wanda_boise said:

The thing that changed for me was not hunger, it was that the constant background negotiation about food simply stopped, and I had not realised it was…

wanda_boise said:

...regarding food noise mechanism of action...

To build on this — the mechanism is more complex than "it makes you less hungry." GLP-1 agonists:

1. Activate hypothalamic satiety centers (appetite reduction)
2. Delay gastric emptying (prolonged fullness)
3. Potentiate glucose-dependent insulin secretion
4. Suppress glucagon secretion
5. Modulate reward pathway dopaminergic signaling
6. Reduce hepatic lipogenesis
7. Have direct cardiovascular protective effects

It's a multi-target drug with systemic metabolic effects. Understanding the mechanism helps us predict and manage side effects.

PurityPaulOR said:

wanda_boise said: ...regarding food noise mechanism of action...

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.

wanda_boise said:

The thing that changed for me was not hunger, it was that the constant background negotiation about food simply stopped, and I had not realised it was…

Same experience, arrived at from the opposite direction. Nothing to add that would improve it.

Clinical perspective, offered as context rather than as advice.

"Food aversion" side effect of food noise that I wasn't prepared for: I used to LOVE cooking and trying new restaurants. Now certain foods — especially sweets — literally repulse me.

It's not just reduced appetite; it's an active disgust response. My therapist says this is common and likely related to the reward pathway modulation. It's mostly a positive change, but I do miss enjoying food the way I used to.