Nina Crowley: The Impact of Food Noise on Weight Management

Episode 24 • 29th May 2024 • Weight Loss And ... • Holly Wyatt & James Hill

**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. Welcome to another episode of Weight Loss And, I'm Jim Hill along with Holly Wyatt. Holly, we're going to talk today about food noise. Now, this is a term I heard not that long ago and I'll have to admit I didn't really understand it at first.

But in talking to a lot of people, it's kind of a term that makes sense. And what we want to do today is explore food noise, understand more about it, and maybe what we can do about it. And to help us understand more about this topic, we have a guest today, Dr. Nina Crowley. Dr. Crowley is a dietitian and a PhD health psychologist. She's been working in the obesity care field for almost two decades and she's an outstanding communicator. She really has this ability to take complex research and distill it in simple actionable ways. She worked with metabolic and bariatric surgery patients at the Medical University of South Carolina. And she still lives in Charleston, which is a wonderful place.

If you haven't been there, you need to visit. She now works with Seca, a company that makes body composition equipment and educates health professionals about moving to use body composition metrics for measuring outcomes of their treatment instead of just weight. And Nina is a fellow podcaster. She has a podcast called In the Know with Nina, where she talks to healthcare providers about the obesity care field, body composition, and how it impacts practice. You can find her resources at www.secambca.com. Nina, welcome to Weight Loss And.

**Nina Crowley:** Thank you so much. I'm so excited to be here with you both.

**Jim Hill:** Well, we like to start by learning a little about our guests. So how did you get to where you are and what are you really excited about right now?

**Nina Crowley:** That's a good way to put it. So yeah, I started my training as a dietitian and I landed pretty quickly in the field of bariatric surgery. I absolutely loved the patients, but I felt completely unprepared as a dietitian to really handle the complex behavioral stuff. So I went back to school to get my PhD in health psychology pretty early on.

And so I do always joke with folks. I'm like, the ROI on that may not have paid off, but to be a behavioral-focused dietitian really has been my practice. And I really think kind of combining those skills has been amazing. And so I did that for about 10 years and then got excited about managing our metabolic and bariatric program.

And I did that for another six. And so through all of that, getting really involved with our obesity care community and the different professional organizations. I know you know about the Obesity Action Coalition. That's one that I'm very passionate about working with and staying connected with patients and learning from their perspective. So I think that's a driving force for me in making sure that we're getting better resources to our patients. And now in my role with Seca, it's been really kind of cool to see all of that come together.

I did not think I would be using as much behavioral background in this role. But we're really seeing, as you guys know, this shift away from just using weight as the only way we diagnose and measure treatment. And it's exciting to see providers wanting to talk more about the adiposity where it's located on the body and even more like the muscle mass stuff of talking to people about sarcopenia and the long-term impacts of having low muscle. And so I've been excited to be able to bring that to people and talk to the healthcare providers about how to use that in their practice.

And it kind of overlaps really nicely with patient satisfaction and how they're able to stay connected and motivated for the long term. Because as you guys know, weight is an and conversation. I love the concept that you guys are here talking about because it is nuanced. And we need it in some way, shape, or form, but we need all that other stuff to really kind of keep people motivated for the long term.

**Jim Hill:** You know, Nina, I've worked in my career with a lot of dieticians and it's not uncommon for them to, I think, realize that diet is only part of the answer. And so they go and learn about exercise science and behavior, etc. And I think that's one of the messages we try to get across. It's more than diet. It's more than any one of those. It's really your whole lifestyle.

**Nina Crowley:** I was just going to say, yeah, working with patients over the years, you learn too that you can have the best thing for someone and they have to live and do it every day. And so I think that's also part of it is you've got to figure out how this human is going to do the things that we think might be the best for them and they may not be. So I think that's a good lesson for all of our healthcare providers to really think about.

**Holly Wyatt:** Yeah, I think we always talk about how you can have the best what to do, but if they won't do it or can't do it or really struggle to do it, it doesn't really matter because it's not going to be effective.

But I also love that you're expanding the definition of success, right? It's not just about the weight. We can think about body composition. We can think about other things in addition to the weight, the And. But Jim and I, one thing we really believe is expanding that definition. We've been so narrow, I think, in what success looks like in a weight management journey. So you're fitting right in. You fit right into this podcast.

**Nina Crowley:** Yeah. And I mean, the black and white, our tendency to just go black and white and put something in a bucket, yes or no, all or nothing is just so strong. I think we constantly have to talk about all the gray areas, and the nuance in between them, and take it to the actual person.

**Jim Hill:** Wow, I love it. She's drinking the Kool-Aid, Holly. She believes in what we believe in. So let's talk about food noise. I hear this all the time and I think where it really came out is with the new anti-B-City medications, the GLP-1 agonist. People say, oh my gosh, the food noise has turned off. What, help me understand food noise and tell me how you see it and what's going on here.

**Nina Crowley:** Great. Yeah, I agree. I think it's, you know, just like a lot of things have gotten a lot more press with the anti-obesity medications. As you guys know, working in this field for several years and decades a lot of it has always been there, we just didn't have the platform to talk about it. So I keep thinking about my time in bariatric surgery and how this is stuff that we recognize, but for whatever reason, that was such a smaller group of people or there was just this bias around surgical treatment as an option. But for whatever reason, we have medications now and that's taken the stage. That's let us have a platform.

There's a lot of stuff I would change and I cringe when I see it being represented in the media, but I do think it's bringing to the real public the conversation that we've all been having in our own professional communities for a long time.

**Holly Wyatt:** So I agree. I think this is something that's been there. We've been talking about it, but really this concept and the term food noise have brought it to the brunt. So how do you define food noise? What is food noise?

**Nina Crowley:** So for me, I've kind of conceptualized it. I've done a lot of looking at the articles about it. There's a report that came out from Weight Watchers in Combination with the Stop Obesity Alliance out of George Washington. And I’ve taken kind of all of that together into, for me, it's four domains. So it's timing, content, intensity, and impact. And so I'll kind of go through that. All of the words that they use are important.

So I'm long-winded and a little wordy in this, but I do think that all of these words can help resonate with someone differently. And so for timing, it's thinking about food all the time and it's considered relentless, constant, pervasive, persistent, incessant, and then ruminating or obsessive preoccupation. So that really gets to this. It's intrusive.

It's all around and it's beyond just, what are we going to have for dinner? It's really that relentless nature. And then the constant part of that is you're constantly thinking about what to eat next. And typically that's things like tasty or tempting foods, the things that you desire, the foods that you crave.

Not often are veggies that go on the side of the meal. So the content of the food cravings tends to speak to us from that perspective. These highly palatable foods, typically, in things that we're craving. And then intensity is really, again, it's not that, oh, what am I going to eat next?

What did I bring for lunch? It's these difficult to suppress, excessive thoughts. People are hyper-fixating on foods and this is really where the medication or surgery can have an impact where it takes that intensity down. And I think we can talk a good bit about today that the goal is not to take it away completely, but it's to turn down the volume or to quiet that intensity.

And then finally, I think the reason for all of this is the impact. So people can have thoughts and food cravings, but really we get concerned and want to talk about it when it has a big impact. So it's when the thoughts are unwelcome.

That's the big part. They're there, they weren't invited, and they make it difficult to stick to the plans that you have made. They contribute to overeating and maladaptive eating behaviors. And sometimes we call that emotional eating and they're often associated with people living with obesity. So it's this intense frequent thought about the food that really impacts you because they're unwelcome. And so when people say, I'm hearing less food noise, they describe it as feeling free.

So it feels like what normal can feel like to other people. And it’s kind of the way I think about it is for me, when I'm sitting out on my back porch and the radiator, whatever that loud noise is, that's the air conditioning unit, right? That's running in the background. And you don't recognize that it's even on until all of a sudden it stops and it gets quiet and you can hear the fountain and the birds and it's really lovely.

And it's like, oh gosh, that was such an intrusive noise that I just kind of got used to. And so that's what I hear, which is so exciting from patients and people who were able to reduce that food noise is that the freedom that they have when it's gone really allows them to stick to the stuff that we've sort of been talking about in clinical practice for a long time, the behavioral plans, the intentions, the stuff that they know. And I think a lot of times we talk about education and teaching people sort of what to eat and how to eat. And I find a lot of patients know that. Not everybody, right? But a lot of people are like, yeah, I know what I'm supposed to eat.

I just struggle to do it. And I think this is maybe a mediating factor in there where they can now stick to the plans to eat the way that they've wanted to eat once that sort of noise or filter has kind of been tuned down a little bit.

**Jim Hill:** Wow, that's the best definition of food noise I've heard, Nina. That makes a lot of sense. Is food noise something new? Has it always been around? And it's becoming more apparent. Or has this changed as our environment has changed over time?

**Nina Crowly**: I don't think it's new. But what I think is really interesting is how, you know, when we get a word for something, I think they call it pop psychology, right? Where all of a sudden, stuff that we hear in a clinical space makes it to Instagram and people are starting to talk about, you know, gaslighting and narcissism, right? And it has become sort of a popular term. I think that's what we're seeing now people are getting a term for something that was probably already there, you know. I know that this happened in bariatric surgery, people would describe that all the time.

What I thought was an interesting statistic from that Weight Watchers and Stop Obesity Alliance study was that they had 57% of people experienced food noise when they described it, but only 12% were familiar with the term before that survey. So I think it's something that we're putting a name to it. I don't know about you guys, but I do still love all of those little fun personality tests and even horoscopes and things like that, right? We sort of like to have this schema to collect our tendencies or the ways that we are and give it a name. I think people like that. And so it does give a name to an experience and maybe that's like by naming it, allowing them to sort of move on and think about how to treat it or how to manage it.

**Holly Wyatt:** Yeah. I think it's been there for, you know. You're right that the wording has helped us come out and say what it is and describe it in a way that we can then communicate it. How would you think it kind of interacted with the environment though? I think our new environment has made you have a lot of food noise. Does that impact your body weight versus an environment, you know, 20 years ago, 30 years ago, food noise in that kind of environment? Do you think that's played a role?

**Nina Crowly:** For sure. I mean, I think picturing however long ago where you just get your food, you make your meals and it's really your private space. You're not bombarded with images all day long. You're not scrolling through pictures of things all day long, the availability of all the cheap easy tasty, highly palatable food is not there. There's probably some good research out there talking about how many food messages our brains are receiving all day long and how that makes you think about it, right? So even someone who's not negatively impacted by the kind of the psychological component, like we are processing food messages all day long, whether we like it or not.

**Holly Wyatt:** And just the easy access. So now it's like, when I think about it, no matter where I am, I can get energy-dense food almost immediately. So if I'm constantly thinking or seeking or having messages noise in my head, it's much easier for me to grab food and consume a lot of calories, which then, impacts my body weight.

**Nina Crowly:** Absolutely. Yeah, I think that that would probably be the environmental part that has changed so much and is just, it's there everywhere. And then it's also kind of adding on to that the availability of all the messaging around pressure to reduce your body size and pressure to change your status.

So it's there, it's easy, it's available, and we're trying to change ourselves constantly. So I think all of that adds up to an uncomfortable state for people who are most impacted by it.

**Jim Hill:** So I assume that not everybody sort of experiences food noise or at least not everyone thinks it's a problem. Is this primarily people who have weight issues? Do we know why some people, maybe it impacts them more than others?

**Nina Crowly:** I think there's probably not enough out there to really say at this point, I know that it’s correlation that people that have a larger body or live with obesity are more likely to experience kind of that negative impact from constant food noise and food messages. I don't know, you know, really what, if we could pinpoint if that's a “which comes first” situation, but I think it's definitely heard as people talk about this more that there are people who are really susceptible to it and it's impactful. And then there are people who kind of don't even know what you're talking about. And sort of, to me, I think it's interesting when you talk about people who really have, they're like, why don't you just eat less like me, you know, or I do this, why can't you just do what I do? And I think those would probably be the people who don't struggle with whatever this sort of complex behavioral psychological factor is.

And they're just very easy to learn some new information and act on it without all that other stuff. And then there's the people who know the information, want to do that, you know, the super smart people who struggle with putting that in play. And I used to say a lot, like, if Oprah has struggled with her weight and she has all the resources in the world, does that not show people how freaking hard this is? And so I think it's been nice to hear her come out and talk about her experience and how, you know, she's had all the tools at her disposal forever. Right now, it sounds like for her taking medication is helping her with some of her struggles as well.

**Holly Wyatt:** So I love your story about the… I think you were talking about the air conditioner being on and not even recognizing it. And then when the air conditioner goes off, you can hear other things.

And I think what has happened for a lot of people is these medications have turned off the air conditioner. First off, they're aware now, wow, that was happening to me. And that's why I think we're seeing this is because when you aren't aware, you can't, you don't know what you don't know in a sense. I often say it would be great to have a pill that someone could take that doesn't have food noise, that would produce food noise. So once again, they can kind of be aware, oh, I get it now.

This is what it feels like to think about those cookies all day long and to have to say no and to constantly battle what I'm thinking in my head or the cues and what's going on in my head. I think people maybe who don't have that, don't realize that there could be an air conditioner on. They think everybody has the same thoughts and feelings that they do because that's that awareness piece. We have had drugs that have done this in the past, but I think these drugs have really made a big impact that has said, oh, I get it. I get now that some people, when I went on medications a long time ago, fen-phen, that it reduced food noise too.

And I said, I finally get it how my spouse doesn't understand how I can't leave the cookies alone. That awareness goes both directions. So I think that's a really great way to think about it. People who don't have it don't understand what it is and people who have it, once they get rid of it, that's when they understand what it is.

**Nina Crowly:** I think we could apply this to the human condition in so many ways. It's sad that education and awareness about any condition don't seem to really hit home until someone has either that experience themselves or someone that they love experienced it. Right? I mean, we can talk about this all day long, but as you said, unless we prescribe them the food noise activator pill that we give them, and they say, oh, now I get it. Like, why do we have to only experience it for ourselves to sort of trust that other people have a valid experience that could be different from ours?

**Holly Wyatt:** Yeah, I agree totally.

**Jim Hill:** Do we know how the GLP-1 medications reduce food noise?

**Nina Crowly:** I think the big component has to do with sort of the action in the brain and the reward systems. And so I don't know all the neurobiology on that, but I do think that's really the component. In addition to their impact on the gastrointestinal tract and the diabetes sort of pathway with that, I think it really has to do with that brain component. And the other thing I think that's really exciting about it is that from a nutrition educator perspective, too, is that I think we really need to think about how these are helping people do the intentional things that they want to do.

And to me, that's what's so exciting. And also why we need to really make sure that people who are taking medication are involved with an interdisciplinary team and they have a nutrition behavior and all that support that we have, like we've had in bariatric surgery for a long time, is you're getting a treatment option that's going to help. But reducing that food noise is really going to help people accomplish all their goals and do all of those healthy things that they have been hearing about and that they want to do.

We can talk about bias and all of that too, but there are so many reasons why we think people aren't doing the healthy thing or the right thing or whatever. But a lot of that, I think, has to this pathway and so freeing that up, then that's where we, you know, that's exciting. That's when it comes alongside nutrition and behavioral interventions. And we're really able to do that comprehensive approach for the long term. We can talk about reducing food noise through medication, but I think we need to make sure we make that jump to, and now that we've reduced that, like that's a prerequisite to, okay, we've freed up this brain space to do the things. So we need to make sure that we're supporting people by making sure that they have access to whatever they're at with needs for education and support and then they can actually start to practice those and do those and maybe make it a long-term change.

**Jim Hill:** I want to explore that a little further, but I have one question here. We've talked about the obvious benefits of reducing food noise. Is there a downside? There are so many signals for appetite. And I know I ran into one woman who said, I'm on the medications. I have to set my alarm clock to eat. As a dietitian, are you worried about a potential negative impact? Because these are certainly cues about appetite and eating behavior, et cetera.

**Nina Crowly:** Oh yeah, for sure. I think that's a good point to talk about is there is this, I think, wide public assumption that hunger is sort of the enemy. And people really come to this where they've battled this their whole life and they just want to make it go away.

And so again, in our sort of all-or-nothing brains, it's like, you either have it or you don't. Let's have hunger or not. And I do know that, again, working with patients who had surgery, they really are so excited to have hunger go away for a period of time. So I think there's a lot of education we need to do, again, about hunger is not the enemy.

We can take all the obsessive thoughts in the preoccupation down. But you need hunger to be able to tell you when it's time to eat again, right? And there's a spectrum of people, of course, who need to set an alarm and try to make sure that they're eating on a regular schedule, that can be a focus. And then there are people who are able to tap into their more intuitive sort of internal cues for hunger. And that's exciting too, because again, people with obesity, they may not have really ever trusted those internal cues.

And so there's a lot of work I think we need to do on that specifically to say, here's where you're at, and here's what may happen with these medications and when to intervene if it's too much. And I think there would be another, you know, the whole other component of maybe people who don't have that much excess weight, who are taking these to lose a little bit of weight, you know, they've been calling that like vanity weight loss. So people who do that may maybe more likely or susceptible to disordered eating, right? We don't want to use them in that way to suppress those cues so much that you're not having enough intake to support life, right?

**Jim Hill:** Yes.

**Holly Wyatt:** So we've talked about the medications decreasing food noise and surgery, to some extent can decrease food nose, bariatric surgery. Are there other ways? So people who aren't on the medications, who aren't having surgery, I know some of my listeners have a question too, is there anything I can do that will decrease food noise, my thoughts about food?

**Jim Hill:** Or are related to those people who might stop the medications? We run into a lot of people, Nina, who lose weight on the meds, but they don't want to take them forever. So when you stop the meds, the food noise comes back. Any tips for people on how they could manage it without the meds?

**Nina Crowley:** Yeah, I think a lot of the, maybe the cognitive behavioral therapy and some of the different therapeutic interventions around food and eating probably do this anyway. I think when you look maybe, maybe not looking directly at food noise, but almost looking at the food craving and the emotional eating literature, I think that's probably been hitting it, you know, something similar. So I think working on sort of your food cue reactivity, how are you responding to what's in the environment and how are you able to manage that? I think some of that will help, again, naming it, and labeling it. And for those people, maybe being on medication for a short period of time to show them, here's what it can be like without that. So sort of this is what we're looking for. But again, there are people who might need to be on them forever.

I have a psychologist friend, Robin Pashby. She's been talking about the medications is almost like people might want to stay on them long term, not just for weight, not just for health, but literally for the reduction in the food noise, independently. Again, there are going to be so many different people and how they respond. But I think that's something to think about too, is that almost being its own factor. If this is the thing that's preventing you from doing the daily behaviors that might result in your long-term weight maintenance, this could be part of that treatment plan. I think probably getting involved with a good comprehensive care team without maybe the medical aspect to work on how you're responding to these thoughts. And when do you give in to the thoughts about like, Hey, I've been thinking about this all day, does just having it suppress that, you know, there's that camp of we don't need to restrict these foods so much because then that makes you think of them more. Or some people are black and white and you know, for them, it is like one bite is 100.

And so you've got to sort of keep those particular foods out of your daily meal plan because it's going to make things harder to control. And so I think there's probably such a range, but engaging in thinking about that and identifying it first. So once someone can say this is an issue for me, then finding the right people to help you, you know, plan to do that.

**Jim Hill:** I want to follow up on that. So where do you turn? If you're someone looking for help with managing food noise, health professionals, or registered dieticians, you talked about comprehensive programs, how does a person know where to go for help?

**Nina Crowley:** So an easy place that has all of those components, again, the Obesity Action Coalition, they do have a search tool on their website called the Obesity Provider Locator. And they have, you know, people who've identified as being in this sort of realm for mental, behavioral, the medical side dieticians are on there, that would be one place to sort of look, I don't know of another kind of all-encompassing search tool. But I also think knowing that there's not going to be a one-size-fits-all answer. There's going to be people who, for them, the dietician is really that key component. And for others, it might be the therapist or the behavioral person. So really, I think being curious and open to let's work on assembling the care team that works for me, is just hard these days too, because there are so many different models.

I try really hard to think, you know, there's not going to be one best, right? So some people, it's going to be in person, you go see your medical provider and work with the team that they have there. Sometimes you find the right medical provider, but you need to use a virtual team for coaching or the nutrition side. And so there's a lot of that out there now as well. And every provider is not the same. So I would say also, just not to be discouraged. I've always had people tell me like, I've been to dieticians and I never clicked with them, but you get me and I, you know, you're my person, right?

So that's always exciting. But I think we have that just like with therapists, right? If you go to one and they're not your style, you have to shop around and find the right fit.

**Holly Wyatt:** So I think that fits exactly. Jim and I don't believe in one size fits all. There are multiple ways and multiple options. So that fits exactly with what we're thinking. I thought of a question, Jim. I think you're going to like it. I don't know if there's an answer to this, but we may have to study this. Is there a relationship? Do we know of a relationship between activity levels? So maybe either being sedentary or exercising and food noise. Does that dial it up or dial it down? Or do we have any ideas? I mean, I would think there might be. I could see, I could hypothesize that there could be a connection. Any, you know, anything about that or maybe we need to study it.

**Nina Crowley:** I think you do. I haven't actually thought about the physical activity component in this other than it being part of something that's probably moving them towards health in some way, shape, or form and kind of having positive feelings after movement, where that can maybe suppress some other things, some of the more negative components of that. But no, I haven't thought about that much.

**Jim Hill:** But it's interesting, Holly. Interesting question. So, Holly, do you know what time it is now?

**Holly Wyatt:** What time is it, Jim?

**Jim Hill:** It's time for the personal vulnerability.

**Holly Wyatt:** Oh, yes.

**Jim Hill:** And I'm going to start. First of all, this is awesome. I understand more about food noise than I did at the beginning. But I'm sitting here thinking, is food noise a problem for me? And I don't know. I don't think it is. But it's like, I guess I'd have to turn off the air conditioner to know it. So Holly has already said, she staked her claim that food noise has been an issue. Nina, is food noise something that has impacted your life?

**Nina Crowley:** That's a really good question. First, I love that you're calling them vulnerability questions because that's one of my big core values. I'm a big Brené Brown ****follower. I always ask, can we have her take on, you know, weight bias and food shaming? So if you guys connect with her, please pass that along. But dietitians, I think are an interesting group too, because just like other fields where people go into it because of their own personal story on and off, my whole adult life sort of struggled with my weight a bit. And for me, the hardest part is back to knowing what to do and practicing it, right? Like not just having my registered dietitian, but also in psychology, you would think the knowledge is pretty high, right? And so if knowing equals doing it, I'd be good. So I think I've had my own kind of thoughts and issues about that.

I think I would probably be more towards the middle. I don't find the food noise to be super high the way that my patients have always described it. But I've also always worked with patients who have a much more severe state of obesity. And so I don't know what the incremental category would be there. I do think that there are times when for me not eating or missing a meal, ramps up the thoughts and thinking about food later on. So that could be more physiological than psychological, but I'm not over there at zero. And I'm definitely not over there at 100.

So I'm probably somewhere sort of straddling the middle with a little bit. But for me, the component that would not be there is that real intensity and the impact. There's timing and content for me. I have those thoughts, I think about that sometimes more than others. And I think when you're counseling patients when I did that more often, that was a lot more of the content of my day where we're talking about this for their food and their eating plans. And when you're doing that, it's sort of like another version of, you know, these food cues all around, oh, talking about food all day, no, I'm getting hungry, right? So that could be part of that too. And maybe now that I'm not doing as much direct patient care, there's less of that.

**Jim Hill:** Let me try to put this in some take-home messages. And you guys correct me if I get it wrong. And so food noise is real, and it's experienced to different extents by different people. And it's not necessarily related to being overweight or losing weight. We know people who are of normal weight and they say, I experienced food noise. So there are differences. It sounds like if food noise is an issue, then addressing that may actually impact long-term success.

And hopefully, we're going to have more options. The medications are one option, maybe cognitive behavioral therapy is another option. But for people who experience food noise and think that it's a, it's a contributor to their excess weight, addressing that is probably a good strategy for long-term success.

**Nina Crowley:** That's it. Yeah. And I would say to kind of this concept of if you're on an anti-obesity medication and it's doing that reduction for you, maybe you're not happy with where your weight's going with that, or it hasn't resolved some of the health conditions that you sought out for, is keeping that food noise dialed down enough of an independent reason to stay on it longer term. And I think the other component kind of in curiosity phase two is, is making sure people know that it's like this is their biology too. So I think that's a big part.

It's not their fault. It's not that, oh, you have a lack of willpower, just think less about food and eat less too while you're at it. It's very much a, oh, this explains a phenomenon that you didn't know before. And I think just naming it is going to be a big part of moving through what can help you either deal with it as is or find some ways to reduce it.

**Jim Hill:** That's a great point. And the fact that the medications reduce it shows that it's a, it's a physiological, biological effect, not something you make up in your mind. So this is awesome. Holly, any last questions?

**Holly Wyatt:** No last questions. I think this is great. I think awareness, I always say in any type of behavioral change or any type of when you're trying to make changes to anything when you're aware of something, then you have so many more choices. It just allows you to understand and make some choices. And to me, this is what this does, this awareness, this exists, I may be experiencing it, we all may have different levels of it. So it may be harder for someone else to adhere to this diet because they have more food noise than I have, that it's a range, and that that's playing a role. I think that will move the field forward if we start using that in our conversations and in our programs to help people lose weight and keep it off. So I think this has been wonderful.

**Nina Crowley:** And if people can connect with this as a concept for themselves, maybe they can have a little more empathy for people who have it in a more severe way and say, oh, it's not just maybe they always do well, eat all along, but now they're able to do it. And I think that can go a long way in helping people understand the real disease process and how to move through that.

**Jim Hill:** That's a great point. I personally don't think it affects me that much, but I have a much better understanding now of how it does impact people.

**Holly Wyatt:** So Jim, we're going to develop a food noise pill for you to take. So a pill that you can take that produces food noise, then you can hear the air conditioner. I love that analogy. You can hear the air conditioner and then you can understand it. So I think that would be good for some people. All right.

**Nina Crowley:** Oh, Holly, I was thinking you meant to give him extra food noise so he can see how terrible it is. And then when you take it away, he really understands what everybody else is going through.

**Jim Hill:** Ah, a pill to increase food noise.

**Holly Wyatt:** That's what I mean. So we need to give Jim a food noise pill.

**Jim Hill:** Nina, thank you. This has been awesome. I totally understand this concept way more than I did in the beginning. And again, if you want to hear more from Nina, listen to her podcast, In the Know with Nina. And thank you so much for being a guest on Weight Loss And. And we will talk to everyone next time. Thanks and bye.

**Nina Crowley:** Thank you so much.

**Holly Wyatt:** Thank you.

**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:** We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

**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.

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