GLP-1s and Food Noise
Why This Was Never About Willpower
For those of you who have been following me for a while, you know that my anchor—my clinical home base—has always been eating disorders, and more recently, Food Noise. I’ve been working in the field of eating and the brain for over twenty years.
If food, eating, and the psychology beneath them fascinate you, I encourage you to follow me on Instagram (@shelovpsych) or TikTok (@shelovpsychology). I post almost daily over there—short-form videos that give the down-low on food, emotions, bodies, and everything in between. But I want to take a moment here to catch you up on what has been unfolding on those platforms—and in my own thinking.
Since 2022, I’ve been watching the introduction of GLP-1 medications into mainstream culture. It’s important to note that these drugs were first introduced in 2005 for the prevention and treatment of diabetes. That is a very long time for a medication to be studied, examined, and refined.
Still, when Kim Kardashian appeared on the Met Gala red carpet in Marilyn Monroe’s dress, I was appalled.
As someone who has spent her career immersed in the world of eating and body image, I sat down and wrote my first blog post addressing what I believed would be the negative impact of these medications.
I saw it as the violent return of thin obsession—and with it, the quiet disappearance of the cultural moment that had begun to embrace curves and body diversity.
I was sad.
Sad for humanity. Sad for my patients. And, if I’m honest, angry.
My first blog post—NOzempic—was published in March 2023 and was strongly against a drug that I feared would re-obsess our society with extreme thinness. I wrote it three full years ago.
To quote myself:
“Our history of quick fixes in weight loss is long and diverse. Diet medications have come and gone, often leaving a wake of side effects—some even leading to birth defects—taken by unknowing future mothers who were unaware that their desire to reduce pregnancy weight would forever impact the children they carried.
Yet here we are again. Women of all shapes and sizes are re-introducing ‘waif’ culture. ‘Heroin chic’ is back in action. Only now, instead of cigarettes, starvation, and diet soda, we have found a new way
A medication—accessible primarily to those with means—that we self-administer to make ourselves so sick we cannot eat.”
I felt strongly then.
And I still hold deep conflict about our culture’s obsession with thinness and bodies. I want our world to be different. I want all shapes and sizes to be profoundly celebrated.
But I do not practice psychology in the world of wishing.
I practice it in the world of reality.
And what I have watched evolve over the past three years has forced me to reckon with something important:
I am witnessing a level of healing in my patients that years of therapy, psychiatric medication, and rigid food scheduling were unable to achieve.
I have one patient who has allowed me to share her story. That generosity is heroic.
She wanted others to see both the struggle and the possibility of healing.
(As always, any clinical story is shared for educational purposes only. All medical decisions must be made with a physician’s evaluation and prescription.)
Her work with me was not initially about food preoccupation—but food noise was always there. Her eating had a restrictive–binge quality that we could never fully resolve. Her relationship with her body eroded her self-confidence slowly and chronically—not in dramatic spikes, but in a steady, wearing way.
About a year ago, we began discussing the possibility of her starting a GLP-1 medication. We tracked her experience closely—every week. She was under medical supervision, saw me weekly, worked with a registered dietitian, and trained with a physical trainer.
The shift was profound.
She began to trust her body. She trusted her relationship with food. She had energy for things beyond thinking about her body and what she ate.
She felt—perhaps for the first time—that her life was no longer organized around food noise.
Last week, she asked me quietly, “Am I healed?”
She is one story of many in my practice.
Stories of shame lifting.
Energy returning.
Living in a body that finally feels like your own.
Anxiety softening.
Hope re-entering the equation.
The space created by the quieting of food noise has allowed us to examine the relationship between self and food—often for the first time—and to truly understand it. In many ways, we are finally able to rewrite the story.
I have always treated eating from a brain-based perspective.
Eating disorders are catalyzed by the changes that occur in the brain when restriction and starvation take hold. Food noise is not a failure of willpower—it is a neurological state.
The introduction of GLP-1s has finally brought the term food noise into the global conversation. Those of us in this field have been describing it for decades. We may have called it the function of the eating disorder, or the internal soundtrack of the relationship with food—but the phenomenon itself is not new.
What is new is the universality.
The light switch that turns on when people realize their noise is real.
That it is biologically driven.
That it may be treatable.
And that they are not alone.
After twenty years of working with people whose lives have been hijacked by food noise and body obsession, I am grateful that we may have a new tool at our fingertips.
As a psychologist, I must state clearly and ethically: we are still in the Wild West of these medications.
GLP-1s are not a cookie-cutter solution. They come with risks and must be used carefully and thoughtfully under medical supervision.
But the idea that people struggling with food and their bodies simply lack willpower is one of the most damaging myths in mental health. This has never been about willpower—it is about brain power.
When the brain has been shaped by biology, repetition, and culture, it can become hijacked by food noise. Quieting that noise is not a moral failure or shortcut; it is neurological relief and repair.
And I am ready for people to finally find freedom from it.
Get to KnowDr. Danielle Shelov
Dr. Shelov's therapeutic approach emphasizes understanding individuals within the context of their families, childhood experiences, relationships, and larger systems as crucial to psychological treatment.
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