As GLP-1 receptor agonists emerge as effective treatments for weight management, anecdotal reports from patients and clinicians alike point to a reduction in what has been colloquially termed “food noise.”
What is Food Noise?
The journal Nutrients defines “food noise” as constant, obsessive food ruminations that are hard to suppress and can even interfere with daily life. Here are some examples:
- You fixate on what, when, or how much to eat.
- You plan the next meal before having finished your current one.
- You compulsively check restaurant menus or delivery platforms.
- You stress about the perceived consequences of food choices.
- You restrict calories to punish yourself for an intense food craving.
Prior studies suggest that GLP-1 medications can counter food cravings and promote satiety, leading to reduced food intake. This reduction in hunger signals leads to less frequent and intense food noise. Additionally, GLP-1 agonists have been associated with changes in taste perception, potentially altering preferences for certain foods.
While GLP-1s can be a great tool to address the biological hurdles related to food noise, they are most effective when paired with a healthy diet and physical activity.
Why Can’t Patients Eat Much on These Therapies?
These therapies have been known to cross the blood brain barrier and act on the brain to stimulate satiety, which leads to food intake reduction and, consequently, body weight loss, which occurs at the expense of fat mass.2
How Do Patients Avoid Nausea While on These Therapies?
Patients should be advised to:
- Improve eating habits.
- Adapt food composition to their requirements.
- Incorporate light exercise.
- Keep a food diary, as it may be useful to identify foods or meal timings that make it worse.
Is “Ozempic Face” a Thing and How Can Our Patients Avoid It?
“Ozempic face” is a phrase to describe various effects of losing weight in the face, including extra facial skin, a hollowed appearance to the face or the appearance of aging.
Although other semaglutide formulations are not FDA approved for weight loss, the term “Ozempic face” has consumed the media with the medication’s rising popularity. This term is a new purported side effect, used to describe the rapid facial weight loss that can leave a distorted facial appearance. This challenges the healthcare team to discern whether a new adverse effect is a novel or a natural consequence of rapid weight loss.
Facial fat serves a protective function and affects facial aesthetics and elasticity. Weight loss can cause dermatological changes and shrinking because the fat that stretches and cushions the skin is no longer in place. The skin of the face also loses its ability to retract after an episode of rapid weight loss due to reduced levels of elastin and collagen, which are essential for structural integrity.
As a result, people taking any GLP-1 analog may report the following facial symptoms:
- Rapid signs of aging, such as lines and wrinkles
- Loss of fat, which can cause the skin to loosen and sag
- A hollowed-out appearance of the face
- Lipodystrophy, which affects how the body accumulates and stores fat
If a person takes a GLP-1 analog as a prescription medication, they may be unable to prevent facial side effects. However, if these are a cause for concern, doctors may recommend any of the following:
- Reducing the dosage of the GLP-1 agonist.
- Switching to a different medication.
- Drinking 1–2 liters of water every day.
- Improving protein intake (see below).
- Seeing a dermatologist to consider using dermatological fillers.
- Lifestyle modifications to maintain a healthy weight.
Foods to Avoid While Taking GLP-1 Agonists
Eating certain foods while taking GLP-1 agonists may increase the chances of unpleasant side effects. Foods patients may want to avoid or limit include:
- Food and drinks with added sugar such as juice, soda, cakes and cookies
- Refined carbs like white bread, crackers, white flour and white rice
- High-fat foods like pizza, fried chicken and doughnuts
- Spicy foods like hot sauce, salsa and hot peppers
- High glycemic index foods such as potatoes, cereal, pretzels and sports drinks
- Fried foods or foods high in saturated/trans fat
- Beverages with added sugar, such as regular soda, juice and energy drinks
Food to Embrace While on GLP-1 Agonists
Consuming a well-balanced diet is key while taking GLP-1 agonists and other anti-obesity medications. Patients should be advised to build their meals around the following types of foods:
- Lean protein such as fish, chicken, tofu, beans, lentils, chickpeas
- Fruits like apples, lemons, oranges and tomatoes
- Whole grains like oats, quinoa and barley
- Non-starchy vegetables (spinach, kale, cucumbers)
How Much Protein Should be Consumed?
Guidance for daily protein intake while taking a GLP-1 medication is the same as that for the general population.
The Recommended Dietary Allowance (RDA) for protein is a modest 0.8 grams of protein per kilogram of body weight, or 0.36 grams per pound.
Simple Tips for patients to increase protein intake:
- Start the day with protein. Kickstart metabolism with a protein-rich breakfast like eggs, Greek yogurt or a smoothie.
- Snack smart. Choose protein-packed snacks like nuts, seeds or a protein bar instead of sugary or carb-heavy options.
- Incorporate a protein shake. Especially useful post-workout or as a quick meal replacement, a protein shake can help ensure you’re meeting your protein goals.
- Diversify your protein sources. Combine both animal and plant-based proteins to ensure you are getting all the essential amino acids.
Dr. Lohiya earned her medical degree from Kempegowda Institute of Medical Sciences in Bangalore, India. She completed her residency at Baptist Health System and a fellowship at the University of Alabama at Birmingham. Dr. Lohiya is board certified in endocrinology, diabetes and metabolism. She has publications in reputable endocrine journals such as Clinical Diabetes and Endocrine Practice. She is a member of the Endocrine Society, American Association of Clinical Endocrinologists and the American Diabetes Association.
