Why can’t some women seem to stop thinking about food?
A desire for chocolate before their period, a sudden urge for something sweet after a stressful day, or constantly thinking about what to eat next, may seem like ordinary cravings
But when thoughts about food become persistent and difficult to ignore, they may be more than hunger
Increasingly described by patients, clinicians and researchers as “food noise”, the term refers to persistent thoughts about food, eating and cravings that continue even when a person is not physically hungry
“Food noise simply means there are constant ‘voices’ or thoughts in your mind that repeatedly remind you to eat,” says consultant endocrinologist Dr Lim Kim Piow
“You crave enjoyable foods or sugary drinks because they give you a sense of satisfaction
“If you don’t get them, you may feel sad, depressed or agitated.”
While anyone can experience food noise, Dr Lim says women face unique biological and life-stage challenges that may make them more vulnerable
Rather than simply reflecting a lack of self-control, he says that appetite and weight are influenced by a complex interplay of biological, metabolic and psychological factors, including hormones, stress, sleep and genetics
For women, food noise may be influenced partly by hormonal changes throughout their life
They go through several reproductive and biological life stages – including menstruation, pregnancy, postpartum and menopause – that can affect appetite, mood and body weight, says Dr Lim
During the menstrual cycle, hormonal fluctuations can influence appetite and food cravings
This can happen in the luteal phase when progesterone levels rise and some women may experience increased hunger or cravings
“These hormones constantly rise and fall every month,” he explains
However, he stresses that this is a normal physiological response and not every woman experiences it in the same way
“PMS refers to premenstrual syndrome, but the symptoms vary from person to person,” he says
“Some women experience increased appetite, while others don’t.”
Pregnancy and the postpartum period bring another significant hormonal change
Dr Lim says that changes in eating patterns, reduced physical activity and postpartum recovery can make it difficult for many women to return to their pre-pregnancy weight
He also notes that traditional confinement practices may involve calorie-dense foods, with physical activity often limited
These factors can compound the hormonal and lifestyle changes that influence appetite and weight during the postpartum period
The next transition comes with perimenopause and menopause, when reproductive hormone levels fluctuate and eventually decline
According to Dr Lim, these hormonal changes can contribute to mood changes, irritability and shifts in fat distribution, making weight management more challenging
Beyond hormonal changes, genetic differences can also influence how the body regulates hunger, appetite and fullness
Several hormones are involved, including ghrelin, which stimulates hunger, and leptin and insulin, which help regulate appetite and satiety
Genetic differences affecting these pathways may leave some people feeling less satisfied after eating or hungry more often
“Even if you eat a lot, you may feel very hungry at any time,” says Dr Lim, explaining that some people are born with genetic differences that can make them more prone to hunger and weight gain
Lifestyle and environment
But food noise is not shaped by biology alone
Dr Lim says lifestyle factors, particularly chronic stress and poor sleep, can also influence appetite and make food noise harder to manage
While acute stress may temporarily suppress appetite, chronic stress can have the opposite effect
He explains that prolonged stress and elevated cortisol levels can increase appetite and drive cravings for energy-dense foods
“When you are under chronic stress, cortisol goes up and more calories are needed,” he says
“When you need a lot of energy, your brain tells you to eat more and increases your appetite.”
The cravings, he adds, are often for energy-dense foods rather than healthier ones
“Usually, it’s glucose. You feel hungry, you want to eat and it’s not to eat chicken breast; you’ll want to have chocolate, ice cream,” he says
Sleep also plays a crucial role
According to Dr Lim, good quality sleep is not simply about the number of hours slept, but whether a person wakes feeling rested and is able to carry out daily activities without persistent fatigue
Poor sleep can leave people feeling tired throughout the day, making it harder to stay physically active and maintain healthy eating habits
Malaysia’s food environment can add another challenge
Dr Lim says Malaysians are surrounded by highly palatable foods, with sweet, salty and spicy dishes readily available throughout the day
Food is also deeply embedded in Malaysian social and cultural life, with eating often forming part of celebrations and social gatherings
With food readily available and often designed to appeal to multiple senses, people may find it harder to resist cravings
For many women, these biological changes are compounded by everyday pressures
Dr Lim describes this as the “super mum” phenomenon, where work, financial pressures and caring for children and family can make it harder to prioritise diet, exercise and other healthy habits
“So everything comes together,” he says
The dangers of food noise
Food noise becomes a concern when persistent food-related thoughts are accompanied by overeating and weight gain.Diet is an important aspect of managing weight, however, Dr Lim cautions against overly-restrictive diets as they are hard to sustain
Dr Lim says that these patterns may increase the risk of obesity and metabolic conditions such as prediabetes and diabetes
He stresses that obesity is a complex, chronic and relapsing condition influenced by factors such as genetics, hormones and metabolism, rather than simply a lack of willpower
For women of childbearing age, the implications can extend to pregnancy
Women who enter pregnancy with overweight or obesity may face a higher risk of gestational diabetes, he points out
The effects may also extend to the next generation, as maternal obesity and diabetes during pregnancy can influence a child’s future metabolic health – a concept known as metabolic programming
“That’s why it’s so important that we pay attention to obesity and overweight among women,” he says
Managing food noise
Unfortunately, there is no single solution for food noise
Dr Lim says managing it begins with addressing the factors that influence appetite, eating behaviour and metabolic health, with sustainable lifestyle changes forming the foundation
Diet is one of the most important areas to address
He cautions against eliminating carbohydrates entirely, as severely restricting these essential macronutrients can leave people feeling deprived and intensify cravings
Instead, he recommends a balanced diet comprising good-quality carbohydrates, more protein, plenty of fibre, and a variety of vitamins and minerals
He also cautions against overly restrictive diets that leave people feeling deprived, as these are often difficult to sustain
Exercise is another important part of long-term weight management
Dr Lim recommends around 30 minutes to an hour of physical activity a day, depending on the intensity
He says the activity should be enough to raise the heart rate and produce some sweating
Good quality sleep and stress management are also crucial
As stress, poor sleep and other lifestyle factors can influence appetite, addressing them may help make food noise easier to manage
He also encourages people to find strategies that redirect their attention away from food
“Exercise is one. Having hobbies is another,” he says
Reading, listening to music, pursuing hobbies and spending time with family and friends can help people stay engaged in meaningful activities and build healthier routines
Long-term change also requires realistic goals and personal motivation
Dr Lim says understanding what motivates each individual can help them stay committed to healthier habits
For some, this may mean weighing themselves regularly or learning more about the complications of obesity as a reminder to stay on track
“You have to know your own character and find the aim of your life,” he says
Regular follow-up with healthcare professionals can also help patients monitor their progress and adjust their weight-loss plan when needed
For people living with obesity who are unable to achieve sufficient improvement through lifestyle changes alone, medication may be considered
Dr Lim says GLP-1 (glucagon-like peptide-1) receptor agonists can reduce hunger, increase feelings of fullness and lessen food cravings by acting on appetite-regulating pathways in the brain
However, these medicines should only be used following a proper medical assessment and under professional supervision
In the end, he hopes the term “food noise” encourages people to look beyond willpower when thinking about persistent thoughts about food and struggles with weight
“Food noise also reminds us that patients shouldn’t be blamed or stigmatised,” he says
