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food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling, why it is not the same thing as nausea-driven aversion, and what its return may signal.

14 questions · sorted by votes

58 votes 3 answers37k views
Hair started shedding at month three. Does the timing tell me whether it is the drug or the weight loss?

Started tirzepatide in February. Nothing unusual until early June, when the shedding started, and it is now substantial: handfuls in the shower, hair on the pillow,…

hair-loss
hair-loss

Telogen effluvium following rapid weight loss versus a drug-attributable effect: the timing signature that distinguishes them, protein and…

14 questions
nutrition
nutrition

Eating on a suppressed appetite: hitting nutritional targets inside a small energy budget, micronutrient risk, meal structure, and what the trial…

92 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
protein-intake
protein-intake

Protein targets in grams per kilogram, per-meal distribution and the leucine threshold, and the evidence for a higher intake specifically during…

53 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by nadia_kowalczyk 14k · 2.0 years ago
53 votes 3 answers33k views
What is "food noise" mechanistically, and which brain regions is the drug actually acting on?

The phrase "food noise" is used constantly and I have never seen it defined precisely. My own experience of it was extremely specific and I would like to know what it…

food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
ecnoglutide
ecnoglutide

A long-acting GLP-1 receptor agonist with a cAMP-biased signalling profile. A niche tag, mostly used for mechanism questions about biased agonism…

14 questions
asked by forty_units 14k · 22 months ago
45 votes3 answers17k views
Why did my interest in alcohol disappear alongside the food noise, and what does that overlap tell us?

I started semaglutide for weight and something I did not expect happened: I stopped drinking, more or less by accident. I was on four or five drinks most evenings for…

food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
asked by mala_venkatesh 21k · 8 months ago
45 votes 3 answers17k views
How do I tell whether I am eating less because of reduced reward drive or because I am subtly nauseated?

Eight weeks in on tirzepatide and I cannot work out which of two things is happening, and I think it matters. Version A: my appetite drive is genuinely reduced, food…

food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
asked by pierce_count 15k · 15 months ago
40 votes3 answers15k views
Food noise came back at month seven. Is that tolerance, and does it mean the dose has to go up?

Months two through six were the quietest my head has been about food since childhood. Around month seven it started coming back, and now at month nine it is maybe 40%…

food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
dose-escalation
dose-escalation

The decision to move up a step: what evidence supports a four-week interval, what happens when you compress it, and how trial protocols handled…

88 questions
plateau
plateau

A stall in progress: distinguishing adaptive thermogenesis from measurement error from adherence drift, how long to observe before changing…

35 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
ecnoglutide
ecnoglutide

A long-acting GLP-1 receptor agonist with a cAMP-biased signalling profile. A niche tag, mostly used for mechanism questions about biased agonism…

14 questions
asked by ivo_paunovic 15k · 2 months ago
39 votes 5 answers28k views
How do I tell vomiting from an energy deficit on 1,000 kcal a day?

Details up front: vomiting · 1,000 kcal. I have a result I cannot explain, and I would rather diagnose it than guess. I have checked the obvious explanations and…

fatigue
fatigue

Tiredness on treatment: how much is energy deficit, how much is dehydration or electrolyte drift, how much is genuinely drug-attributable, and…

38 questions
nutrition
nutrition

Eating on a suppressed appetite: hitting nutritional targets inside a small energy budget, micronutrient risk, meal structure, and what the trial…

92 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

36 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by siobhan_deasy 16k · 2.4 years ago
38 votes 5 answers40k views
What is a sensible monitoring routine for dulaglutide over two weeks?

Stated plainly: dulaglutide · two weeks. I am trying to build something sustainable rather than something thorough that I will abandon. I have already decided the…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

284 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
plateau
plateau

A stall in progress: distinguishing adaptive thermogenesis from measurement error from adherence drift, how long to observe before changing…

35 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by coldpack_88 37k · 2.1 years ago
20 votes 5 answers28k views
What fraction of loss on liraglutide is lean mass according to REDEFINE-1?

The specifics, since they change the answer: liraglutide · REDEFINE-1. I have the document in front of me and I can read the numbers. What I cannot do is interpret…

lean-mass
lean-mass

Lean body mass as measured rather than assumed: what DEXA, BIA and air-displacement plethysmography each actually estimate, the body-composition…

164 questions
muscle-loss
muscle-loss

Loss of contractile tissue during energy deficit: what fraction of total loss is lean mass, why the commonly quoted figures are measurement…

82 questions
dexa
dexa

Dual-energy X-ray absorptiometry: what it measures, its precision limits, why hydration state and scan positioning move the numbers, and how to…

84 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by lucia_marchetti 18k · 17 months ago
20 votes 5 answers4.2k views
If food noise returns, is that tolerance or a plateau?

Scale weight, waist circumference and a repetition maximum, all logged weekly. I want to know whether this is a real physical effect or an artefact of how it is…

food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
plateau
plateau

A stall in progress: distinguishing adaptive thermogenesis from measurement error from adherence drift, how long to observe before changing…

35 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
orforglipron
orforglipron

A non-peptide, orally bioavailable small-molecule GLP-1 receptor agonist studied in the ATTAIN programme. It is not a peptide, which changes…

14 questions
asked by label_claim 11k · 3 months ago
17 votes 5 answers13k views
What fraction of loss on survodutide is lean mass according to PIONEER-4?

The case in front of me: survodutide · PIONEER-4. I would like to know the limits of what can be inferred from this. What I am trying to avoid is over-reading a…

lean-mass
lean-mass

Lean body mass as measured rather than assumed: what DEXA, BIA and air-displacement plethysmography each actually estimate, the body-composition…

164 questions
muscle-loss
muscle-loss

Loss of contractile tissue during energy deficit: what fraction of total loss is lean mass, why the commonly quoted figures are measurement…

82 questions
dexa
dexa

Dual-energy X-ray absorptiometry: what it measures, its precision limits, why hydration state and scan positioning move the numbers, and how to…

84 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by Dr_Ilse_Vandenberg 78k · 19 months ago
13 votes2 answers14k views
Is early satiety a side effect or the mechanism working?

No other medication changes, no dietary changes, nothing else obviously confounding. I want to know whether this is a real physical effect or an artefact of how it is…

gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by otto_brenner 19k · 12 months ago
10 votes3 answers12k views
How do I hit a protein target when appetite suppression is severe?

I would like to know what to measure as much as what to do. I am trying to do this correctly the first time rather than learn it by getting it wrong. I have already…

protein-intake
protein-intake

Protein targets in grams per kilogram, per-meal distribution and the leucine threshold, and the evidence for a higher intake specifically during…

53 questions
nutrition
nutrition

Eating on a suppressed appetite: hitting nutritional targets inside a small energy budget, micronutrient risk, meal structure, and what the trial…

92 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by unit_math 13k · 18 months ago
6 votes5 answers20k views
How do I tell vomiting from an energy deficit on 800 kcal a day?

Details up front: vomiting · 800 kcal. I have a result I cannot explain, and I would rather diagnose it than guess. I have checked the obvious explanations and…

fatigue
fatigue

Tiredness on treatment: how much is energy deficit, how much is dehydration or electrolyte drift, how much is genuinely drug-attributable, and…

38 questions
nutrition
nutrition

Eating on a suppressed appetite: hitting nutritional targets inside a small energy budget, micronutrient risk, meal structure, and what the trial…

92 questions
electrolytes
electrolytes

Sodium, potassium and magnesium during reduced intake and GI losses: what the symptoms of a shortfall look like, when a panel is worth drawing,…

36 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
asked by siobhan_deasy 16k · 20 months ago
5 votes 5 answers2.9k views
How much of the effect is delayed gastric emptying versus central satiety?

This matters because it predicts what a related molecule should do. I keep seeing this stated as a fact with no explanation attached, and unexplained facts make me…

glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
food-noise
food-noise

The reduction in intrusive, appetitive thinking about food that most people on the class describe. Its likely basis in central GLP-1R signalling,…

14 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
asked by Dr_Colm_Fitzhenry 85k · 6 months ago
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