You're listening to Food is Food, the podcast that will support you to ditch diet culture, break free from food rules, and debunk nutrition misinformation. I'm your host, Talia Chiquelli, specialist eating disorder dietitian and founder of the TC Nutrition Clinic. If you would like to learn more about our one-to-one nutrition support and group program, or download your free portioning guide, head to wwwtaliachely.com. Each week we will cover topics that delve deeper into nutrition, intuitive eating, psychology, diet culture, and the consequences of under-eating. Our relationship with food is so complex and is influenced by our thoughts, emotions, and life experiences. Which is why healing from disordered eating is about more than just food. Welcome back to Food is Food. I am delighted to welcome Eva McMahon, a KORU and HCPC registered dietitian specializing in relationship with food, body image, and inclusive nutrition care to the Food is Food podcast today. Ava has extensive experience across bariatric care, GLP1 support, and weight management services. And these are some of the topics that we are going to be discussing today. Eva's approach is centred on lived experience, validation, and evidence-based nutrition. She has also very recently launched her own podcast inside bariatrics. And you can find more about Afa and where she offers support in the show notes. Welcome to Food Is Food. Thanks for having me on, Talia. Ah, you're very welcome. I'm so excited to talk to you today about a couple of really big topics that are very prevalent in the media at the moment, which are around GLP1 medications and also weight stigma, because we know that that's so prevalent in the area that you and I both work as eating disorder dietitians. And from my experience, a lot of people that I'm working with have a pressure to consider the use of GLP1 medications, and that's in addition to the pressure that majority of us already feel about changing our body shape and size. So I thought, Eva, to start, could you explain what GLP1 medications are and how they work?
SPEAKER_01Yeah, they're everywhere. They're at the moment, they're just absolutely everywhere. Technically, I suppose GLP1's glucagon, like peptide one medications, mimic a hormone in the body, a hormone called glucagon. And this hormone is involved in blood sugar regulation, it's also involved in normal appetite regulation. And so originally we saw GLP1 medications being used for blood sugar management in diabetes, and still is. And at the time, weight loss companies were noticing that some people would lose some weight on these medications. So they decided to kind of look into that further and shift some of these medications into weight loss land. Um they also kind of whacked up the dose as well to see if there was any impact in terms of weight. So I suppose one of the things I'll say is for the purpose of this episode when I'm talking about these GLP ones, unless I kind of say otherwise, it is in the context of weight loss and not referring to when they're being used for diabetes. But I yeah, I remember actually previously being approached by when I was working in bariatric surgery in the past by a drug company representative, and they were talking about a medication at the time. It's not part of the current iterations of these drugs, but it was it was Saxenda, some people will be familiar with that one as well. And that drug just the weight loss wasn't significant enough for it to be pushed onto the market or for it to be accepted by the market, and the injection was needed to be taken every single day. So then when it shifted to a medication where the weight loss was then deemed as being more significant, sometimes it was being likened to approaching to bariatric surgery level kind of weight loss outcomes, and also the injection only being needed to be taken at once a week. You can see why that became quite a bit more attractive then, and there was a lot of heavy marketing as it started out. These drugs are absolutely everywhere. Um yeah, so I suppose that's where we're at now. But when you think about GLP1s, it's it's thinking about an artificial appetite suppressor, but there are other effects as well.
SPEAKER_00I think a lot of people don't understand that they have been around for a couple of decades now, used in the diabetes management space. So it's very new that they've become as popular as they have over the last 12 to 24 months. And you said something really important there is around the marketing, and there's a lot of celebrity involvement in marketing these drugs, especially in the States, and that's really influenced their popularity and how people are able to access them. So if we think about GLP1 medications as a weight loss tool, are you able to explain, AFA, how it does influence the human body and how it leads people to eating less?
SPEAKER_01Yeah, yeah. So there's a couple of ways that GLP1s, when it comes to the impact of the body and then resulting in weight loss, as I mentioned, one of them is a dampening of the appetite, kind of appetite suppression and feeling fuller sooner. And there's also a slowing of the digestive system as well. And so when food is moving through your digestive system more slowly, then that can have a knock-on impact to how full you might feel. Another one is that it can alter the pleasure that you experience from food. And with GLP1 medications, there's also anecdotes and more evidence out there that these medications might have more far-reaching impacts to pleasure and satisfaction even more broadly than food. It's kind of beyond the scope of what I can talk about, but just to acknowledge that as well, it can also have an impact on food pleasure. And, you know, as human beings, pleasure, satisfaction, fullness is something, these are important mechanisms for us on a day-to-day basis to support nourishment on our body, which our body runs on, it runs on food. It needs food. We need it every single day. So it's quite significant the effects that these drugs can have. But again, also just to say that it the impact from person to person varies. So some people can experience these things quite significantly, and other people can experience them to a much lighter degree.
SPEAKER_00And I think it's important to say that both of us have and do support people using GLP1 medication. So we are not anti-GLP1 medication. However, what we really want to talk about today is the safe use of GLP1 medication, especially in the context of disordered eating and eating disorders. Yeah. So we know that all human bodies are so different and they're going to respond to medications differently, just like anything, antidepressant medications, even paracetamol. And so we know that GLP1 medications do have some significant side effects for some people. Are you able to share for what you've noticed with those side effects and people that you've supported?
SPEAKER_01Yeah, and just to reiterate what you're saying as well, my approach, and I think we'd probably be quite similar, is it's very high autonomy approach. I'm not someone who is making you take these medications and I am not forcing you to stop these medications. And I think it's really important that people feel in the driving seat of their care. And part of that is sharing information about these drugs and why doing a podcast like this can be really helpful with that as well. In terms of how this can show up for people who are on the medications, I think it's really worth, if possible. I mean, I started off by saying again that these drugs are everywhere. So I do know people in my life personally that are on these medications. I think many people listening will feel similar as well. If there is someone that you know that is comfortable sharing their experience of being on these GLP bonds as well, it can be a very sensitive topic. So if you have that relationship with them, I would encourage you to listen to the real experience of people on them and how it affects them as well. Because it's all sometimes through listening to someone actually on these medications, you can start to really get a sense of how someone can experience these medications. But as I said earlier, it's it's quite wide-ranging. A lot of people do experience the impact to the appetite and their drive for food, and in some cases, it can be it can be quite severe, you know, and I and I do want to mention that because some people are getting to the point where they're not actually hungry enough to eat meals. And as a dietitian, as someone who works in nutrition, that's something that I'm really tuned into because the human body needs food every few hours to sustain you, to keep you happy, to keep you well, to keep you functioning, and being the person that you deserve to be, showing up in the world as. And so for some people, the appetite suppression can be incredibly severe for the food uh pleasure as well. Some people can experience kind of changes in the foods that they desire. And also, kind of again, when we're talking about the spectrum, sometimes it can be to the point of food apathy where some people don't have that interest in food at all, and again coming back to the body and what it needs on a day-to-day basis, and how food pleasure is involved in getting those nutrients that the body needs when someone is feeling food apathy, and if the appetite is coming down to a point where they're struggling on a day-to-day basis to have meals every day, then that can be a concern. At the same time, I just want to, I suppose, take a step back and say that for some people, and this is some people that you know I work with, it's also in the literature as well. We know that people who are drawn to take these weight loss medications are fed up of living in the body that they're living in, or they're sick and tired of feeling out of control with food. They feel like they either eat too much or eat too little, or they just can't get a control over it. And so these GLP1 medications, as the promises appetite suppression, body control, that you'll just eat less and that everything will be fine. It's a really attractive, simple solution for someone who is experiencing that. And then if someone takes the medication and whether they're hoping to lose weight or where they're already losing weight, it can become a real, I suppose, challenge to navigate experiencing that weight loss, experiencing the change in how the world is interacting with you, or maybe clothes that you were able to buy that you haven't been able to buy more recently, the comments that might be being made on your body, or the hope that that will happen, versus okay, I'm actually not feeling hungry enough to feed myself during the day. And so people are finding themselves in that situation, kind of experiencing those coinciding things.
SPEAKER_00I think definitely for me, especially as an eating disorder dietitian, is that I am going to be really cautious about is someone eating enough to maintain their nutritional well-being whilst taking GLP1 medications? And then within that, we know that as a byproduct of eating less, it can mean that there are certain nutrients such as protein that can be difficult to meet nutritional requirements just from the fact that someone's eating less, so therefore their overall diet in terms of their nutritional intake is going to reduce protein and getting enough energy for nutritional well-being, uh, two of the really key nutritional areas that I will talk to people that I'm supporting about. And then the other part is sort of maintaining muscle mass because with reduced energy intake, we want to really ensure that that muscle mass is protected. Are there any other areas or anything else that you wanted to add on sort of the key nutritional and lifestyle considerations that we should be really focusing on prioritizing whilst on GLP1 medications?
SPEAKER_01Yeah, I and I would agree with you as well that with these medications and with the weight loss that might be experienced, it's similar to when I used to work in bariattic surgery as part of the bariac surgery work-up, and that you're talking about after this surgery, you're going to have a significantly decreased ability to consume food. And so these are your nutritional needs based on that, and that the importance of protein to maintain your muscle mass. I've also started to incorporate talking about, because this is in the research as well, that sometimes it's not possible to eat enough protein now to mitigate the amount of muscle loss that's going to be experienced while on these drugs. And sometimes it's not possible to exercise enough to again mitigate the amount of muscle wastage that's going to occur on these drugs. And this is in the research as well. And sometimes when there's this expectation of your appetite is going to be quite decreased, but then you also have to have a almost like a diet transplant where you were following food that you might have really enjoyed, or was easy or accessible, or you've got a busy life, and this is how you're able to nourish yourself, and then all of a sudden that's actually not accessible, or maybe the amount that you can have at any given moment isn't the same that you may not be able to meet those nutritional needs. It can be a challenge. It is a real conversation worth having about what that is actually going to look like for a person. Because for some people it's possible, there's also a risk of food obsession there as well, potentially, becoming obsessed with enough protein intake to mitigate this medication-induced muscle loss or becoming obsessed with exercising enough. And if someone has gone from a place where, again, people who are considering these drugs might be in a place where they're feeling out of control around food, they can be across the body spectrum, but they may not have that obsession around exercise or macronutrient contents. And so to start talking about these things as well, it's there's a lot in this GLP1 conversation and then a lot that's worth being spoken about, worth space being held for because at the end of the day, no one's going to be going through this GLP1 medication use except for you, the person who's taking it. And any kind of changes that are going to be experienced, it's going to be you that's at the the end of that's going to be experiencing them. So that's what I always kind of come back to kind of broaden out this is these are the types of things we were talking about, and then bring it back to the person. What have you noticed about yourself in the past? What kinds of things are realistic for you? This is the potential with these drugs. Does that fit?
SPEAKER_00Thank you for bringing that up. It's so important, and I think it really highlights for me. I see GLP1 medications as it's a tool in the toolbox for some people. And ultimately, what we're trying to support as nutrition professionals is also that foundational work of those lifestyle changes and how they fit into a person's life around the GLP1 medication use. And what I mean by that is your nutritional pillars, eating enough, eating a balanced diet, from a relationship with food perspective. We're also thinking about food enjoyment and multiple reasons why a person will eat, stress levels, movement. There's all of these so many complicated layers to consider when someone is using GLP1 medication. And I think these are the things that we really need to explore when someone is considering GLP1 medication, is in terms of the relationship with food, is it something that we can focus on alongside GLP1 medication use, or is it thinking about doing a bit of that foundational work with relationship with food and then bringing in GLP1 medication as an additional tool? And this is where it's, you know, I say this all the time, but it's so important to have that individualized care, especially in this area where, as I said, there's multiple factors and multiple layers that we need to consider.
SPEAKER_01Yeah, definitely. It's always coming back to the person and also it's coming back to the potential intervention that they're looking at or support that they're looking into relationship with food support, GLP1 support, and the information that's available on those kind of treatments.
SPEAKER_00Sadly, where I see GLP1 medication being misused is, I mean, this again, I was just going to say one thing and then more came into my mind where I'm thinking about how easily accessible it is, which means that some people are accessing the medication when clinically it wouldn't be indicated. So for example, I've worked with some people with clinically diagnosed eating disorders who are under a healthy weight for them. That temptation has been there from the eating disorder self to purchase GLP1 medications, which can be extremely harmful. And I also think that another part of that is due to health inequality, where some people are able to access these medications, other people aren't. And then the other layer that's just come to my mind is also thinking about the societal sort of pressure to be in a certain shape or body size, people believing that they're over a healthy weight when actually they may be very much a normal healthy weight. Yeah, I guess they're the three sort of things that came to my mind. So Ifra, I was thinking it would be helpful maybe for us to talk about weight stigma and that health inequality piece in the context of GLP1 medications.
SPEAKER_01Yeah, I think it's it's a big topic, and you've named a couple of things there. For people that I'm working with, I suppose initially when we're talking about access to these medications, like what we said at the start, they've been marketed, they've been pushed out into the world before it's kind of been fully supported by healthcare systems. We don't have those systems in around supporting people to access these drugs. So a lot of people at the moment quite easily are finding them outside of the healthcare system. And that means that there aren't people there to monitor physical health, which is something that, again, is kind of beyond what I'll focus on today, and then also the impact to their nutrition long term as well. For people accessing these outside healthcare, I would argue that it's people in all shapes and size bodies, not just people who are weight suppressed, and a lot of people as well may have a relationship with food that's really challenging or really distressing, may fall into a DSM criteria for an eating disorder. But the majority of people who have eating disorders go undiagnosed. And so there are people who are accessing these drugs who it may not be clinically indicated for, who have diagnosed eating disorders, who don't have diagnosed eating disorders, or who are in every single body shape and size. And regardless of, I suppose, what body you're in, your body needs nourishment, needs regular nourishment every single day. And the the real risk for someone who may not understand they have an eating disorder and who may access these drugs because they're feeling in that place that they might provide this simple solution. And if they're coming from this place where the GLP1 is kind of being brought into the fold of a bigger picture of an eating disorder, in terms of malnutrition risk, appetite suppression, it can happen and happen for anyone. And it's it's almost like there's a term that I came across kind of unintentional or unexpected anorexia, where you seek this medication, maybe even thinking it'll help with your health, or thinking it, you know, from a there's various reasons why people will seek this medication, and then they can find themselves in a situation where it's either making an eating disorder worse that they may already have had, or it's shifting their their relationship with food before their eyes, and it was not an intended consequence at all going into accessing the drug. I'm not sure. I realize I kind of went on a different pendant because there's just so much to talk about when it comes to these medications, but yeah.
SPEAKER_00No, I think that that's so important, and it just reminds me of when we think about how eating disorders show up in a person's life, is that it's that perfect storm, isn't it? So someone might have a pretty good relationship with food, or maybe, you know, slightly engaging in some disordered eating. And then I guess what I'm hearing is it's similar to sort of further restricting the diet, it's the same as maybe starting a GLP1 medication where it's just that last piece of that storm that can then influence a person's relationship with food more significantly. And even if we put GLP1s out of the equation, this is what I also see really commonly in my clinic is a lot of people will just start to eat healthily, and then that you know further develops into something more extreme. So I'm really glad that you brought that up because it's definitely not a person's fault, and it definitely is not their intention for their relationship with food to shift. However, because of how the GLP 1 medication. Works for some people that can have a negative impact on their relationship with food.
SPEAKER_01Yeah, 100%. I think the perfect storm analogy is a really good one to compare it with.
SPEAKER_00Where I think about the inequalities to access GLP1 medication as well is thinking about the strict criteria in the NHS or HSE where where you're an island. And also for those that can't access the public health system, the medications as they stand are quite expensive to access them outside of public health care. So I think until the medications are regulated, then there's always going to be a divide in people that can access GLP1 medications, which are for many people absolutely life-changing in a really positive way, and those that aren't able to access these medications.
SPEAKER_01For some people in the short term, these drugs can feel amazing and life-changing. And what we see from the research so far is they fall into this kind of similar pattern to previous weight loss medications. We've had weight loss medications actually for over 50 years now. And there's a reason why ones in the past don't still exist is because they just don't stand the test of time. The two hurdles that they tend to fall at is putting themselves out onto the market before they're actually deemed safe and before they actually are deemed that they work long term. And so we have had weight loss medications in the past pulled because they are not safe long term. With these GLP ones, although they've been in like the diabetes sphere for, as you said, for a while, the weight loss sphere, the doses are increased. And so we don't know the long-term effects of taking these medications for your health long term. And I think we owe it to ourselves to kind of put that back on the drug companies and say we need to know the long-term health effects of these things and put it back on research and healthcare as well. And then the other thing is whether they actually work. And you mentioned kind of that they can be this miracle drug, and sometimes people can get on with them really well. At the moment, they're so new. Most people are going to be getting on with them. We're in the kind of honeymoon period. People who have experienced bariatric surgery know this honeymoon period of the kind of one to two years after people have had surgery. That's when you're looking at the graph of the weight. It kind of has that downward slope, it's coming down. And there's the positive reinforcement from people around. We have with GLP1s, the celebrities talking about taking it, all of these different types of things. So everything's positive, positive, positive right now. There are mumblings and grumblings that is going on, but right now we're in this honeymoon phase with these medications. And for me, as an evidence-based practitioner, what I'm most interested in is in the evidence. And for these GLP1s, the longest research that we have at the moment is four years. And for that four-year research, what we see is the downward slope for the weight loss, showing that in that kind of one-year mark, that people can lose weight, and then it steadies out. And when initially looking at that research, it looks quite positive. And we're quite conditioned as a society to see weight loss and kind of run with it. So we see evidence of weight loss and kind of assume that that will work long term. But with this particular research, the dropout rate was astronomical. So there was an 89% dropout rate from that piece of research. And that's significant because people are basing their thoughts and expectations based on 11% of the population that this is tested on long-term, long-term being beyond two years. When we're looking at weight loss research, when we're looking for long-term outcomes, it's beyond that two-year mark. And for GLP1s and for weight loss in the past, as a society, we've done this before. We've seen the two percent that can lose weight, or the 10% or whatever it is. We have researchers back again as far as the 50s at least, showing that there's a small percentage of the population that with an intervention will lose weight and keep it off long term. But the statistical majority will regain their weight. And so far, again, keeping with being an evidence-based practitioner and just looking at the evidence that's in front of me, the evidence isn't there to show that it works long term. And with weight, the typical pattern is like what we call the Nike tick of weight loss research. You'll be familiar. So there's that initial kind of weight loss, and then weight regain can happen. And the other conversation around these drugs is that the majority of people do stop taking these drugs for various reasons. Again, we don't know the full ins and outs because that population is not researched well. But if you start a GLP1 today, you are statistically highly likely, more than 50% likely, to not be on it in a year's time. And people, people who are considering GLP1s haven't arrived at this decision light. They've often tried to diet for years or tried various things for years to manage their weight or control their body, control their food. This can, again, like I've said before, it can be really inviting. And at the same time, what we see from the research is that the most likely pattern is that you'll start the drug, likely come off it, or even if you do stay on it. We just we don't have the reason. I'd love to be able to fill in the blank there. I want to be able to fill in the blank. It's there's only there's only 11% of the population that we have that data on. What's happening in the other population? How's their relationship with food? Do they feel like they've just been tossed out again by another diet, another weight loss medication? So yeah, there's a lot of questions around the effect. I have a lot of questions around whether this drug actually works long term.
SPEAKER_00Yeah. And the fact that it's not regulated to me is a red flag within itself, just how accessible it is. Yeah. Given these statistics, is really worrying. Really worrying. And thank you so much for sharing that research because it's so important when it comes back to someone having that informed decision and knowing what the likely outcome will be. And ultimately, what you're saying, and what's so important for people to understand, is that we just don't know the long-term impact. We know that it's, you know, what we're seeing is that people are regaining weight if they stop the medication. That's more of an outcome than not, isn't it? Yeah. Ultimately, we're we're not sure how it impacts a person's relationship with food. And in our area of work, that's just so important. Yeah. When we think about that long-term nutritional well-being.
SPEAKER_01Yeah. I I don't know, when I was preparing for or getting my thoughts together kind of for today's podcast, I was thinking about different people that I've worked with, and there's plenty, and I'm sure you're the same, where lots of people listening, lots of people that I work with are either considering these drugs, feeling the pull for these drugs, or they may already be taking them. There was one patient that I was working with who had patterns of binge eating restriction. She was in a bigger body, she had a really challenging relationship from childhood, was never diagnosed. I was the first person that she was seeing, and it was later on in life. I was the first person she was seeing for her relationship with food. And she had just been prescribed a GLP1 by an endocrinologist a few months prior to me seeing her. And what happened was she would try one GLP1 medication, it didn't have an effect. She would stop. The restriction, the binging continued. She'd kind of almost tried to harness the impact of the GLP1, but find that it wasn't long-lasting. Then she'd try to stop for a while. And then because her appetite had been restricted while she was on the GLP1 somewhat, the appetite came back with a vengeance when she went off. This reinforced the idea that I need to be on a GLP1. I can't control food when I'm not on it. And so she sought it in other ways as well, or tried other GLP1 medications. This is another thing that we're seeing. People will try one medication, it may not work. And so they're seeking another and another. And the weight loss companies themselves are kind of capitalizing on this and making combinations of these drugs and GLP1s on top of one another. And but for this particular patient, she was then in a place where she was on like the third different brand of GLP1. Her weight sometimes was going down, sometimes it wasn't, it was fluctuating. Her relationship with food got to a point where it was actually far more complicated than it had been prior. And I just thought it's not everyone, and there will be people listening. As we said at the start, everyone has a very different experience of these drugs, but the experience that's spoken about now is the honeymoon experience. And I do think it's important to name other experiences that can happen on these drugs. And if you are not experiencing what you expected, that you're not alone and that it's it's very real and we're seeing it more and more.
SPEAKER_00Yeah, I had one person recently who it was a combination of diabetes management and living at a higher body weight that was impacting her physical health.
SPEAKER_01So her Sorry as well, you just reminded me the GLP one, even though it was prescribed by an endocrinologist, it was primarily for weight loss rather than diabetes management in that patient. Sorry.
SPEAKER_00Yeah, no, that's good. I was just thinking, I was like, which other example can I use? One of my clients that was on it for both sort of indications, and she absolutely hated it, and she really wanted to stop because she experienced really terrible side effects that made her feel really sick. However, there was such a pressure for her to continue on them from the diabetes perspective that she continued taking them even though they made her feel so awful, and it's just such a such a confusing area for people where there's this push and pull between this is what maybe one of my healthcare team is recommending, but I'm feeling really awful, but I do want to lose weight, I do want to control my diabetes, but it's making me feel so awful, and it's just such a difficult position that a lot of people are in that push and pull.
SPEAKER_01Yeah, a hundred percent. Speaking of this kind of theme, I had a patient who again was in a bigger body, and she's done a lot of, she did a lot of work herself. She's a very scientifically minded person, and she did a lot of her work herself on weight inclusivity, intuitive eating for like 10 or 15 years, and she actually pulled herself out of quite severe binge eating, which is amazing. And what she started seeing me for was pre-diabetes, and she was really worried that it would develop into diabetes. So we did a lot of work on the stigma and then around this, and that medication is actually really important for diabetes management and being able to access medication to manage your blood sugar levels is really important. And she ultimately then went on to be recommended a GLP1, primarily for the purpose of managing her diabetes, and it was even for someone who was so solid in her recovery, and she was concerned she did not want to go to a place where she noticed her appetite was being decreased or her weight was changing, and that this triggered desires to control her weight or control her food. She was so conscious of that. She has, I'm glad to say, managed when I was chatting to her last successfully navigate the GLP1. And while she was on the GLP1, her weight has changed, and just like previous changes in her life, she has had to kind of say, okay, that that is happening. And at the same time, the most important questions are Am I well? Is this serving me? How do I feel? Is this helping me manage my blood sugars? How's my relationship with food? And so being able to do that and bring it back to that. But this is someone who is so experienced, and still it was an incredibly triggering place for her. And I can only imagine for people who maybe don't have that background of working on their relationship with food to that extent, and then they're in a clinic and they've been diagnosed with diabetes, and then there's these recommendations, or if they come in with a non-weight related thing and it's not to do with diabetes, and they still get recommended these GLP ones, you can understand how it can lead into that perfect storm that you were talking about earlier.
SPEAKER_00Yeah, and we see so much weights to go in healthcare. The example that you just gave people going to see a healthcare professional not for weight loss advice, and then that being taking up most of the appointment and then being recommended to lose weight, even though if you looked at all of the clinical outcomes, their health is in quite a good place. One of the phrases that comes up, and maybe this is something that we we sort of finish up with today, is the phrase food noise. So if you know, for you and I working in eating disorders, food preoccupation is something that we talk about all the time. And since the rise of GLP1 medication, the phrase food noise has really taken off in social media land in particular. I'm just wondering if, in your experience, there is a difference between food preoccupation and food noise. Is it a marketing term? Or yeah, like are you able to tell us more about that?
SPEAKER_01Yeah, I first started hearing the term food noise in 2023 alongside the rise in these medications. And I have a lot of people who use their experience of their relationship with food or use this term to describe how they think about food and how they feel about food. And so, first of all, I kind of want to say that if you experience food noise, that's completely valid. I was speaking about this with another dietitian recently because she's doing a lot of work in research in around food noise as well. Food noise, when we're looking at it and when we're peeling back the layers and kind of understanding what food noise is, it's not something biologically that we've noticed that people tend to have more at birth or less at birth or things like that. It tends to be people's description of hunger, and people can have various forms or various intensities of hunger and thinking about food, planning food, worrying about food, trying not to eat. These are the things that we notice when we're asking someone what does food noise mean to you? Because it can mean different things to different people, but for the most part, it seems to describe that, and that's quite similar to what we would see in eating disorderland, and what we would would raise a flag of okay, is there food preoccupation there? Because with food noise, and when I mention the term hunger, a lot of a lot of the time when people are experiencing food noise, they're experiencing extremes of, they're very familiar with extremes of hunger and extremes of fullness, and maybe less familiar with gentle forms of hunger and gentle forms of fullness, and there's various reasons for that. A lot of the time it can be a disconnect or with the body, a mistrust that their body can tell them when they're hungry or when they're full. There's not that belief and felt safety that, okay, throughout the day, my body's gonna give me gentle hunger cues and gentle fullness cues, and I'll kind of eat and stop eating. There's not that trust there. And people are finding themselves in a situation where they're more and more connected with the extremes. And this is where we would see a lot of people, if you are listening and if you are finding like you're more connected with the extremes of hunger and fullness than the gentle hunger and fullness throughout the day, it may be an indication that you might benefit from support with your relationship with food or considering your relationship with food, because while food noise describes that, the proposed solution to food noise is a GLP one. And for some people, as we've mentioned before, potentially helpful, but for some people, especially when there's a bit of the I'm coming back to the storm analogy again, thinking of the clouds coming in, if there's something going on already, then that can add to that. And where if you have someone who's struggling with the extremes of hunger and fullness, I mean, I work with people like that all the time. I'm sure you do too. The work that you can do with someone, the progress that someone can achieve, people say, like, I don't think I can ever trust my body to tell me I'm hungry or to eat according to my hunger cues, and then to come to a place where people mention the word peace, calm, easy, quiet, quiet. So there are more options out there. If you're experiencing food noise, there's the option out there of GLP1. We've spoken about what my thoughts are, what our thoughts are today. There are also other options out there, and considering your relationship with food and potential support for your relationship with food is also an option. And like what you said, Talia, earlier, if you're considering both, you can also come to someone, a dietitian that works with relationship with food, because we work with people who are considering these drugs all the time, are on these drugs. And like what we said at the start, our job is not to take them from you or to make you have them, but it's to create a space where to support you to reflect on these drugs in the context of whether it's serving you and particular focus on the relationship with food, relationship with your body, that kind of thing.
SPEAKER_00Yeah, absolutely. I couldn't agree more. And I think it's really important to I just want to add as well, similar to what you just said, how many people I've supported that have had food preoccupation and food noise, and through healing their relationship with food, through learning about nutrition, what foods serve them best, they have been able to quieten and overcome that food noise and food preoccupation. I think you summarized our podcast really well. Ultimately, what we're really saying is to reflect on if GLP1s or working with a dietitian to heal your relationship with food andor both are going to serve you because ultimately it's what's going to work best for you. Well, thank you so much for joining the podcast today, Ava. I'm going to include all of the links on where people can find you in the show notes. And excitingly, Ava has just launched her own podcast. So I will include the link to her podcast, which name it is? Thanks, Talia.
SPEAKER_01It's Inside Bariatrics. And as Talia knows, I have actually only landed on that name this week. The aim of the podcast is to talk all about this stuff. It's about bariatric surgery, it's about GLP1 medications. And while there's loads of resources out there about these things, a lot of the time the focus of the resources is ultimately a weight focus outcome. And so with this podcast, I'm hoping to talk about like you, your life, your relationship with food, all of these kind of things. So just the broad spectrum of these medications. And I'm hoping it can be helpful to help people to feel informed. I have no doubt that it will.
SPEAKER_00Thank you so much again, Eva. Thanks, Emil. Thank you for tuning in to Food Is Food. If you found the episode nourishing, hit subscribe so you don't miss our weekly episodes. And just before we wrap up, a little reminder that the discussions in each episode are for informational purposes and don't replace individualized advice. Because every recovery journey is so unique. Please consult your healthcare provider for support. That's all for today. Stay nourished and see you next time.