Jim Hill:

Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:

And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

Jim Hill:

Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:

Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

Jim Hill:

Ready for the “And” factor?

Holly Wyatt:

Let's dive in.

Jim Hill:

Here we go. Holly, today we're diving into a topic that's getting a lot of attention. Have you heard of food noise? It's something that many people struggling with weight management deal with, and yet it's only recently being recognized in the scientific community.

Holly Wyatt:

Yes, Jim. Lots of people are talking about food noise. And I've really been looking forward to this conversation because we do hear about it from so many people. And I think a lot of people would like to know a lot more about it. And what is the science behind it? And it kind of got started, but what does it really mean? And a lot of people talk about constant thoughts about foods and cravings, or they talk about food calling their name. But I do think it's a real challenge for people. And for many of them, food noise may be one of their biggest barriers to their long-term success in weight management.

Jim Hill:

Exactly. And that's why today we have the perfect guest to help us unpack this topic. Today, we're joined by Dr. Corby Martin. Corby is a leading expert in ingested behavior, weight management, and health promotion. He's at the Pennington Biomedical Research Center, one of the really places that is exceptional at weight management research and Corby's conducted groundbreaking research on food intake, appetite regulation, and how new technologies like mobile health interventions can help manage their weight more effectively. And Holly, he has developed the very first way to actually measure food noise. And this is very exciting. So Corby, welcome to Weight Loss And.

Holly Wyatt:

Yeah. So Corby, I have so many questions for you, especially how you can measure food noise. But before we dive in, can you tell us a little bit about your journey in this field? And for our listeners who may not be familiar, can you explain what human phenotyping is and why it matters in weight management?

Corby Martin:

Two great questions. Yeah. So I ended up in this field via my graduate training. I'm a clinical psychologist by training. And during my doctorate, I was treating and developing a research program on eating disorders. And I took a keen interest in binge eating disorder which is a condition characterized by overeating and binge eating without compensatory behaviors.

So obviously, it's associated with very heavy BMI. A lot of people that struggle with that condition are living with obesity. And that really led me to the weight loss arena. And I became keenly interested in really trying to dissect the variables and traits that really affect what we eat, how much we move and exercise, and things that ultimately affect our energy balance or our tendency to gain weight or lose weight over time. Now, linking that to human phenotyping. Human phenotyping is really a fancy term that we developed or we have in the scientific field to very comprehensively assess an individual's traits and characteristics that affect things like how they react to food, how they react to exercise, and allows us to identify both physiological or biological conditions or traits that may affect their body weight in the future and their current body weight. But it also allows us to measure psychological traits or behavioral patterns or dietary intake patterns that also affect our future weight gain and our current weight. So it's really a critical component, and it's the key to unlocking personalized medicine. Because for us to better deliver interventions and have them be much more effective, we have to personalize them to the individual. And we can do that via comprehensive phenotyping.

Jim Hill:

Wow, fantastic. Well, thanks, Corby. So let's start with some basics. What is food noise, and why is it such a big deal now?

Corby Martin:

Boy, food noise is currently white hot, right? It's all over in the media. We hear about it all the time.

Jim Hill:

Everybody thinks they know what it is. You're going to tell us what it really is.

Corby Martin:

Exactly. Yeah. So food noise has really hit the media hard in large part because of these new GLP-1 medications that, as you know, were used to treat things like diabetes and obesity. And when people take these medications, they reported that their food noise stopped and their thoughts and desire to consume foods really went down. And so the term was kind of coined in the popular media, perhaps even before a scientist could define it. So since it has become apparent in the media, we have taken a really methodical approach to defining it. There's a really nice article by a group out of Penn State that first published on food noise, and they reported that food noise seemed to be this kind of heightened sensitivity to food cues in the environment. And we very much believe that is true, but when we did surveys and talked to people that report food noise, they reported that it's kind of this constant chatter and constant thoughts about food, and critically, those thoughts about food occur even in the absence of food cues. So I don't need to be seeing a fast food sign or smelling a cinnamon roll to have food noise. It can come out of the blue and it's really persistent and is really intrusive.

Holly Wyatt:

Yeah, and I think you can have food noise and be full. Yeah, which I think is a really interesting thing.

Corby Martin:

It is, Holly. And that gets to one of the other really important aspects about food noise is that people that experience it report that it really limits or impedes their ability to make healthy behavior change. So it's this constant, intrusive thoughts about food that makes following a healthy diet really quite challenging.

Jim Hill:

So do we know that? Do we have data to show that food noise is actually linked to maybe a worse dietary pattern or overeating?

Corby Martin:

That is the million-dollar question. So again, this is a new area, but in our development of the food noise questionnaire, and I did just post a link to the article here in the chat, and you can share it with your listeners if you wish. But in our article, we validated this survey. It's called the Food Noise Questionnaire. It's a very brief five-item survey that is very easy to administer, and it's free. Anyone can download it and utilize it in their clinical research or in their clinical delivery in, say, a weight loss clinic. So we're really anxious for people to use it. But what we found in that article is that the people that we would expect to have higher food noise did indeed have higher levels of food noise per this questionnaire. So what I mean by that is say people who were trying to diet on their own, they reported higher levels of food noise. Women reported higher levels than men. And so we're starting to see a pattern that we might expect. But critically, we don't yet have all of the research that we need to know if it's predictive of weight change or how food noise might change during a diet. We're pretty sure what happens to it during GLP-1 treatment based on subjective reports, but we need objective studies to study that as well. So more research to come, Jim, to answer that question.

Jim Hill:

Holly, this is a great example of the importance of science. To really understand food noise, you have to measure it. So we've been out there talking about it and how important it is without actually being able to measure it. So the first critical step, now that we can measure it, and kudos to Corby for putting it out there, everybody can go out and figure out some of this stuff.

Holly Wyatt:

But Jim, I also want to point out how this shows the bidirectional kind of real-world data and then going back into the science world because we really wouldn't be measuring this if it wasn't for real-world saying, I went on these GLP-1 drugs and suddenly I realized that the way I think about food isn't normal. Right? If you think about, if all your life had a lot of food noise, you think that's the normal baseline. You think that's what everybody feels. Suddenly we had drugs that I believe took away this food noise for a lot of people and people went, whoa, if this is how other people feel, I get it. There's something different about me, which then prompted science to say, let's go measure it. So I think it's both direction.

Jim Hill:

Holly's always said, Corby, we need a drug that helps people who don't feel food noise to fill it so they know what it's like.

Corby Martin:

Yeah, that would definitely create some empathy as well, right? We really need to walk a mile in another person's shoes, correct? To kind of truly understand these things.

Jim Hill:

Great point.

Holly Wyatt:

And I would also say that I don't think the GLP-1s are the first medication that have helped with food noise. I think they've done it in a way, you know, bigger way, really shut it down maybe in more people and all of that. But I've never been on a GLP-1, but I have been on other medications because I struggle with my weight. And I noticed that when I was on it, that I didn't think about food all the time. And that really got me thinking, okay, my ex-husband, who I don't believe had as much food noise, you know, I was like, you wait, you don't know what it feels like to think about cookies 24-7, you know, when they're in the cupboard. So I'm glad we're now doing some science behind it, because I do think it's important.

So what do we know about the brain's role in food noise? How does it differ from hunger? Maybe that's maybe where to start.

Corby Martin:

Well, that is a really good place to start, exactly, Holly. So we know that when people report hunger, and we know that when we define hunger in the purest term, it's really a drive to consume energy, whether it be energy in foods or in beverages, and it's not really energy from specific foods. So it's really this drive to consume calories and this drive to consume food. And we generally believe is to really fulfill this physiological need of deprived energy within the body. So if our body has burned all of our energy during the day and we need more fuel to keep our body going, hunger is the lever that our body pulls to make us consume more food so we can continue to function and be active and whatnot.

Now, when we talk about these other constructs like food noise, it's not necessarily tied to this physiological need. And so, it's this constant chatter about food. It's not really tied to physiological hunger. And they critically appear to be different but related constructs or related traits. So, they're not totally distinct, right? They do kind of correlate a little bit together, but they are different. And the other thing that I want to mention is that we should pull in other constructs from the appetite literature into this conversation. And I mentioned this because one thing that we're starting to hypothesize is that perhaps food noise functions in a similar way to say food cravings or food preferences, which is really desire and drive to eat specific types of foods or certain foods, right? So if a person has a craving for ice cream, what they're really telling us is that the only thing that will satisfy that craving is ice cream. Conversely, if a person reports just a great deal of hunger, their hunger could be satisfied by any number of food. It's really a matter of energy consumption. So this is really an area where the research needs to go, is to determine whether or not food noise kind of reacts to, say, dieting and so forth in the same way as other constructs like food cravings.

Holly Wyatt:

We haven't talked as much about food noise, but when I'm doing cravings and hunger and talking with some of my patients, I'm like, if you'll eat a dry chicken breast and broccoli, if you're like, yes, you're hungry. But if you say, no, I don't want that, but I really want the chocolate chip cookie, that's more craving type.

Jim Hill:

Corby, this is fascinating. We talk about obesity being a complex result of environment and genes and so forth. But you wonder, back before, I don't know, in the early part of the 20th century, was food noise there or was food noise created as a consequence of this environment we've created where food's everywhere?

Corby Martin:

That's such a good question. Yeah, Jim, you and I agree, I think, on this. The current food environment and also physical activity environment is not normal, right? We did not really evolve to really necessarily do well in today's environment where we don't have to be physically active to make a living, at least for most of us. And we're in this very rich food environment where food is abundant. Much of it is processed to be shelf-stable, but also be extremely tasty, right? Our food is very tasty. We're no longer eating just a slab of meat cooked over a fire with maybe a baked potato without many seasoning and whatnot. So we're in an unfair environment, as I think we would probably agree. And I think that that environment has probably contributed to the development of some of these food cravings and things like food noise.

Jim Hill:

See, I think that is fascinating. How much of this is sort of the cause of obesity versus how much is the consequence of obesity? I think a lot of the comorbid conditions or the conditions associated with obesity might not have been there to cause the obesity. They might be the result of this period of being obese. And we know that's affecting every organs and it probably affects the brain quite a lot too.

Corby Martin:

Very true. Yeah. And I think that our current food environment, it's unique at all levels. And what I mean by that is that, again, most of us have very easy, ample access to sugar-sweetened beverages, to donuts, to cakes, to savory foods as well. But we're also exposed to a culture that really glorifies chefs and fine dining and also things like value at say certain fast food restaurants. So there's this entire segment of society that is really I think driving us to over consumption which kind of makes sense right because of course these these organizations probably make more money the more the more we consume. But I think that has really probably distorted our relationship with food into an unhealthy framework.

Jim Hill:

Wow. So many more questions, but I want to now focus on some things that might be relevant to people that are listening. People that are on GLP-1 medications are thinking about it. From what we know, Corby, does the disappearance of food noise, does that stay disappeared with chronic use of the medications? If somebody's going on, can they anticipate that maybe the reduction in food noise is a permanent characteristic of being on the meds?

Corby Martin:

That's a good question. Yeah. So we need more research to know for sure. And so I'll try to draw a parallel with some of the appetite literature. And so we do know that when people are on these medications, such as GLP-1s that are very powerful, they have this dramatic reduction in appetite and food cravings and food intake. And that appears to be pretty well sustained at least over say eight or 12 weeks or so. So we can assume that individuals who are on those medications over the long term will indeed retain that benefit. Now, after three or four years, we need more data to know for sure, but I think it is an expected outcome that we anticipate seeing as more research is conducted.

Jim Hill:

[But it's pretty clear that if you stop the meds, the food noise tends to come back.

Corby Martin:

That's probably a safe assumption. Yeah. Again, this is really uncharted territory. We know from the literature that weight is, of course, regained when people stop these medications. Now, there was a very nice recent article that showed that people who lose weight successfully on GLP-1 medications can sustain weight loss very effectively with old school, very affordable medications.

Jim Hill:

I find that fascinating. And I think it really opens the door to there are many tools that we can bring to bear on this. And as you know, Holly and I are very interested in lifestyle things to help people keep the weight off. But it's very tough. When you come off the medications, it's very tough to prevent that weight regain.

Holly Wyatt:

I think you got to have a plan because if you don't have a plan and substitute something else, at least, I think chances are, well, the data would show you tend to regain the weight. So that kind of leads me to this next question.

For the people who think they struggle with food noise, what other strategies beyond the medication do you know that can quiet? Is there anything else that people who maybe either aren't on the medication or coming off the medication could help with food noise?

Corby Martin:

Yeah, such a good question. So I think additional research needs to be conducted in that area to answer it for sure. And so, again, I'll try to draw a parallel between, say, food noise and the appetite and food craving literature. And this is where your listeners should really be empowered to make healthy dietary and other behavioral changes to facilitate decreases with these other appetite measures. And so what we know from the literature and from really nice clinical trials where people come in and they engage in a lifestyle change program to lose weight, or they say go on like a shake-based, very low-calorie diet, we know that when people make those healthy lifestyle changes, that contrary to what they might expect, things like food cravings go down.

And we also know from our work and Tom Wadden's work and other people's work that when people go on these really restrictive diets, say if they're using a shake-based meal plan or it includes a lot of portion-controlled foods, we know that their food cravings and appetite can go down quite markedly. And so one thing that I would really encourage your listeners to do is to think about, say, food cravings or food noise in reverse. And that is that we believe frequently that, say, food cravings or food noise is driving our food intake, but it's also true that what we eat can impact our food cravings and food noise. And so that gives us power to make healthy dietary change and then reap the benefits of, say, decreased food cravings and better appetite regulation. So this is really empowering to your listeners and to people who may struggle with this because it highlights that if they make some changes, they will indeed get these rewards. And that makes it easier to sustain these changes in the future and make other healthy lifestyle changes.

Holly Wyatt:

I love that you're saying this because I think sometimes my patients say, I have food noise, I can't afford the medications. And they just throw up their hands and say, therefore, I have to live with it and kind of take on this victim, not an empowered type mindset. What you're saying is what you eat and the lifestyle you live can impact the food noise, which is great, right? Whether you're coming off the meds or whether you can't be on the meds at all, you can do something about that. So I love that message. Though I want to maybe make clear, because I've seen this out there a lot, that people are talking about foods that increase GLP-1. And while there are some foods that increase GLP-1, my understanding is that the GLP-1 doesn't stay around very long. That's really not the mechanism to go after for what you eat and trying to get rid of the food noise or mimic the GLP-1 meds. Do you agree with that or what have you found?

Corby Martin:

I do. Yeah, I think when it comes to, let's just call it problematic food intake for say a patient or a person out in society, the best approach is to like identify what food is problematic or what pattern of food intake is problematic. So for many of us, we simply eat too many calories at night, right? Between 4 or 5 p.m. and say 9 or 10 p.m., many of us consume a lot of calories And that's where we might overconsume or we might consume too many foods that maybe are less healthy, like a lot of saturated fat or ice cream, heavy cheeses, things like that. And so it's critical to then target that behavior in particular. So move some of those calories earlier in the day. Schedule a walk after your dinner so you don't sit on the couch and then watch a movie and start to eat popcorn. And so really, again, personalizing the approach that is right for you is really helpful there. And I really like what we're saying here because in this case, you know, biology and so forth isn't as deterministic as we might believe. And so just because I say I really crave popcorn at night, I might view that as really deterministic or as kind of my fate. But what I can do is I can no longer eat popcorn when I watch a movie at night. And then that craving or the desire for popcorn lessens over time. So I'm in control and I'm in the driver's seat of really influencing what my body is kind of trained to crave or to expect during those occasions.

Holly Wyatt:

Yeah, and that feels good, right? That empowerment. I say that feels good. You're not, you know, destined to have these cravings or food noise all of the time. And I say, you know, pay attention to when you get cravings, what foods give you cravings, what combinations of foods. For me, sometimes if I eat a lot of sugar, something with a lot of sugar by itself, I know I'm going to have some cravings in a couple hours. But that's just me. But being aware of that, I think, and then changing it is something that I think a lot of people need to hear, that they can do something.

Corby Martin:

Absolutely.

Jim Hill:

Corby, could there be a downside to reducing food noise?

Corby Martin:

Boy, that is a good question that I honestly, Jim, I haven't really considered.

Holly Wyatt:

Well, look at the meds.

Corby Martin:

Yeah, from the meds.

Jim Hill:

Yeah. You know, for the first time, we're talking about people not eating enough. We've had people tell us, Corby, I forget to eat. It's the end of the day and I forgot to eat. I worry a little bit about that.

Corby Martin:

I do as well. Yeah. So, Jim and Holly, we hear the same thing, right? We might have a visit with a patient at even 3 or 4 p.m. They walk in and we ask how they're doing that day and they realize, “Oh, come to think of it. I haven't really eaten or drink anything today.” And that's a problem, obviously, because we have to have healthy nutrition throughout the day. But critically, if these patients also aren't drinking enough water, they can get themselves in all sorts of trouble. Right? So, yeah. So I think that there could be some downsides to this. And again, that's a really critical area for us to investigate.

Holly Wyatt:

Well, I mean, we think we're saying food noise is bad. But in a different environment, food noise was probably a good thing. And to take it completely away may not be a good thing.

Corby Martin:

Perhaps.

Jim Hill:

Well, now that we have your way to measure it, we can start looking at some of this. So I want to talk a little broadly because you're a big thinker in this area. And, you know, it's like you remember when leptin came along and they told Holly, well, what are you going to do now? What kind of job are you going to get now that we've solved the problem? Same thing is occurring with the GLP-1s. There are a lot of people that say, okay, we've got this obesity thing. People don't have to worry anymore about feeling like they need to go to the gym or eat healthy. How do you see our field handling all this as a guy who really focuses on lifestyle?

Corby Martin:

Oh, of course. Yeah, lifestyle still matters. And I'd love to hear Holly's opinion on this as well. But I think the striking thing about these GLP-1 medications is that they're working through lifestyle change. They're really prompting this dramatic change in dietary intake. And so I think it really highlights the importance of lifestyle change and maintaining that lifestyle change, let's say over years, if the medication becomes less effective for some reason. Or if people need to go off the medication or change medications for any reason, focusing on the sustainment of the lifestyle change is absolutely critical. So this is a big field. There's definitely room for all of us, pharmacologists, physicians, dieticians, behaviorists, but lifestyle is the key. And I think the other thing that we forget in this conversation is really the health impacts of exercise and being physically active.

Jim Hill:

I'm glad you were. I was going to go there next, Corby.

Holly Wyatt:

I was too. I had my question ready, but you knew where we were going.

Corby Martin:

There are dozens and dozens of benefits of exercise, and almost all of those are weight loss independent. So when we view exercise as a vehicle for improving quality of life, decreasing pain, and improving all these other really important disease risk factors, exercise should be paramount, right? We're of course focusing a lot on diet in this talk, given the conversation, but exercise and dietary change and health improvement go hand in hand.

Jim Hill:

You know, Corby, Holly and I talk about, one of the things that's happening with this. The meds coming in being so effective, it's a chance to rethink our measures of success. Is it simply that number on the scale? And if it's the number on the scale, the medications, we've got it solved. But there's more than that. There's fitness and there's mental health. You know, as Holly always says, people come to her and think, if I lose weight, my spouse is going to be kinder. People are going to invite me to parties and all this other stuff. And that doesn't happen with just weight loss. So maybe it's a chance to begin thinking about success as not just a number on the scale.

Corby Martin:

Totally agree. This is about holistic change, right? We need to focus on diet and physical activity and wellbeing and sleep. And I think the GLP-1s and these newer medications, boy, they have been a catalyst and thank goodness they're here, right? It really helps people manage their diet much more effectively, very quickly. But maybe it gives us the brain space to, again, Jim and Holly, focus on physical activity, focus on other areas of wellness that we may disregard, like getting sleep or eating enough fruits and vegetables, things like that.

Jim Hill:

That's exactly what we think, Corby. We welcome them because, again, what we've seen over and over, we're really interested in weight loss maintenance, but nobody was ever getting to the point where they were interested in weight loss maintenance. As Holly says, they would say, yeah, Holly, I'll think about it when I lose another five pounds or 10 pounds or whatever, and they never got there. So I think it's an opportunity. And we, like you, we welcome the medications as a much needed tool.

Holly Wyatt:

Yeah. So just because I'm so glad we have you on, I'm going to switch topics just a little bit, but I would love to hear kind of what role you think the other big area, the gut microbiome, is playing in appetite regulation. That's the other thing I think is really hot right now to kind of try to understand. And the more that we learn about this gut bacteria and the gut environment, how might that be influencing food choices or maybe even food noise? Any thoughts on that?

Corby Martin:

Oh, that is such a good question. And that's an area where we definitely need more research. But akin to food noise, the gut microbiome is also white hot, right? We hear about it all the time. And so what we can glean from that literature thus far is that the gut microbiome, it's absolutely important. It is, of course, related to disease risk factors and health outcomes. But what we're starting to learn about the microbiome is that akin to things like food cravings, it's also dependent in large part upon our behavior. And so what we know is that the gut microbiome has a better balance or a more healthier balance in people that eat a low-fat diet, eat lots of fruits and vegetables, and exercise. And so what it means for us and for the listeners is that akin to other endpoints, we can have more control over our microbiome by engaging in healthier behaviors. And I think that's really important because we all know that in order to change our microbiome, we either change our behaviors or we have to have a transplant, right? If someone else's microbiome that is healthy, and we know what that might entail, it's a little bit gross. But it really lets us remain in the driver's seat and to know that if we're eating a healthier diet, if we lose a little bit of weight, and if we exercise, our microbiome will be healthier, and that should be correlated with these other health benefits that we're going to achieve from that healthy lifestyle.

Jim Hill:

Wow, I agree with you totally, Corby. I see that microbiome is part of metabolism, and metabolism is influenced by the way you live. And even with the so-called microbiome transplants, I'm not sure that's going to be maintained because I think you're going to get back to a microbiome that reflects your lifestyle, your eating patterns, your physical activity. And so again, there's so many things here that we need research to see how they connect together.

Corby Martin:

Absolutely. And I think this is where your podcast and similar venues can really do a service to the community at large to really pick this apart for the listener and to understand what the scientific findings mean. Because most of us interpret them as really deterministic, like we said earlier, where I might feel that my fate is tied to the microbiome that I can't really manipulate. But once I learn the science, I'm going to be like, oh, I can change my microbiome by engaging in these health behaviors. So it really can help motivate me to engage in those health behaviors and then realize the rewards and the health benefits.

Jim Hill:

Well, keep studying this, Corby. We need more information. I don't think there's any question that food noise is going to turn out to be important. We just don't know how yet.

Holly Wyatt:

Well, I want to ask the one thing for the listeners, because there's lots of noise out there talking about the microbiome and saying, take this probiotic, take this supplement, change your microbiome in this way, and it's associated with A, B, C, or D. Are we there yet? Or do we know that? What do you think about that? Because I think people are spending money, they're hearing things. I think it's an important message to get out there.

Corby Martin:

Yeah. Admittedly, I'm not the best expert on the microbiome, but I think this is what I'm hearing, is that I'm hearing that we as Americans, we want the simple fix, we want the fix in a pill, and the microbiome is largely about behavior. Now, obviously, probiotics affect the microbiome. That's well understood because you're really ingesting different microbia. But I think critically, this is really about behavior. And I think that some of these supplements or whatnot may change the microbiome a bit, but to get the most benefit, I think we have to change our behavior.

Holly Wyatt:

Once again, food is medicine, exercise is medicine, right?

Jim Hill:

But it comes back also to something else you mentioned, personalized nutrition. We're going to understand how maybe different diets affect people differently.

Corby Martin:

Absolutely.

Jim Hill:

Hey, Holly, you want to do some listener questions?

Holly Wyatt:

I do, because we had quite a few. And I think there's some really, really good ones. Let me see. We've answered a little bit, but let's do this one and make sure we're clear on this since we had a question about it. Is food noise different from cravings or are they the same thing? I think a lot of people are confused about that.

Corby Martin:

Oh, that's a really good question. They are distinct from cravings. At least that's what we currently conclude from our literature and our research. And the reason that I mentioned that is because this concept of food noise, it's this constant chatter kind of in a person's head about food and what they're going to eat and so forth. And it's really this kind of nagging occurrence that occurs throughout the day. Now, cravings are a bit different in the sense that they're this pretty discreet period where a person has this dramatic drive or desire to consume a specific type of food, right? So they might at 3 p.m. Really have a drive to have a milkshake, and the only thing that is going to satisfy that is a milkshake. And so it's this drive to seek out a milkshake, whereas food noise is this kind of constant chatter about food. It limits my ability to eat healthy, but it's kind of this constant background noise that gets really nagging over time, so to speak.

Jim Hill:

All right. I have one here. Can poor sleep really increase hunger, or is that a myth?

Corby Martin:

Yeah, what we find about poor sleep is that if we don't sleep well, everything is dysregulated. Our mood is negatively affected. We're grumpy. We might be quicker to anger. And so it dysregulates kind of all of our systems, and that can include appetite. So many people might eat less when they're sleep-deprived, but the next day, they might eat a lot more. So it does tend to dysregulate eating akin to other things that sleep disruption disrupts. Yeah, it's really, really not good. We all need to be getting a lot of sleep.

Holly Wyatt:

All right, I've got one. This is another hot area. Does intermittent fasting or timed eating (but really maybe the fasting part, I think, this question was about), help regulate appetite or does it make food noise worse? Is that how it's working or could it make things worse?

Corby Martin:

Such a good question. We know that time-restricted eating actually has some benefits to appetite. That is, it helps us manage our appetite and our eating a bit more, even though people that are doing those types of meal plans aren't specifically asked in all occasions to restrict how much they eat. We find that they still lose about two to four percent of their body weight, however, pretty reliably. And this is critical for us to understand, right? It means that people who are trying to eat, say, early in the day and stop eating by, say, 4 or 5 p.m., All they're being asked to do is to eat within that window. So they may be asked to eat between, say, 8 a.m. And 4 p.m. or 8 a.m. and 5 p.m. But during that time, they theoretically can eat whatever they want. We find that they lose a little bit of weight. And so by extension, their appetite is being a bit better controlled. Importantly, those time-restricted eating paradigms, you know, they tend to allow us to eliminate eating from parts of the day that are frequently pretty challenging for us, especially the evenings and night. So it's a really blunt message, right? You have to stop eating by four or five. That includes things like alcohol or sugar-sweetened beverages. And so it means that you're kind of giving yourself license to not go out to eat or not go out to drinks with your colleagues after work. And so that could also really be part of the effect that we see on both appetite and things like body weight.

Jim Hill:

I think, though, Corby, different people may do better or worse with that. I'll give you an example. My wife and I both tried intermittent fasting and time-restricted feeding, and she's not overweight. I have no problem with it. I can do it. I do time-restricted feeding. It's no big deal. She hated it. She said, there is no way I can do this. Back again to personalized approaches to things. Maybe it would affect us the same, but there's no way she was going to be able to do it, and I could do it.

Corby Martin:

Totally agree. Yeah, going back to that phenotyping comment earlier, right? What is driving things for individual people? And once we know that, then we can better personal treatment. You're exactly right, Jim.

Jim Hill:

Wow. Holly, are we ready for vulnerability questions?

Holly Wyatt:

Sure, let's do a couple.

Jim Hill:

You want to start?

Holly Wyatt:

I can start. Let me see. I wrote one down. All right. So, Harvey, have you ever personally struggled with food noise or appetite regulation? And if so, how did you manage it?

Corby Martin:

Of course. Yeah. I'm human and I live in the environment that the rest of us live in. And actually it's worse. I live in South Louisiana which is…

Jim Hill:

Oh yeah. Lots of food noise there.

Corby Martin:

Lots of food noise down here. Yeah. So this is a food culture. There's a lot of festivals and Mardi Gras season. So to many of you, Mardi Gras is a day, right? It's Fat Tuesday. For us, it's like two months of pink cakes and really savory food. And so, I happen to have been born in 1972, which is when a lot of sweeteners were being added to our food. So I really like sweet things. I admit that. And king cakes and things like cinnamon rolls are a problem for me. And so I have to manage the environment if there's a king cake. So a king cake is basically a Mardi Gras thing that we have down here where it's basically a big, huge cinnamon roll with very nice icing. And it's like two feet in diameter. It's huge. And they're in everyone's house. They're in all workplaces. So if there's a king cake in my vicinity, I really struggle not to eat too much of it.

Jim Hill:

Wow.

Corby Martin:

If we have a king cake in the house, I ask my wife to just bring in a little bit of it because otherwise I will overeat it. Yeah.

Jim Hill:

So one question we ask a lot of our guests, if you could go back to the time you were just starting as a young scientist, which isn't that far back for you, what kind of advice would you give yourself?

Corby Martin:

Yeah. I think it's to really, you know, give ourselves some forgiveness and not take everything too seriously. And I think that also applies to things like making dietary changes. And so if a person is trying to follow a certain dietary approach, and they slip a little bit, it's okay. It's better to acknowledge the slip and get back on track as soon as you can. But you know, it's okay for me to have a little bit of king cake, it's obviously not the end of the world. We can't take everything so seriously. We have to have a sense of humor about some of these things.

Jim Hill:

I love it. Before we end here, Corby, talk to the people who are listening that are struggling with food noise. And I think they've learned a lot here. What's the future going to hold for them? Give them some optimism that as we learn more about food noise, how that's going to actually help us really help people manage their weight better.

Corby Martin:

Oh, for sure. Yeah. So we have ongoing research to identify what happens to food noise during various lifestyle change programs, also during things like bariatric surgery, and also, of course, during pharmacotherapy for weight loss. So what those studies are going to do is going to help us understand what existing tools that we already have in our toolbox have the largest impact on food noise. So that means that many of us who are currently, say, going through a lifestyle change program to manage our weight and to be more active, we could find that those types of programs have a very good effect on food noise. We might find that to have the biggest effect, you may need some certain kind of pharmacological compound. So we think we already have a lot of tools and treatments in our toolkit that can effectively, at least partially, help address food noise. We just need a bit more research to find out what has the biggest impact for certain people.

Jim Hill:

And my guess is this is going to move pretty quickly, that we're going to be putting some of these into practice sooner rather than later.

Corby Martin:

Absolutely.

Holly Wyatt:

So while they're waiting for this research to come, and it's great to know that that's what you're studying and you're measuring these things, and we're going to get some answers, but let's leave our listeners with something that's actionable. We always call it pie in the plate instead of pie in the sky, it's coming, but pie in the plate. So what's one small change that they could make maybe today that you think might help regulate their appetite or food noise or support their weight loss journey maybe?

Corby Martin:

Absolutely. Yeah. So I think during my training, a physician that I worked with said to, he always said, wherever there's smoke, there's fire. And so I would use that metaphor here. And that is for people to sit back and think about the one dietary behavior or other health behavior that they're just most concerned about. Say it could be drinking too much alcohol in the evening. It could be consuming dinners that are too big or consuming too many sweets. And to really focus on that behavior in isolation and start to chip away at it. So let's use the king cake example. So I really like to have some king cake for dessert. And if I feel that's problematic and is unhealthy for me, each night I would have a little bit less. And when I felt that I could, I would swap it out with something that was also sweet, like some fruit or something similar that is going to be healthier, but will really kind of like fulfill my sweet tooth. So I like really isolating those things, then chipping away at them sequentially over time, because that makes the big behavior change and big dietary change that much easier because doing a little bit incrementally each and every day.

Holly Wyatt:

Yeah, love it. What a great pie in the plate, something you can do. Sometimes I do think people think too broadly. I've got to do all these things. You're saying, let's think about one thing and then take it and chip away at it. Great, great advice.

Jim Hill:

Well, Corby, this has been awesome. Thanks for sharing your experience with us. We're going to put the link to the food noise questionnaire on the website, Holly. So can people at home sort of go on and take the survey, Corby?

Corby Martin:

They can. Yeah. So the link will be there to download the article and the article tells you how to score it. And then again, the actual food noise questionnaire is in the supplemental material, which is a link at the bottom of the webpage where you can access the article.

Jim Hill:

Cool. So find out where you land on the food noise scale. And as always, send us in questions that we can ask our guests. So Corby, thanks for joining us and thanks to all of our listeners and see you next time on Weight Loss And.

Holly Wyatt:

Bye, everybody.

Jim Hill:

And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:

If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

Jim Hill:

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Holly Wyatt:

And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.