Most adults with obesity did not meet food noise criteria in US survey

Persistent thoughts about food are gaining recognition as a psychological experience, but researchers still face questions about how to measure them and what they mean for health.

*Important notice: Research Square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Want to read later? Download your clean, ad-free, print-friendly PDF copy by clicking here.

Obesity is a complex condition affecting about 40% of the adult population in the US. Use of glucagon-like peptide 1 receptor agonists (GLP-1RAs), which reduce weight, appetite, and food intake, has drawn attention to an underrecognized experience: food noise. It has recently been defined as persistent food-related thoughts that people perceive as dysphoric or unwanted, and that may cause physical, mental, or social harm.

Food noise was initially identified through patient reports of a marked reduction in food-related thoughts after initiating GLP-1RA treatment. These reports suggest that food noise may have been a familiar, poorly understood experience for some people with obesity. Empirical research on food noise is scarce.

About the study

Researchers at Drexel University and the University of California, Irvine, USA, used data from the nationally representative NORC AmeriSpeak Panel. Participants completed a baseline survey and were invited to complete additional surveys. The analysis drew on the Fall (August–October) 2025 wave, which included measures of food noise and other pertinent variables. Participants currently using GLP-1RAs were excluded.

The five-item Food Noise Questionnaire (FNQ) was administered to evaluate food noise experienced in the preceding two weeks. It assessed persistent food-related thoughts, their interference with daily activities, the time spent on these thoughts, lack of control over them, and their negative effects. Responses were rated on a Likert scale. The researchers calculated a food noise score by averaging responses across the five items, with higher scores indicating greater food noise.

Sociodemographic variables included gender, age, ethnicity/race, education, and household income. Weight status (e.g., underweight, normal, overweight, or obesity) was determined based on body mass index (BMI), an imperfect indicator of adiposity. The study sample was split into two approximately equal sub-samples, with survey weights retained for participants. The researchers used one group to explore how the five FNQ items related to each other and the other to test the resulting structure.

Food noise endorsement was defined by three criteria: a mean FNQ score of at least 4; agreement or strong agreement with at least 3 of the 5 items; or the same response to at least 4 items. Food noise estimates were compared between participants with and without obesity using each definition. Survey-weighted regression examined associations between demographic characteristics and food noise.

Findings

The study included 3,646 participants, with women accounting for 53.9% of the weighted sample. About 40.8% of participants were classified as having obesity, 30.6% as overweight, 26.9% as normal weight, and 1.7% as underweight. Endorsement across FNQ items ranged between 6% and 15%. The five FNQ items appeared to measure a common underlying experience, accounting for around 80% of the variance. A second analysis generally supported this finding, but one measure indicated that the model matched the responses less closely than expected. The proportion meeting food noise criteria varied by definition.

About 9.5% of adults met the criteria when using the least stringent definition, which required at least three items rated Strongly Agree or Agree. This estimate declined to 6.1% when endorsement of at least four items was required, and to approximately 4% when a mean score of ≥ four was required across all items. Among adults with obesity, estimates ranged from 6% to 13.7%, depending on the definition.

Participants aged 18–59 years had higher food noise scores than those aged ≥ 60 years. Before adjustment for BMI, lower education was associated with higher food noise scores, with high school graduates having higher scores than university graduates. The education association was not consistent after weight-status adjustment. Men had lower scores than women. In analyses adjusted for weight status, individuals with overweight or obesity had higher food noise scores than those with normal weight.

Conclusions

The study provides preliminary population estimates of food noise endorsement among US adults not currently taking GLP-1 medications. A greater proportion of adults with obesity met the criteria, but most did not; food noise scores were higher in younger people and women and progressively increased across BMI-defined weight categories. The estimates remain preliminary because no clinically validated threshold for food noise exists. The cross-sectional design cannot establish whether food noise contributes to obesity. Further studies are needed to evaluate its clinical relevance and mechanisms, and to determine whether it is distinct from food cravings and food preoccupation.

*Important notice: Research Square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Source:

Journal reference:

• Preliminary scientific report. Branislav Jovanovic, Nickolas Jones, Fengqing Zhang et al. (2026). Food noise among U.S. adults: Psychometric evaluation and prevalence estimates from a nationally representative sample. Research Square. DOI: 10.21203/rs.3.rs-10997388/v1, https://www.researchsquare.com/article/rs-10997388/v1