Hunger – or Lack Thereof

A long-awaited GLP-1 update

photo by Thought Catalog on Unsplash

hunger (həŋ-gər) noun
a: a craving or urgent need for food or a specific nutrient

b: an uneasy sensation occasioned by the lack of food
The small meal wasn't enough to satisfy his hunger.

c: a weakened condition brought about by prolonged lack of food
died of hunger

2: a strong desire : CRAVING
a hunger for success

I’d never heard the term “food noise”¹ before the emergence of GLP-1s, or, rather, before their massive boom in popularity in the latter half of 2023. I’d heard the word “hunger”, of course, and I thought that was what I was experiencing; a near-constant stream of consciousness in which I thought about what I’d just eaten, what I’d eat next, what food I could consume that would, I hoped, satisfy the hunger that simply never seemed to go away.

The food noise

In the three months since I took my first dose of Mounjaro, I’ve been, honestly, shocked by the difference in my inner monologue. It feels… if not quiet, at least not quite, dulled, dampened, muted slightly by the noticeable decrease in appetite.

When people talk about “getting rid of” this “food noise”, there seems to be a generally accepted feeling of relief that comes hand in hand. Indeed, search “food noise” and you’ll find multiple articles telling you how to “quiet”, “get rid of”, or “combat” it.

“I haven’t stopped thinking about food altogether, but I’ve stopped craving it, wishing for it and, in a lot of ways, experiencing it as joyful or exciting.”

What I have yet to see is a robust discussion of how disorienting this sudden shift can be, or how confusing – because I haven’t stopped thinking about food altogether (I still have to eat, after all), but I’ve stopped craving it, wishing for it and, in a lot of ways, experiencing it as joyful or exciting.

And for someone who really, truly, frequently experiences food as both joyful and exciting, this has been really difficult to get my head around. I feel no shame in telling you that I am a big fan of comfort eating.

I eat when I’m anxious and stressed and sad, and it soothes me in a way I can’t quite explain, although I’m happy to try: the feeling of fullness is somehow related to the feeling of being held, of lying next to someone with the solid mass of their arm around you, of sinking into a couch beneath the weight of a cosy blanket.

And to no longer have that, as someone who suffers from depression and, occasionally, anxiety, is, quite frankly, terrifying. How do I soothe myself when this method I’ve used for decades no longer works?!

To be clear, I still try. I sit down with something I used to find deeply satisfying: a butter chicken from my favourite Indian restaurant in Fort Wayne (for which I have to fork out an extra $4 for delivery because it’s too far from my house); a tub of Ben & Jerry’s Salted Caramel Brownie Topped ice-cream; hot toast, freshly buttered (with Kerrygold, of course). But the magic isn’t there.

At best, I eat and I feel… not much at all. At worst, I eat and I am almost immediately besieged by cramping which abates only when my stomach has emptied itself (through the back door rather than the front, which is my one small comfort; I don’t think there’s any end “result” that would allow me to justify regular vomiting bouts).

The side effects

The cramping – and diarrhea, to be absolutely clear – are the only “negative” side effects I feel from my time on tirzepatide (the generic name for Mounjaro, which, technically, is on my prescription, as I get mine from a compounding pharmacy), at least physically speaking. I do think the lack of satisfaction from food is a negative side effect, too, albeit one that has less of an obvious impact on me and my everyday life.

As for the positive side effects, there are some of those, too. In a way, the lack of excitement that comes with food, now, allows me to be more considered in my choices. There’s no urgency, any more, either to my hunger or to my desire to eat something delicious to make myself feel better; even when I feel hungry (and I do; as I said, that hasn’t gone away, although I am still on a very low dose, as my nurse practitioner has recommended we stay on as low a dose as possible for as long as possible), it’s as if there’s now space inside my brain to stop and think about what I’d like to eat, or what I should eat.

Sometimes, I’ll snack on Greek yogurt with peanut butter and a little honey; other times, I’ll have a banana, or a hard-boiled egg (when I think to consider my protein intake which, honestly, I don’t do enough). And look, other times I’ll have a packet of crisps (which I never would have gone for before, so maybe my taste buds have changed, too) or four squares of Cadbury’s chocolate or a bowl of Coco Pops or some toast with Dubliner cheese (and butter, obviously). I haven’t suddenly turned into some sort of perfect weight watcher.

But the new thing is that I’ll then stop eating after the four squares of chocolate, or one bowl of cereal, or two slices of toast – and I don’t feel as though I’m consciously restricting, or having to employ whatever sliver of willpower I’m able to access that day. The new thing is that, no matter what I’m eating, no matter what time I’m eating it at, and no matter when I last ate, I’m not feeling guilty or ashamed or as though I probably shouldn’t be eating that because, for the first time in my life, I know that my hunger has a limit, and that it will tell me when I need to stop eating. Not only will it tell me, but I’ll be able to listen to it.

@rosemarymaccabe

Rosemary on Instagram: "my #ootd for bagels with a friend downt…

The weight loss

Of course, none of these are the things people really want to know, when they ask how you’re getting on, taking a GLP-1. What they really want to know – what I want to know, when I click into people’s Reels and Stories and Substack posts about Ozempic or Mounjaro or Wegovy or whatever name is being given to whatever GLP-1 they’re taking – is how much weight they’ve lost, and how fast.

But truly? This information can also be really harmful, and triggering, to a lot of people who have struggled with their weight, who have struggled with eating disorders, and who continue to struggle with either, or both, of those things. So I’m not going to include it here, for that reason.

I’m not trying to gatekeep the numbers (intentional weight loss is a numbers game, after all), but I’m aware that sharing one’s intentional weight loss can be harmful, and I’m trying to mitigate the further harm that could be done by adding numbers to that. If you really feel you need to know, feel free to drop me a message and I will tell you. Like I said, not gatekeeping.

What I will say is that I’ve lost more weight than I’d expect, based on how hard it’s been. Because it hasn’t been hard at all. I haven’t had to go to bed hungry, or drink a large glass of water “in case I’m just thirsty”, or limit myself to one of something I want to have four of, or, or, or. I haven’t had to do any of that.

I’ve been eating when I feel hungry, and I haven’t been exercising a lot (between the jigs and the reels – that is to say, going home to Ireland and then moving house and trying once again to toilet train Atlas and packing up every single thing we own and booking an AirBnB to move into between houses – I haven’t had a second, honestly), and I probably haven’t been drinking enough water or eating enough vegetables or getting enough sleep. And yet. I’ve been steadily, consistently, losing weight.

It’s not the first time I’ve lost weight. It’s not even the first time I’ve lost this much weight, but what’s different, this time around, is that barely anyone has said a single thing about it. The last time I lost a significant amount of weight, almost 10 years ago now, every time I saw anyone – truly, anyone – who’d ever seen me before, they commented on my body.

This time around, not one single person has said anything, which has been a weird and marked difference. It’s really made me consider who I wanted to lose weight for – was it for myself, or for the external validation of not being considered fat by other people? or for the compliments?!? (there’s not a lot I wouldn’t do for a compliment, honestly) – and how it feels to be smaller if no one else is acknowledging it.

To be clear: I’ve lost a lot of weight, considering it’s been three months and I haven’t been starving myself or exercising obsessively, but it’s the kind of weight loss that means all of the clothes that fit me when I started are now looking a bit sloppy, and all of the clothes that were too small for me when I started are… still too small. So that’s annoying!

I’m also still in the “obese” BMI category, and even though I know that BMI is objectively a terrible way to measure anything, I’m irritated by that, and want to be out of that category so that I can… what? So that I can what? I’m not sure. Feel smug about not being deemed obese (by a measurement that makes no sense and is not useful in determining health or really anything else).

I HAVE A LOT OF COMPLICATED FEELINGS ABOUT EVERYTHING!

And the worst thing? I can’t eat my way through any of them.

ANYWAY. I’m sorry if that was rambling. It’s been a bit of a ramble! I’ll try to do more regular updates, I’m happy to answer any and all questions you might have about this whole thing, and I hope that I don’t sound like an ad for GLP-1s or a cautionary tale against them because this is a medication and any decision we make about going on or off medications, whether for weight or mental health or anything, should be made in tandem with our doctors and no one else. Especially not someone with whom we have a parasocial relationship thanks to Instagram, or Substack, or TikTok (or the internet at large).

P.S. Please send me any and all things you to do soothe yourselves when you’re feeling shitty or anxious (or both), because peshwari naan isn’t doing it for me any more and I truly worry sometimes that, if I have an especially dark period, I’ll struggle to know how to get a little quick-fix dopamine hit to help myself out of it when my one tried ‘n’ trusted method is no longer working.

P.P.S: ROBYN IS BACK!

1. Food noise is defined as “constant and persistent thoughts about foods and eating that were difficult to suppress, to the point of feeling as if their lives revolved around food” – What Is Food Noise? A Conceptual Model of Food Cue Reactivity (2023) Daisuke Hayashi ^1,*, Caitlyn Edwards ¹, Jennifer A Emond ², Diane Gilbert-Diamond ², Melissa Butt ³, Andrea Rigby ^3,4, Travis D Masterson ¹