When Lauren and her husband decided they wanted to have another baby, she found out from her doctor just how badly she had lost in the genetic lottery. Her husband could eat anything he wanted and not gain a pound, but she had put on weight and kept it after the hungry year of nursing her first child. She had insulin resistance and borderline gestational diabetes—not too surprising, since she comes from a family with a history of type 2 diabetes. She also has PCOS, which can interfere with conception and pregnancy. A whole list of other hormonal imbalances made her less than an ideal host for a developing baby. And on top of all that, her doctor told her that the mere fact of carrying extra weight makes it more difficult to carry a baby to term. She decided she needed to lose around 50 pounds in order to increase her chances of having a healthy pregnancy.

So she turned to what at first may seem like an unlikely fertility booster: weight loss drugs.

Five or 10 years ago, Lauren would have had to grit her teeth and try another round of what doctors call “lifestyle modification”: losing weight through diet and exercise alone, using sheer willpower. But now willpower has been overthrown as the dominating factor in weight loss. Since the FDA approved a diabetes drug called semaglutide—most prominently sold as Ozempic—for weight loss in 2021, the pharmaceutical companies have claimed that the world can forget about food cravings thanks to the new shot (now sold in pill form as well). These treatments make weight loss, and the health benefits that can come with it for some, a function of not just mind ruling matter but also matter transforming mind, and its supporters say it could change Americans’ famous love-hate relationship with food.

Far more factors than just eating habits affect a person’s weight: genetics, activity levels, the availability and affordability of quality food. But a troubled relationship with eating is, for many reasons, why Lauren has concerns about her fertility and is—rightly or wrongly—the main focus of millions of people’s lifelong wars with their weight, with battles waged everywhere from the drive-through to the supermarket to the pharmacy. Lauren calls herself an “emotional eater” and says that her other health problems were exacerbated by a less-than-ideal diet, which she found herself unable to change on her own. The causes of Americans’ problems with eating are complex, but Lauren’s story is a familiar one: People know they should eat better; they try for a while; they give in to the hunger that comes from dieting by returning to their old comfort foods; they rinse and repeat. 

If Americans are failing to fix their toxic relationship with food, it’s in part because they, self-made men that they are, still believe against all evidence that they can transform themselves and their desires to move beyond their basic needs. Seen this way, the solutions on offer for fixing America’s problems with eating—Ozempic, MAHA, RFK’s new dietary guidelines—seem less like cures than like signs of a deeper disorder.

Ozempic and its competitors—known as GLP-1 agonists for the hormone that the drugs mimic to achieve their effects—claim to be able to break the vicious cycle that Lauren experienced. Their premise is that overeating is essentially a biological problem, and a medically treatable one. All you have to do is make people not want to eat so much food. GLP-1 drugs can effect that transformation: They imitate the hormones that manage satiety, or fullness after eating, stimulate the release of insulin, and slow the emptying of the stomach so people feel full longer and can resist cravings or even avoid them entirely. For those whose bodies react well to the treatments and can handle the common side effects, such as nausea and digestive discomfort, the weight flies off, far more effectively than from previous medical weight-loss treatments. The GLP-1 agonists are hailed as miracle drugs, a medical revolution that continues to reveal new applications, including the treatment of addiction, reduction of heart disease risk, mitigation of fibromyalgia symptoms. 

Whether these (or any) drugs can produce long-term results on the seemingly intractable problem of rising obesity remains to be seen. U.S. obesity rates dipped slightly downward last year, but long-term trends can’t be predicted. Weight tends to return rapidly for those who stop taking the drugs, which, because of their high sticker price and insurance companies’ hesitation over covering them, aren’t affordable on the model that many doctors are offering them: as lifetime regimens. But, for people like Lauren, the point for now is that they work.

Lauren is lucky: She works for a women’s health clinic in the Seattle area that uses FEMM (fertility education and medical management), a women’s health program that helps women improve their fertility through hormone-tracking and medical treatment. So she easily found a doctor who prescribed a trifecta of drugs: compounded semaglutide (the active ingredient in Ozempic and related drugs), metformin, and empagliflozin. When I spoke to her, she had lost around 45 pounds over the last six months, and she had only 10 or 15 to go. She was eating better, exercising regularly, and feeling more emotionally stable. The drugs, she said, gave her the boost she needed to do the things she knew she needed to do but never could before: “I needed that mental push and the support and the motivation to have that lifestyle change with the medication.”

Lauren’s term for this dramatic change is the reduction in “food noise.” “I think you don’t really know how much you think about food, especially someone who has emotional eating or cravings,” she said. “I think that’s the biggest thing that semaglutide has done for me, where I don’t think about food as much.” 

What’s wrong with thinking about food? For Lauren and many others, the problem is it never stops. They’re planning their next meal while eating the current one, they can’t stop eating when they’re full, they can’t resist the call of McDonald’s french fries or the sleeve of Oreos in the pantry. Anyone with a sweet tooth can understand this problem, but GLP-1 patients and researchers are just beginning to glimpse how unmanageable the far end of the food-obsession spectrum can be.

Daisuke Hayashi is one of the first researchers to study the rise of food noise, a phrase that appeared seemingly organically in 2023 after the approval of GLP-1 agonists for weight-loss treatment and proceeded to take over TikTok and Instagram. Hayashi is a doctoral candidate studying nutrition at Penn State University who co-wrote the first paper on the term with his supervisor, Travis Masterson, and also conducted a study of the rise of the term on TikTok.

In the paper, they propose a definition of the term that establishes it as more than a craving. It’s a sensitivity to eating cues that leads to “food-related intrusive thoughts and maladaptive eating behaviors.” In the study of TikTok videos featuring the term, Hayashi found that the term took off among the demographic of users most likely to be taking weight-loss drugs: white women, who recount the effects of the drug with surprise and relief. One representative TikToker said while injecting herself with the drug on camera, “And just like that, quiet. They’ve actually found something to help the chaos, to help the obsessions and compulsions.”

The rise of “food noise” reveals that struggles with overeating are just as much about one’s mind as about one’s body. They also show that problems with food are social, not just individual, which means that obesity epidemics have far more causes than just weak individuals making bad choices. With the MAHA movement’s rise to national prominence, this is an idea that has as close as Americans may come to bipartisan consensus: Something about our food is bad, and the system that produces and sells it is broken.

However you parse those reasons politically, the use of the term “food noise” itself suggests that there are external forces making matters worse for the inner food-aholic, not just challenging his willpower but conditioning his mind and warping his appetites and desires. For GLP-1 users, there’s more going on than the nagging voices in their heads, they say; the volume of the environment around them is blaring with demands that they eat (usually unhealthy) foods. Advertising is America’s unique gift to the world, our national art form; food advertising is its summit. Who doesn’t love a Happy Meal? 

Most of what’s shown on TV and sold in fast-food restaurants is ultra-processed food, engineered to reach what the psychophysicist, market researcher, and developer of Cherry Vanilla Dr Pepper Howard Moskowitz called the “bliss point,” the blend of salt, sugar, and fat that makes food optimally irresistible. These are also the foods that nutrition experts say make people sick, inflaming guts, destroying metabolisms, causing diabetes and cancer. But the processing and packaging contributes to food noise blaring through people’s heads, and many GLP-1 users are just relieved to turn off the megaphone.

Though the psychological research is new, the story is older than Ozempic, food noise, or MAHA; it traces back to the industrialization of food and agriculture in the previous century. Ultra-processed food, in the critics’ telling, is also engineered to be optimally profitable for the most powerful players in the food economy: Big Corn, Big Soy, and Big Agrochemical. What began as an attempt to make foods shelf-stable became a fierce competition to make food as cheap as possible, using the most readily available and adaptable ingredients. 

It was a winner-takes-all game. The array of colorful junk food brands in the central aisles of the supermarket masks the fact that most food is sold by a small number of big companies—Nestlé, Mondelez, and Unilever, to name the top three—using formulations of the same few ingredients: soy, wheat, and corn. (Oreos? Mostly wheat and corn. Cool Whip? Corn. Breakfast cereals? Lots and lots of corn.) These crops are cheap because they’re easy to produce in large quantities using pesticides and herbicides that protect them from nature’s whims. Farmers are encouraged to grow them because of crop insurance and other handouts that skew the market toward monocultures. They’re heavily subsidized by the federal government (including by the Trump administration, which issued major subsidies, mostly to large farms, last year). The junk food domination extends beyond cereal crops and soy. Most potatoes grown in the United States are sold to McDonald’s. Most chickens are destined for the same fate.

Some say—and again, MAHA and the anti-establishment right aren’t the first to say it—that this amounts to a conspiracy to get people fat and sick, and then to sell drugs and diet products, keeping people yoyoing throughout their lives with deteriorating health and empty pockets. Robert F. Kennedy Jr.’s HHS often repeats this line. “Most American children’s diets are dominated by ultra-processed foods,” the recent MAHA Report reads, and it explicitly links consumption of these foods to “a range of chronic diseases, including obesity.” As his department released the new Dietary Guidelines for Americans in January, Kennedy edged closer to conspiracy: “Our government has been lying to us to protect corporate profit taking—telling us that these food-like substances were beneficial to our health,” he said. “Federal policy promoted and subsidized highly-processed food and refined carbohydrates and turned a blind eye to the cataclysmic consequences. Today, the lies stop.” 

But to say that the obesity epidemic is purely a malicious conspiracy is misleading, and by pumping up the drama for political purposes it worsens the very trends it claims to fight. It’s a vicious cycle: Companies sell what makes money, and customers buy what’s cheapest and most convenient, and soon they come to love what they’re accustomed to eating (or what they can afford) and turn to it when stressed—even by, say, a disturbing number on the bathroom scale or a prediabetes diagnosis. Then they go on a diet, and—hey presto—suddenly there are high-protein Pop-Tarts in the breakfast aisle. Individual choices matter, but incentives matter too.

Which is central to struggles with weight, then: biology, psychology, or sociology? Nature or nurture? Food or the system that produces it? As with most complex human problems, the answer is all of the above.

Yet complex problems are always susceptible to oversimplified solutions, and these solutions often come in the form of sales pitches. The grocery store, the TV, and Instagram are full of diet foods and programs, guilty pleasures, and then more diet products to atone for the guilty pleasures. Government policy rarely helps navigate the confusion, especially when it waffles between conspiratorial individualism—don’t trust Big Ag, just eat organic!—and cronyism. Kennedy, who spent much of his career as a lawyer suing Big Pharma companies, championed whole foods as medicine and said on the campaign trail that Novo Nordisk, the maker of Ozempic and Wegovy, is “counting on selling it to Americans because we’re so stupid and addicted to drugs.” But as the administration has become more Ozempic-friendly, pushing for drug-makers Novo Nordisk and Eli Lilly to lower prices and planning to offer deals for weight-loss drugs on TrumpRx, his position has shifted. In November he called weight-loss drugs a “tool in the toolkit.”

Whether RFK’s advice is a sign of personal hypocrisy, government pressure, or conversion to the Big Pharma creed is less important than what the MAHA movement reveals about health messaging. In the era of revolution by algorithm, consensus is less important than individual choice. 

The alt-health market is the future of health care, a new Wild West of health fads, trendy diets, Instagram influencers selling protein powders, direct-to-consumer companies such as Hims and Hers selling not just hair-loss medications and abortion pills but also compounded weight-loss drugs. If everyone seems to be selling you something, you’re not alone, and probably not far wrong. Casey Means, a Kennedy advisor and Trump’s current nominee for surgeon general, founded an app-based health company called Levels that aims to improve people’s health through personal nutrition and blood-glucose monitoring—health advice so individual that it tells you how your body liked the sweet potato fries you had for lunch. On this model, you can get rid of your food noise by uploading it to the algorithm, turning food from bites into bytes.

The alt-health industry is worth $145 billion per year and is expected to grow by nearly five times in the next five years. The GLP-1 drug market, by comparison, is valued at nearly $50 billion and is expected to shoot up to almost ten times that in the next seven years. It’s not just Ozempic. The idea that you can fix your problems with food simply by adopting a new regimen is big business. 

But it’s not that easy for consumers. Opting for alt-health alternatives to weight loss drugs doesn’t mean escaping the makeover mindset. In a time when even Snickers sells protein bars, it doesn’t necessarily mean escaping ultra-processed food, either, or fundamentally changing one’s way of eating and living. GLP-1 drugs, when taken without diet and exercise, are still facially effective. People lose weight. But with the fat goes a large portion of vital muscle, which can contradict the very benefits weight loss was supposed to provide, leading to illness and injury later on, especially if the person gains weight again. Health is more than scale-deep. 

The nature of the Ozempic transformation is something people misunderstand, intentionally or not, about Ozempic, Lauren said. Some people think that “you do the shot and nothing changes,” she said. But in reality, for the drug to work she has had to change her life, eating well, exercising, tracking her protein intake so the weight loss wasn’t all muscle, which would leave her worse off than before. 

Hollywood, of course, has elevated the abuse of GLP-1s to an art form. “Life After Food?” asked a notorious essay in the Cut about celebrities’ early uptake of Ozempic. It portrayed Los Angeles as a zombie town inhabited by waifs picking their salads and complaining about how they couldn’t possibly eat a bite. 

As it so often does, Hollywood shows America to itself by taking its dangerous tendencies to the extreme. Its early uptake was a premonition. Now, the confluence of the MAHA movement and rise of weight loss drugs—hyperindividualized health and the pharmaceutical and technological means to pursue it—has the potential to further break down Americans’ relationship with eating. 

Take the nutrition advice that doctors give people on Ozempic. They encourage people to eat more protein, fiber, and whole foods. These are good counsels in themselves, but they are also an exercise in abstraction, turning food into calories, macros, and micros and making people more susceptible to eating what one “health food” enthusiast interviewed by the Wall Street Journal memorably called “protein crap.” The protein-pumped chips, muffins, and doughnuts taking over grocery checkout aisles are another result of the idea that food is mere fuel. And protein is the premium grade of gasoline. Eighty-five percent of people in a Chobani study last year said one of their top nutrition goals was eating “more protein.” If people think that anything with added protein is health food, then nothing really has to change. 

Even chicken nuggets have proven to be remarkably malleable. Tyson reported an 18 percent higher demand for their signature product last year. “We love to sell protein,” said a spokeswoman. The company has released a “high protein” line of nuggets, in case anyone missed the memo about what chicken is made of. This kind of marketing means that consumers may end up consuming more of the same ultra-processed foods, just with new health claims on the label.

Many, especially on the MAHA side, say that the idea of food as fuel is better than nothing—at least people are eating marginally better food, which has the potential to improve their health. Food, after all, is the best medicine. Yet while using food to heal one’s body may be helpful for some, the philosophy behind it is more similar to the GLP-1 approach than it appears. Both approaches medicalize food and seek to transform people’s bodies by a disappearing act. GLP-1 drugs vanish the appetite itself, while “food is fuel” and “food is medicine” transform it into macros and minerals whose health effects are more important than their flavor.  Thus, medicine becomes the real purpose for eating, not nourishment, or community, or any of the other underlying reasons on offer for eating. 

This is more than a game of semantics. When drugs are the reigning paradigm for health, they become justified, in fact morally necessary. This logic was on full display at the Obesity Medicine Association’s latest conference, when the Wegovy-sponsored gathering’s top pediatric expert recommended, or insisted, that weight-loss drugs should be prescribed as a “front-line treatment” for children as soon as they were diagnosed as obese. Root causes could come later; immediate action is necessary to fix the bodily disease, and changing minds and lifestyles would have to wait. The rise of GLP-1 drugs has shown that body and brain work together in managing weight, but the medical industry puts the body first.

And it’s not just kids on Ozempic. For many of us, food is approaching mere fuel. Many Americans in fact forego traditional meals entirely. According to recent research from the Food Institute, young people are turning to protein bars and shakes during lunch breaks, and increasingly at other meals, as well. “This is extremely popular with the younger generations,” said Julie Murphy, a market researcher at Brightfield Group. “They are much more apt to skip meals. They are fine with having a protein drink or a bar or something to replace a meal, so I think this will only get more prevalent as they get older.” A well-formulated protein bar gets you closer to hitting your macros than most of the other options on offer, anyway.

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For Lauren, one of the best aspects of taking a GLP-1 drug is this separation of food from pleasure. “Food in our culture and in our life is supposed to bring us some joy,” she said. But “every meal doesn’t need to just be this experience that makes you happy or brings this emotional response. Yes, on your birthday dinner, or when you’re out with friends, you can really enjoy your meal, but every day when I’m at home, I can have something that just satisfies my hunger.”

This is another way in which Lauren is lucky: She knows her reasons for wanting to be well. Melissa Buchan, a health and wellness coach who often works with women with weight and fertility concerns, said that this reflection, not the bare desire to lose weight, is what leads to health: “We’re so busy in life that we don’t take time to set, breathe, and reflect, Why do I really want to be healthy?” The first reason many people give is that they want to look good. “Body recomposition”—losing weight or getting fit—“can get us in the door, but it’s “not really a sustainable goal,” and it can lead to “disordered thinking.” 

“We have to have a secondary goal to fall back on when things get hard or as we mature out of that,” she said. Then health becomes not a number on a scale but something like life: “I want to be healthy, I want to have energy, I want to be able to be a grandmother who can get on the floor with her grandchildren.” These are the kinds of goals that help people to eat better in the long run—and they lead to deeper transformations as well.
Not every day should be a feast day any more than every meal should be a Happy Meal. But food is not just fuel, any more than human beings are machines. Food is an occasion for pleasure, a chance for community, a creator of memories, a seed of good health in more ways than we know. We risk leaving a piece of our humanity behind when we solve problems with food by trying to transcend it. If the weight loss drug revolution or the attendant health-conscious movements can restore food to its proper place—both sustenance and ritual—then it will be the first modern innovation in eating to turn from isolating people and products for profit toward real nourishment.