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ForumsOff-TopicWhat is everyone binge-watching this week — what worked for you? Page 2

What is everyone binge-watching this week — what worked for you?

wanda_boise Thu, Oct 31, 2024 at 8:05 AM 44 replies 2,364 viewsPage 2 of 9
Dr.NutriCornell
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Oct 31, 2024 at 11:49 AM#6
BethLabQueen said:
Alcohol relationship change with food noise: I used to drink cocktails most nights.

Central vs peripheral GLP-1R signaling in food noise: elegant studies using brain-penetrant vs peripherally-restricted GLP-1 agonists show that ~80% of the weight loss effect is centrally mediated[1].

The key brain regions: arcuate nucleus (appetite), area postrema (nausea), NTS (satiety), VTA/NAc (reward). Peripheral effects (gastric emptying, insulin secretion) contribute but are secondary for weight loss.

This has implications for next-gen drugs: optimizing brain penetration and CNS receptor occupancy may be more important than systemic exposure.

References:
[1] Secher A, et al. J Clin Invest. 2014;124(10):4473-4488.
24 19emily_PDX, Dr.SleepRoch, laura_annarbor and 21 others
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BiostatsBrad
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Oct 31, 2024 at 1:17 PM#7
wanda_boise said:
The food noise came back three weeks after I reduced my dose, well before the weight moved, which tells me something about which effect tracks what.

Neuroscience perspective on food noise:

GLP-1 receptors are expressed throughout the CNS, with high density in the hypothalamic arcuate nucleus, area postrema, and — critically — the mesolimbic reward pathway[1].

This is directly relevant to food noise because the central effects of GLP-1 agonists extend far beyond simple appetite suppression. The reduction in "food noise" that patients describe is likely mediated by modulation of dopaminergic signaling in the VTA and nucleus accumbens.

The emerging data on reduced addictive behaviors (alcohol, gambling) further supports this mechanism. food noise should be understood in this broader neurobiological context.

References:
[1] Merchenthaler I, et al. J Comp Neurol. 1999;403(2):261-280.
Last edited: Oct 31, 2024 at 2:17 PM
23 18Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 20 others
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PharmacoVig_BOS
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Oct 31, 2024 at 2:45 PM#8
Dr.NutriCornell said:
Central vs peripheral GLP-1R signaling in food noise: elegant studies using brain-penetrant vs peripherally-restricted GLP-1 agonists show that ~80%…

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

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

22 17DataDave, Dr.GutHealth, amsterdam_pete and 19 others
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PedsEndoPhilly
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Oct 31, 2024 at 4:13 PM#9

Following on from Dr.RaviCardio — and this may be the naive question:

What would you measure differently if you were starting again?

21 16Dr.LeslieOBGYN, MikeNYC_runner and 18 others
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wanda_boise
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Oct 31, 2024 at 11:13 PM#10
PharmacoVig_BOS said:
"Food aversion" side effect of food noise that I wasn't prepared for: I used to LOVE cooking and trying new restaurants.

Phantom hunger vs real hunger on food noise: learning to distinguish between the two has been a revelation. Real hunger: gradual onset, physical stomach sensation, any food sounds good. Phantom hunger: sudden, emotionally triggered, specific food cravings, occurs right after eating.

The GLP-1 agonist suppresses real hunger beautifully. Phantom hunger still pops up but I can now recognize it for what it is — an emotional signal, not a physical need. Mindfulness training helped enormously with this distinction.

Last edited: Nov 1, 2024 at 4:13 AM
25 0ben_calgary, patPC_UT, Dr.DermMIA and 22 others
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