Food noise: Are you constantly thinking about food?

Having breakfast and already wondering what to eat for lunch? You might be suffering from food noise. — HASSAN BAHRI/The Star

When you hear the term “food noise”, you might imagine the sound of someone chewing loudly. 

However, it actually refers to the constant mental preoccupation with food – what to eat, when to eat and how much.

According to Universiti Teknologi Mara (UiTM) consultant endocrinologist Prof Dr Rohana Abdul Ghani, food noise is a medical term used to describe persistent thoughts about food, even when the body isn’t physically hungry.

Understanding this phenomenon begins with the physiology of hunger, which is regulated by hormones such as ghrelin and leptin.

Ghrelin, often called the “hunger hormone”, stimulates appetite by signalling that it’s time to eat.

Meanwhile, leptin, known as the “satiety hormone”, signals fullness from our fat cells to the brain, letting us know that we have eaten enough.

These hormones work together to regulate food intake and body weight, explains Prof Rohana.

While everyone experiences hunger, some people are more affected than others.

“After six hours without food, a growling stomach is a normal response,” she explains.

“But food noise is different: you may have just eaten and still feel compelled to reach for dessert, or find yourself planning your next meal long before it’s necessary.”

This ongoing mental pull toward food is what experts refer to as chronic hunger, or food noise.

Understanding the journey

Constantly thinking about food can lead to impulsive eating and make it harder to maintain healthy habits.

This is especially challenging for those managing weight or eating disorders.

While diet and other lifestyle changes remain the foundation of weight management, additional tools may be required for some individuals.

One such approach is pharmacotherapy – the use of medication to support weight loss when lifestyle changes alone are insufficient.

Masters student Ayyub Muhammad Amirulhusni Alshukor is one such individual who has had to use pharmacotherapy as part of his weight-management journey.

“Initially, I joined a weight-management programme at the UiTM Health Centre for seven months, with monthly doctor visits and structured lifestyle guidance,” the 25-year-old says.

During the programme, he lost about 10kg.

However, within three months of completing it, he regained 5kg, which he attributes to lapses in motivation and self-management.

Before treatment, Ayyub weighed around 119kg.

Later, under Prof Rohana’s supervision and with the introduction of weight-loss medication, he lost 20kg and has maintained that weight loss since.

His most recent check records his weight at approximately 90kg.

Prof Rohana shares a general strategy for managing patients’ weight.

“The first step is understanding the patient’s journey,” she says.

“In Ayyub’s case, he was relatively slim in adolescence, but gained significant weight over time.

“We explore underlying factors, including hormonal issues, and establish a baseline through body-fat analysis and other tests.”

The next step is intervention, beginning with diet and lifestyle modifications.

Ayyub now combines medication with mindful choices – opting for roasted foods over fried options, and treating sweets as occasional indulgences rather than daily habits.

He also incorporates regular physical activity, including gym sessions twice a week, walking or cycling with family members, and practical dietary changes such as adding vegetable soups to meals.

“These adjustments allow patients to manage their weight without feeling deprived,” Prof Rohana says.

“That sense of sustainability is crucial.”

A multi-pronged approach

Being overwhelmed by food noise – where you are always thinking about what to eat even when you’re not hungry – is one of the factors that can make it hard to control your weight. (This visual is human-created, AI-aided)

Medication is never used as the sole tool for weight management.

Prof Rohana emphasises that comprehensive support is essential.

“Our weight-management programme includes clinical psychologists, physiotherapists and physicians,” she says.

“Obesity is complex and multifactorial.

“A one-dimensional approach does not work.”

It was only after Ayyub experienced weight regain following lifestyle interventions alone that medication was introduced as an additional support.

“The goal is to empower patients to understand that obesity is not a failure of willpower,” Prof Rohana explains.

“It is a disease influenced by factors such as stress, sleep deprivation and social environment.”

Beyond weight loss, Ayyub has seen marked improvements in his metabolic health.

His glycated haemoglobin (HbA1c) level, once in the pre-diabetic range at 6.2%, has fallen to 5.6%.

“That was a life-changing moment for me and motivated me to take control of managing my weight,” he says.

He has also noticed improvements in sleep quality.

“I used to snore a lot – my parents were the ones who noticed,” he says.

“Now my mum says I haven’t snored in a long time.”

The medication serves him as a supportive tool to sustain his lifestyle, helping him maintain progress and work toward long-term health goals.

“Ultimately, I am more motivated by a desire to be healthier for myself.”

His stamina has improved significantly, allowing him to participate more easily in everyday activities.

Reducing food noise

Clinical data shows that certain weight-loss medications can significantly reduce food noise.

One such medication is semaglutide, which mimicks the actions of the naturally-occurring hormone glucagon-like peptide-1 (GLP-1) that helps regulate blood sugar and appetite.

It does this by stimulating insulin release, suppressing glucagon and slowing gastric emptying – all of which contribute to increased satiety and reduced hunger.

According to Novo Nordisk Malaysia general manager Dr Praful Chakkarwar, semaglutide has demonstrated strong results in both clinical trials and real-world studies. These include:

• A 46% reduction in food cravings
• More than 20% weight loss in one in three individuals
• An 84% reduction in fat mass in targeted areas
• A 20% reduction in major adverse cardiovascular events (MACE), including heart attack and stroke.

Additional benefits include improved mobility, increased energy, enhanced emotional well-being and better overall quality of life.

“These improvements allow individuals to engage more fully with their work and family,” he says.

Not all eligible

Not everyone is suitable for pharmacological treatment however.

Clinical guidelines recommend the use of medications for individuals with a body mass index (BMI) over 30, or over 27 if other weight-related illnesses are present.

“Drug therapy must always be an adjunct to lifestyle modification,” Prof Rohana stresses.

“Medication alone is not effective without dietary changes and physical activity.”

BMI classifications also differ between populations.

Universiti Malaya honorary consultant endocrinologist Prof Emeritus Dr Chan Siew Pheng, explains that while the World Health Organization (WHO) defines overweight as a BMI of 25-29.9 and obesity as 30 or above, lower thresholds are used in Asian populations.

In the Asia-Pacific classification, overweight is defined as a BMI of 23-27.4, while obesity begins at 27.5.

“Using WHO criteria, about 54% of Malaysians are overweight or obese,” she says.

“With Asian-specific thresholds, that figure rises to 70%.”

She explains: “This difference exists because Asians, especially South Asians, tend to develop health issues, like diabetes, at lower BMIs due to higher body fat percentages.

“As a result, lower thresholds are recommended for Asian populations to reflect their health risks better.”

Pricing for weight-loss medications varies depending on the provider and distribution channel.

Dr Chakkarwar notes that pharmaceutical pricing typically decreases over time as access expands.

Prof Rohana, who is also the president of the Malaysian Obesity Society (MYOS), says the organisation is advocating for obesity treatment to be recognised and reimbursed within the public healthcare system.

“Obesity is still viewed as a lifestyle issue, rather than a disease, so it is not covered,” she says.

“We want to highlight to the government, policymakers and insurance companies that investing in effective, but relatively expensive, medications earlier will prevent far costlier complications in the future.”

The doctors and Ayyub were speaking at the recent launch of the injectable semaglutide in Malaysia.