physicians offer tips to navigate medical
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  decisions and build a healthier future.
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  Thanks so much for joining us.
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  I'm Joey Wahler.
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  Hi there, Doctor, Jamie.
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  Welcome to you both.
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  Rhonda Mough, MD: Hello, thanks for having us today.
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  Host: Absolutely.
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  Appreciate the time.
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  So first, for you, Doctor, what do we mean by the term food noise?
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  Because I know in preparing to speak to you both, this is a new one on me.
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  Rhonda Mough, MD: Yes.
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  So, it's a relatively new term that has come about since really
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  the advent of GLP-1 medications.
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  And there really isn't a clear scientific definition for food noise.
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  But typically, what it is referring to is this food chatter.
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  So, repetitive thoughts about food that are really unwanted and
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  can be distressing for patients.
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  And it can kind of become a beast of its own where it's difficult for
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  patients to focus on other aspects of their life because they're having
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  these repetitive thoughts about food and cravings and really strong urges
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  to consume certain types of foods.
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  Host: And so, really in a sense, right, Doctor, when we say food
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  noise, we're talking literally about noise or a voice, if you will, in our
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  heads that says, "It's time to eat.
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  It's time to eat X, Y, and Z.
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  It's time to eat such and such an aMough," right?
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  Something that kind of is this inner voice urging us what to do, yes?
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  Rhonda Mough, MD: Yes.
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  Jamie Hamm: Right.
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  Host: And so Jamie, how do we know we're experiencing food noise and
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  too much of it, and that it's not just looking forward to a good meal
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  and doing what we should be doing?
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  Where's that line, would you say?
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  Jamie Hamm: It's
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  for the patients, they can't cut off the thoughts.
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  Whether they've just eaten, whether they're full, they're still thinking,
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  you know, I want to eat more.
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  What am I going to eat next?"
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  And I mean, it can interrupt their workday.
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  It can interrupt their thought process, their time with friends,
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  because they're just constantly thinking, "What am I going to eat?
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  When can I get, you know, that next snack?"
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  Host: So, Doctor, as the two of you well know, there's that old saying, don't
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  grocery shop while you're hungry or you may end up buying a lot of stuff that
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  you don't need if you weren't, right?
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  So if you are full, can you still experience food noise?
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  Tell us a little bit please about that link between hunger and noise.
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  What's the connection there?
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  Rhonda Mough, MD: Yeah, absolutely.
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  And oftentimes that is exactly the case.
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  So, you know, hunger is something that we need to have, right?
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  We need food.
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  There's a reason why we eat.
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  And so, not all food thought is food noise.
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  So, thinking about what your next meal is going to consist of, making sure you're
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  having good nutritious meals is fine.
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  The difference between hunger and food noise, hunger typically
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  is more of a gradual onset.
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  So, you know, it's getting to be time for a meal, so you start to feel hungry,
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  you get that growling in your stomach, as opposed to food noise, which is more of
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  a kind of out of the blue, sudden urge, craving for a specific type of food.
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  It's another big difference between hunger and food noise.
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  Hunger typically is satisfied by with whatever you eat, right?
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  It doesn't really matter what it is, it'll satisfy the growling in
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  the stomach and you'll feel better.
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  With food noise, it's very specific, and typically the only thing that will
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  satisfy the food noise is that specific food, whether it's chocolate or chips or
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  whatever it is, pizza, it's that specific type of food that's going to satisfy.
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  Host: And when you say that, Doctor, that there's only a certain thing
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  that'll satisfy that craving, is that typically more mental, more physical,
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  or maybe a combination of both?
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  Rhonda Mough, MD: I mean, it can be a combination of both.
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  What we believe is that there's part of the brain that's involved
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  with reward and cravings.
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  And when that gets activated by a particular food, oftentimes it's something
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  that's higher in sugar or fat or salt.
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  Those are the foods that we tend to crave or some combination of those,
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  that once that gets activated and we feel some reward from eating that food,
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  we're going to tend to do it again.
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  We tend to repeat rewarding activities.
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  And so, that's why we engage in those types of behaviors.
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  Host: I'm not saying, Doctor, that this works for everyone.
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  I'm sure it certainly doesn't.
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  But I know for me, one trick that I use doesn't always work, but it
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  works I think more often than not, is sometimes I'll get a craving for
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  something and usually if it's something unhealthy, I'll first try to wait.
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  Like, I'll think, "Let me grab some candy."
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  But then, I'll think, "How about if you don't grab some candy?
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  Give it five minutes."
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  And I find usually that'll at least put it off for now, right?
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  Which is better than nothing.
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  So, how much of this is impulsiveness, where as soon
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  as we have that food noise in
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  our head, we try to react to it?
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  Is there something to be said for trying to back off and give it
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  a little time, a little space?
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  Rhonda Mough, MD: I mean, I think that does work for some people.
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  You know, a lot of times these thoughts are very distressing though.
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  It's almost like the itch you have to scratch, right?
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  And so, people have a hard time sometimes not giving in just because
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  it's such an uncomfortable feeling.
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  But to your point, yes, if we can just hold off and maybe engage our thinking
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  brain and think, you know, start an assessment of when did we last eat?
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  Are we really physically hungry?
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  That if we slow down and start thinking through those things, sometimes that
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  can allow us to hold off on, you know, moving forward with that food.
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  Host: Jamie, how about some strategies for tackling this food noise?
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  For example, choosing healthy snacks and any other tips you can give
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  people for how they can combat this.
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  Jamie Hamm: Teaching our patients to kind of what Dr.
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  Mough said, assess, "Did I just eat?
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  Am I really hungry?"
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  Making sure that they are getting protein throughout their day to keep them full.
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  Making sure they're well-hydrated.
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  Making sure that they are getting good sleep so that they have
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  hopefully less of those hunger cues.
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  And then, also, distraction.
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  You know, when you have that cue, can you go do something else?
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  Can you do something to give your body that five minutes to say like, "Wait,
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  maybe I don't really need that food"?
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  Host: You said something there, Jamie, that really got my attention, which
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  was ask yourself, "Am I really hungry?"
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  How often are people hearing food noise when in fact they're not even hungry?
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  How much does that exacerbate the problem here?
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  Rhonda Mough, MD: Yeah.
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  So, I mean, I think that happens often, honestly, that patients
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  are experiencing food noise.
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  You know, it's like you finish a meal and you know that there's a pint of your
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  favorite ice cream in the freezer, and you're not physically hungry, but that
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  ice cream's there and it's a cue, right?
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  You know it's there.
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  Or, you know, it's walking around work and seeing the bowl of candy
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  and knowing that, you know, you just had lunch, you're not really hungry,
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  but that candy looks really good.
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  So,, a lot of times we're just cued by things in our environment, whether
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  it's something we're physically seeing.
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  It could be an ad on TV for a fast food while we're watching TV at night that
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  makes us start thinking about that food.
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  So, I mean, that is fairly common.
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  I'll add one more thing to what Jamie had mentioned, and that's stress.
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  Stress makes stress hormones go up, like cortisol.
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  When our cortisol increases, we crave sugar because our
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  brains prefer sugar as a fuel.
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  And our brains feel the need to figure out how to manage the stress, right?
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  We have to solve the problem.
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  And so, that is also a strategy that can help people manage food noise,
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  is dealing with stress and finding some healthy coping strategies.
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  Host: And speaking of which, Doctor, hence the term comfort food, right?
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  Eating makes us feel comfortable.
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  It's something we can control.
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  It's something that tastes good.
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  It's something that can literally make us feel good, at least for the
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  moment, but it also makes us ignore the consequences oftentimes, right?
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  Rhonda Mough, MD: Right.
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  And, you know, sometimes food can be a distraction.
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  You know, if there's something that we need to do that's stressful or
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  that we're kind of procrastinating and don't want to do, it can kind of be
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  an escape from a situation as well.
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  So, food can serve a lot of purposes in our lives.
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  You know, we have complex brains.
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  And so, we find a lot of ways to cope with those types of situations.
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  Host: And, Doctor, GLP-1 medications were briefly mentioned
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  earlier in our conversation.
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  So, meds like Ozempic and such that have become all the rave in recent years.
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  They can quiet food noise, so to speak.
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  So, how does that work exactly?
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  Rhonda Mough, MD: So, one of the major ways would be through
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  affecting that reward center in the brain that I had mentioned earlier.
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  So, kind of quieting some of the reward that comes from
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  eating and reducing cravings.
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  There are a couple of other things as well that GLP-1s do.
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  They do promote a feeling of satisfaction.
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  So, I mean, part of the issue with food noise is people don't feel satisfied
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  despite being physically full, right?
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  They're still not satisfied.
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  And so, it can help with that by reducing some of that reward from food as well as
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  promoting that feeling of satisfaction.
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  And then, finally, they help stabilize blood sugar.
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  And blood sugar fluctuations throughout the day can definitely
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  lead to more and more cravings.
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  So, we want more stability in our blood sugar, which can come from
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  dietary changes and also from taking medications like GLP-1s, and that can
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  help reduce cravings and food noise.
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  Host: And picking up on that point, Jamie, how would you say food noise
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  contributes to struggles with weight?
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  If you look from the experience that you and yours have with people that
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  have difficulty maintaining a proper weight, how much of a factor, if we were
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  drawing a pie chart, for instance, how much of a factor is food noise in adding
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  to those difficulties, would you say?
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  Jamie Hamm: For some patients, it's really the major thing that
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  keeps them from staying on track.
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  You know, we can have the whole team, we can have the diet plan, the
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  exercise plan, they're doing great.
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  But if you just constantly have this record over and over again, even the
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  best, you know, laid out plans can be very hard for a patient to follow.
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  Rhonda Mough, MD: Yeah, 100%.
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  And the other thing I would add to that is that when weight loss does
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  happen, particularly patients who are really trying their best with diet
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  and exercise, our bodies respond to weight loss by increasing our appetite.
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  And of course, because our body wants to go back to our previous weight.
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  Like, we have a set point, and that's where our body wants to go.
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  And so, we're going to crave higher calorie foods if our body is trying
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  to regain the weight we lost.
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  And so, that is part of the reason why it's so tough to
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  lose weight and keep it off.
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  Host: Well, Jamie mentioned a moment ago that we're talking here about
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  trying to stick with a plan, right?
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  It's not a one-size-fits-all.
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  These things have to be tailored to individual patients based
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  on their lifestyle, their particular obstacles, et cetera.
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  And so, Doctor, your clinic of course has a registered dietician,
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  bariatric surgeons as well.
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  How about the resources that you and yours can offer to
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  support people in this journey?
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  Because you need that support to say the very least, right?
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  Rhonda Mough, MD: Yes, absolutely.
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  And so, we have a team here of professionals who are very passionate
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  about helping patients achieve better health and manage their weight.
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  And, you know, as we've been alluding to, there are a lot of different components
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  in terms of what can affect weight and the ability to manage weight long term.
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  So yes, we do have a dietician who can definitely help with
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  some of the macrodistribution.
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  We've been talking about protein, fiber, healthy fats, those sorts
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  of things that can help you with that satisfaction and managing
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  blood sugars and avoiding cravings.
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  We have a social worker on our team as well, which is important for, of course,
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  the mental health piece of this because there is a large part of it there.
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  So, she can help too with some alternative coping strategies.
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  You know, if, you know, stress is a trigger, for example, for food noise or
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  eating certain foods, just helping with some alternative strategies there as well.
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  And of course, we have Jamie and myself as the medical side of weight
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  management, and we do have a number of bariatric surgeons as well for
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  patients who are looking for a surgical route for long-term weight management.
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  So, we aim to offer all of those needs here in one place.
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  Host: And so, to kind of put a bow on this here, in summary, Jamie, what
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  advice would you offer to someone joining us, struggling a long time with
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  all this, feeling like they've already tried a lot of diets as so many have,
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  and who knows what else in terms of solutions that haven't worked long-term?
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  What do you want to say to them about taking that first step to try
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  to take advantage of these great resources that you and yours can offer?
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  What can you tell them about what they can expect when they come to that first visit
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  and try to go down the right road, whereas they've gone down the wrong one so far?
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  Jamie Hamm: The biggest thing is, you know, of course, we're going to talk
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  to them about, you know, their diet and their exercise, you know, and a
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  lot of times patients will say, like, "I've done that, I've heard that."
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  But we have the benefit of having more time to really go through, get to know
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  them, like, what is your eating style?
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  Where are you struggling?
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  Is it the food noise?
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  Is it simply a knowledge deficit?
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  Do we need to bring a dietician in?
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  Is it that you have untreated anxiety or an eating disorder?
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  Do we need a social worker?
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  Do we need, you know, a special counselor?
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  And we can meet with them, you know, as frequently as needed.
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  And then, we can also implement medication to help.
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  So, I think the difference is with us, it's building a team around a patient
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  that is not just going to see them occasionally, but is going to, you
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  know, see them throughout their journey while also working with their primary
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  care and their other specialists.
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  Rhonda Mough, MD: Absolutely.
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  Yeah, I agree 100%.
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  And then, the other thing is to not be afraid to ask for help.
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  You know, this is a chronic medical condition that we're talking about,
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  and it's no different than asking for help with management of any
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  other chronic medical condition.
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  And so, this just happens to be what our passion is and we're here to support them.
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  They don't have to walk this alone.
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  There's so much conflicting information out there.
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  Come see us.
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  You know, we'll get you pointed in the right direction.
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  Host: Great point to emphasize there, Doctor.
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  And I think it's important as well that you've both touched on the fact
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  that oftentimes in these situations there is a mental health component.
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  And you, of course, can offer that help there as well if needed.
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  Well, we hope that you're now more familiar with food noise.
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  Doctor, Jamie, keep up all your great work and thanks so much again.
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  Jamie Hamm: Thanks.
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  Rhonda Mough, MD: Thank you so much.
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  Goodbye.
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  Host: Absolutely.
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  And to find a physician, please visit novanthealth.org.
• 15:42
  For more health and wellness information from our experts,
• 15:45
  please visit healthyheadlines.org.
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  If you found this podcast helpful, please do share it on your social media.
• 15:52
  I'm Joey Wahler.
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  And thanks so much again for being part of Meaningful
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  Medicine, a Novant Health podcast.