An immense cultural discourse has sprouted around Ozempic and Wegovy, two prescription drugs that are being used to help people lose weight. One effect of these drugs that you may not have heard about is their ability to “quiet food noise;” users of the drugs report that food noise, or frequent thoughts about food, decreases while on the drugs. Presumably, this effect occurs because the drugs slow digestion and cause a user to feel full. Ozempic and Wegovy contain semaglutide, which mimics GLP-1: a naturally occurring hormone that the gut releases in response to eating.
I have a few worries about the term “food noise,” which is beginning to catch on. As I will explain in this blog post, I fear the term medicalizes a perfectly normal enjoyment of food and pathologizes hunger. This will further marginalize fat people, who are already targets of socially-sanctioned stigma.
What is food noise?
A New York Times article on food noise from June 2023 reports that videos tagged with “food noise” have been viewed over 1.8 billion times on TikTok, while searching “food noise” on Reddit returns pages and pages of results from subforums like r/WegovyWeightLoss, r/loseit, and r/Ozempic. The term is still loosely defined and vague as it gains traction, but users of the term seem to be referring to persistent thoughts about food. Consider this quote from the NYT article linked above:
Almost immediately after Ms. Klemmer’s first dose of medication in February, she was hit with side effects: acid reflux, constipation, queasiness, fatigue. But, she said, it was like a switch flipped in her brain — the “food noise” went silent. “I don’t think about tacos all the time anymore,” Ms. Klemmer, 57, said. “I don’t have cravings anymore. At all. It’s the weirdest thing.”
Here’s another quote from a user on r/Ozempic, describing their experience of food noise:
My noise, “what cookies will I make. What cooking show is on TV, what grocery store deals should I buy.” At breakfast what should I eat for dinner? Oh, I’m hungry?… great let’s eat. I’m tired have a cookie. There are stale crackers in the cupboard, a few won’t hurt. I’ve just eaten 4 slices of pizza and I’m stuffed? Just have another one. It tastes so good. Going on a 1 hr car ride grab 2 granola bars. Just in case. Stop at a gas station, I deserve mini donuts.
Seriously, I could go on for hours…After [Ozempic]- hum, am I hungry? Not really let’s wait a bit. A couple hours later… I’m starting to feel Hungry how about a small chicken and rice bowl with a little Fruit on the side? Wow, I ate half my portion and it just doesn’t look appealing anymore.
As evidenced by the New York Times report cited above, articles on websites like WebMD and Health.com, and the term’s use on websites like Reddit, “food noise” is gaining cultural cache as a term by which people feel able to capture some aspect of their phenomenal experiences related to food and hunger.
Why should we care about “food noise” gaining traction?
Medicalization of eating and feeding refers to the transformation of social behaviors of eating into symptoms of diseases that must be treated with medical interventions. The increasing use of the term food noise contributes to the medicalization of eating and feeding in a straightforward way: by characterizing non-pathological incidences of hunger and thoughts about food as symptoms to be treated by medical intervention.
In chapter 8 of philosopher Kate Manne’s book, Unshrinking: How to Face Fatphobia, Manne discusses the authority of hunger and our attempts to control it through dieting and medical interventions like bariatric surgery or previous classes of appetite suppressants like fen-phen in the 1990s. In fact, America’s obsession with diet drugs reaches back even further: Obetrol, a diet drug used in the 1950s and 60s, suppressed hunger via a mixture of amphetamines. In the 1970s and 80s, surgeons sometimes wired jaws shut to reduce food intake. It seems like Americans are obsessed with controlling our hunger, and hunger is often a natural side-effect of weight-loss dieting. And although contemporary American culture enforces conformance to the thinness norm for everyone, historically, hunger suppression aids like Obetrol have largely been targeted at women. Having a large appetite is seen as decidedly unfeminine—think about the social pressure for a woman to order a salad versus a burger or a steak on the first dinner date with a new potential partner.
People eat for many reasons. As Manne describes, hunger “gnaws” at us, urging us and bidding us to eat. Hunger is a normal, non-pathological feeling. And hunger isn’t the only reason we eat. In addition to eating to celebrate, to mourn, to court, and to socialize, we eat simply because some things taste good. Eating is enjoyable! Thinking about food is not a normatively-charged act. It doesn’t deserve moral judgment, and especially doesn’t deserve blame.
There probably are pathological ways to think about food. A Health.com article claims that some obese people experience “excess” food noise, and specifies that the term refers to “obsessive or intrusive thoughts about food.” As someone who suffers from OCD, or obsessive-compulsive disorder, I know first-hand that obsessive and intrusive thoughts can be highly disturbing and unpleasant. And I don’t want to minimize or undermine the claims of anyone who has disturbing, obsessive thoughts about food. But the phenomenon that many users of the term food noise are describing doesn’t seem to me to be thoughts of that kind. They seem to be normal thoughts about hunger and eating. Thinking “I like tacos a lot and want to eat them” often doesn’t seem pathological to me; it seems like a normal thought of someone who likes tacos a lot and wants to eat them often. Similarly, thinking “What should I have for dinner” while one is having breakfast, or “I should stop and buy some granola bars on this hour-long drive” doesn’t seem pathological. It just seems like some of the normal thoughts of a person who enjoys food and eating.
Why is the medicalization of eating and feeding bad?
The medicalization of eating and feeding is bad for at least two reasons. The first is that it normalizes medical interventions that are physically damaging or even fatal. It’s easy to balk at interventions like prescribing amphetamines or jaw wiring to induce weight loss, but bariatric surgery has steadily increased in frequency since at least 2011 (with the exception of 2020, the pandemic shutdown year). The procedure’s mortality rate has decreased from a high of 1% in a 2007 study, but complications like gallstones or gastroparesis occur in up to one-fifth of patients. And though new weight-loss drugs are being touted as safe, users can experience gastrointestinal issues resulting from their use. Semaglutide-based drugs like Ozempic and Wegovy work by increasing hormone levels that signal fullness to the brain, but they also slow down digestion. This can lead to side effects like nausea, diarrhea, vomiting, constipation, and cramping. And the long-term effects of these drugs are currently unknown.
The second reason the medicalization of eating and hunger is socially bad is because it stigmatizes non-pathological thoughts and behaviors surrounding food. This is bad for everyone, and particularly bad for fat people. A bevy of research continues to provide evidence that fat stigma and fat shaming exist. Fat people are bullied in school, have a harder time finding work, and make less money. They do worse at finding romantic partners. These effects are compounded for women and sexual minorities, and especially queer women, who tend to have higher rates of non-conformity with respect to the thinness norms of Western culture (compared to heterosexual women). The medicalization of eating and hunger further stigmatizes fat people because medicalization alleges that not only are eating and hunger symptoms to be treated, but fat people are failing to treat them. The social stigma of failing to intervene on one’s fatness is further supported by the notion of the “good fatty”, someone who is fat but is trying to lose weight. The notion of a good fatty exists because social norms view someone who is trying but failing to lose weight as having better moral standing than someone who is fat but doesn’t try to lose weight. Medicalizing eating and hunger further entrenches these social norms. It’s easy to imagine doctors saying things to fat patients like, “Why aren’t you on Ozempic? It’s safe and effective.” In other words, why aren’t you a good fatty?
In sum, “food noise” pathologizes normal and healthy behavior around food. That’s bad for our society, and it’s bad for fat people. It stigmatizes one of life’s most basic pleasures: eating. Ozempic and Wegovy are only the latest in a long history of medical interventions on weight. I think that as a society, we should be working to discard the notions that these medical interventions are medically necessary and that fat people are morally blameworthy. But I fear that discourse around “food noise” only reinforces these claims.
The Women in Philosophy series publishes posts on those excluded in the history of philosophy on the basis of gender injustice, issues of gender injustice in the field of philosophy, and issues of gender injustice in the wider world that philosophy can be useful in addressing. If you are interested in writing for the series, please contact the Series Editor Alida Liberman or the Associate Editor Elisabeth Paquette.
Madeline Ward
Madeline Ward is an Assistant Professor of Philosophy at Western New England University. She works on feminist and anti-oppression philosophy, and has published on fat oppression in the Kennedy Institute of Ethics Journal and the American Medical Association Journal of Ethics. More of her work can be found atwww.madelineward.com.”
