When Joel Brown was a chef in the 2010s in Toronto, tasting a brilliant new dish was like hearing a piece of life-altering music. He’d let out a bewildered laugh, rendered speechless by the revelatory flavours and textures. He reacted that way after he tasted a mortadella sandwich on a cornetto with pistachio remoulade. And another time after eating a spoonful of hazelnut gelato. Then again after a bite of focaccia that was “70 per cent oil and 30 per cent bread.”
But in 2024, just a week after Mr. Brown, now 40, began taking the weight-loss drug Mounjaro, the joy had vanished. Flavours and textures lost their thrill. He struggled to find even a fraction of his past delight at mealtime.
“It was like, ‘I need this many calories to survive today,’” he recalls. “It was more of a detached, less emotional, more statistical way of eating.”
After a month on the drug, which he’d been prescribed by a telehealth provider to help him lose weight, he decided to stop. He wondered about the long-term side effects and he wanted to meet with his own doctor to discuss them.
But more importantly, he was disturbed by how Mounjaro had zapped so much enjoyment from his life.
Canadians starting GLP-1 medications such as Ozempic, Mounjaro or Wegovy know these drugs will make them consume less food by cutting their cravings and making them feel full sooner but don’t often consider the psychological effects of taking them: how they can strip pleasure from eating, make once-loved dishes taste revolting and leave them desperate for joy in other realms of their lives.
As they’ve grown in popularity, experts and patients alike are realizing the drugs don’t solve every food-related issue and in some ways introduce new ones – something that could be addressed with therapy and support, the standard approach for those who undergo bariatric and metabolic surgery.
Where does the rise of GLP-1s leave the body positivity movement?
When it comes to weight loss, it’s easy to measure the results of a GLP-1 on a bathroom scale or in the fitting room of a clothing store. But how does one measure the other things lost? The delight in taking the first bite of a French fry, fresh from the deep fryer. The pleasure of sampling dishes shared family-style at a friend’s birthday dinner. The spontaneous joy of grabbing an ice cream cone at the local scoop shop, even if you’re full from lunch.
In A Room of One’s Own, Virginia Woolf famously wrote, “One cannot think well, love well, sleep well, if one has not dined well.”
For most of us, food is our first and most basic source of pleasure. When is it worth it to give that up?
There’s a big difference between hunger and appetite.
We feel hungry when the levels of nutrients in our blood change and the hormone ghrelin is released by the stomach, signalling to the brain – specifically our hypothalamus, which controls thirst, hunger and body temperature – that our energy reserves are low and we need food. Our stomach might start grumbling or we could feel light-headed. After we eat and reach the point of satiety, other hormones, such as insulin, are released and when they hit our hypothalamus, they signal that we should stop eating. This is eating stimulated by our body’s caloric needs.
Appetite, meanwhile, is controlled by the pleasure centres of the brain. When we eat for pleasure and our hypothalamus releases dopamine, it can affect our bodies in many positive ways: improving memory, sleep and blood flow. It can also help reduce stress, as anyone who has taken the edge off a bad day with a pint of Ben & Jerry’s would know.
‘);var b=document.getElementById(“giScriptEl”).parentNode;b.removeChild(document.querySelector(“#giScriptEl”));(function(){var d=new IntersectionObserver(function(c,f){c.forEach(function(a){0
But food that is ultra-palatable can light up this part of our brain and override the signals telling us to stop eating. Seeing or smelling certain foods (especially those high in fat and sugar) can trigger extra-strong cravings and the release of dopamine in the brain that can make us want to eat these foods – sometimes to excess. The strong desire for food even when our stomachs are full is known as “hedonic hunger.”
Research has shown that people who struggle with overeating and obesity have a hyperactivation of the reward pathways in their brain and experience this hedonic hunger more frequently than the rest of the population. And women have higher rates of hedonic hunger than men.
GLP-1s reduce the activation of those reward pathways as well as the dopamine released, according to studies performed on humans and animals, thus curbing overeating. They can also quiet “food noise,” a term used to describe thoughts of food that are repetitive, unwanted and distressing.
But with GLP-1s, there can sometimes be too much of a good thing. The drugs can be so effective at blocking food noise and reducing the release of dopamine that they can cause anhedonia: a reduced ability to feel pleasure.
The anhedonia that can result from taking GLP-1s needs to be better measured and addressed, says Emily Dhurandhar, an obesity researcher and the director of research special projects at Texas Tech University Health Sciences Center. These impacts, like so much with GLP-1s, are understudied. Much of what researchers like her understand about this side effect has been informed through anecdotal reports, many of them shared on forums such as Reddit.
How will cheaper versions of Ozempic tip the scales?
After Mr. Brown, the former chef, left restaurants for a job in sales for a cannabis company, he found himself increasingly behind a desk or the wheel of a car en route to sales calls rather than on his feet, logging thousands of steps a day. He ate restaurant food about 10 times a week and it was catching up to him.
A few years into this new lifestyle, he noticed a dip in his metabolism and started putting on weight. A family history of heart attacks and diabetes had him concerned about his future. He started working out a lot – more in two years than he had his whole life – but his weight stayed the same. And that’s why he started on Mounjaro.
He didn’t face any of the common side effects he’d heard about, such as nausea or bloating, but in the weeks that followed the first injection, he experienced a “psychological shift.”
Food is how we connect with and care for other people. It’s one of the ways we preserve our culture, and the most common way we’re exposed to new ones. Food is nostalgia and comfort. Some of our strongest memories are tied to the look, smell or taste of a dish we had as a child.
For Mr. Brown, food had always been the biggest source of happiness in his life: not just cooking and eating it, but learning the history of different cuisines and seeing how meals brought people together.
And then it all evaporated.
“I would look at a restaurant menu or I go into a grocery store, and it would just be like, that part of me is dead,” he said.
He wanted to limit his caloric intake but didn’t anticipate what the loss of appetite would mean for his psyche.
After stopping the drug, Mr. Brown – to his great relief – regained the pleasure he’d lost when eating good food. But he also gained back the 10 pounds he’d shed in just a few months.
He was back where he started and knew he needed help fighting back against the diabetes and heart disease risk in his family. After almost a year and half of consideration, Mr. Brown decided to go back on the drug again this January, but this time after discussing it with his doctor – including his fears about the return of the anhedonia from last time. He was prescribed the lowest dose of the drug – lower than what he’d taken in 2024 – and so far, it’s been a more pleasant experience for him.
For some who have struggled their whole lives with body-image issues, the loss of pleasure in food can seem a worthwhile trade-off for weight loss.
Heidi MacKay, a 53-year-old in Vancouver, can’t remember a time in life when food wasn’t the enemy. At birthday parties, when the kids around her giddily wolfed down slices of birthday cake, she felt shame for doing the same. When she was still in elementary school, her parents enrolled her in Weight Watchers.
She had an intense sweet tooth and loved bringing candy or cookies to bed to nibble on at the end of a long, tiring day. The fries and coleslaw from the local chain White Spot were her “favourite thing in the whole world.” But after she was done the negative feelings kicked in.
‘);var b=document.getElementById(“giScriptEl”).parentNode;b.removeChild(document.querySelector(“#giScriptEl”));(function(){var d=new IntersectionObserver(function(c,f){c.forEach(function(a){0
She almost exclusively ordered delivery or takeout from restaurants, so unbearable was the feeling of being watched and judged for her body and her perceived lack of self-control.
She was always curious about the relationship people who weren’t fat had with food. Did they just sit down and eat it without any of the baggage? Did they crave something, give in to the indulgence and then feel fine after?
When Ms. MacKay learned the term “food noise” in conversations about GLP-1s, she immediately connected with it. She was intrigued by the idea of the volume being turned down on her persistent thoughts about eating.
On Mounjaro, which she was prescribed to treat diabetes, it felt like the dial was turned down to zero during her first year on the drug. For the first five days after her weekly injection, she had no feelings of hunger and had to force herself to eat. In those initial weeks she was also struck by an anxiety so debilitating she messaged her endocrinologist with worry, asking if it was something he’d seen in other patients. The doctor replied curtly, saying he’d never heard of that.
Two months into starting the drug, she ate a quesadilla with cheese, sour cream and salsa and spent the weekend feeling like she needed to go to the ER, that’s how intense the nausea, vomiting, constipation, diarrhea and stomach pain were. She felt similarly ill another time when she ordered a veggie burger with fries and coleslaw from her beloved White Spot.
She messaged the clinic again, seeking treatment for the digestive issues but was told that as a diabetes clinic, they could not prescribe her anything. But she was shedding pounds rapidly, so she stayed on Mounjaro.
In that first year, she would start each day with coffee with artificial sweetener and coffee creamer, followed by oat or soy milk blended with protein powder and ice for breakfast (adding in extra shakes like this if she felt she wasn’t getting enough protein for the day). For lunch she’d eat something like half a vegetarian sandwich from Subway. Dinner would often be plant-based chili and salad.
There was “just no food joy anymore,” she said.
Throughout her life, Ms. MacKay had seen dietitians, counsellors and therapists about her weight, but all were focused on helping her drop pounds, rather than addressing her mental health and the impact being fat and bullied had on her self-esteem.
Dozens of online-pharmacy ads, including for weight-loss drugs, appear to violate federal rules
People on these drugs “may have some need for psychological support and for coping mechanisms related to that loss of joy, that loss of pleasure,” says Ms. Dhurandhar, the obesity researcher at Texas Tech. She pointed to the holistic approach taken with metabolic and bariatric surgery patients as a model worth replicating.
Canadian guidelines recommend a comprehensive psychosocial assessment of patients before surgery to identify any mental health issues. Psychiatrists and psychologists are often part of care teams alongside surgeons and nurses and therapy is a common part of post-op care.
Preliminary research on the impact of GLP-1s on depression and mood disorders is mixed: Some studies suggest the drugs can alleviate symptoms; others suggest a side effect is heightened risk of depression and suicidality.
‘);var b=document.getElementById(“giScriptEl”).parentNode;b.removeChild(document.querySelector(“#giScriptEl”));(function(){var d=new IntersectionObserver(function(c,f){c.forEach(function(a){0
