"The Day the Food Noise Died"

Until the new obesity drugsobesity drugs: medicines designed to help people lose weight — 减肥药 arrived on the market, the term "food noise" lived nowhere on any research agendaresearch agenda: the topics scientists choose to study and prioritise — 研究议题. Researchers developing Ozempic, Wegovy, Mounjaro and Zepbound measured doses, side effectsside effects: extra effects of a drug, often unwanted, beyond the main effect — 副作用, weight lossweight loss: the act or result of losing body weight — 减重 and improvements in diabetesdiabetes: Any of a group of metabolic diseases whereby a person (or other animal) has high blood sugar due to an inability to produce, or inability to metabolize, sufficient quantities of the hormone insulin — 糖尿病, heart disease and sleep apneaapnea: The cessation of breathing — 呼吸暂停sleep apnea: a sleep disorder in which breathing repeatedly stops and starts during sleep — 睡眠呼吸暂停, while the incessant chatterchatter: Talk, especially meaningless or unimportant talk — 絮叨 inside patients' heads — what to eat, what to resist, when to give in — went entirely unrecordedunrecorded: Not recorded — 未记录的. Then patients began reporting that the chatter had simply gone quiet, and an unstudiedunstudied: Free of artifice or cunning; innocent, spontaneous and unaffected — 自然不做作的 phenomenon walked into the clinic demanding a name.

Lena Smith Parker, 53, spent decades dietingdieting: The act of following a diet — 节食 and regainingregain: To get back; to recover possession of — 重新获得 weight, plaguedplague: To harass, pester or annoy someone persistently or incessantly. — 困扰；纠缠 by an internal dialogueinternal dialogue: the conversation a person has inside their own head — 内心对话 she had long assumed everyone shared. She likensliken: to (followed by to or unto) To compare; to state that (something) is like (something else) — 比作 one voice to a relentless auctioneerauctioneer: A person who conducts an auction on behalf of a vendor, taking bids to find the best price for the vendor — 拍卖师 urging her towardtoward: In the direction of — 朝着；向 the cake in the kitchen, another to a used-car salesmansalesman: A man whose job it is to sell things, either in a shop/store or elsewhere — 销售员 shaming her vegetables, a third to a flat-out bullybully: A person who is intentionally, physically, or emotionally cruel to others; especially to those who are weaker or have less power or privilege — 霸凌者, and a fourth to an advance plannerplanner: One who plans — 规划者 staging cupcakecupcake: A small cake baked in a paper container shaped like a cup, often with icing on top — 杯子蛋糕 runs days ahead. This is the food noisefood noise: constant, compulsive thoughts about food running through someone's head — 进食杂音 the article names — a churningchurn: To agitate rapidly and repetitively, or to stir with a rowing or rocking motion; generally applies to liquids, notably cream — 翻搅 internal dialogue no clinicianclinician: A healthcare provider working in a clinic or hospital — 临床医生 used to ask about, because no drug seemed capable of touching it.

To understand why such voices exist, researchers turn to an elusiveelusive: Evading capture, comprehension or remembrance — 难以捉摸的；难以理解的 concept from the 1940s, when rodentsrodent: A mammal of the order Rodentia, characterized by long incisors that grow continuously and are worn down by gnawing — 啮齿动物 made to gain or lose weight stubbornly returned to baselinebaseline: A datum used as the basis for calculation or for comparison — 基线 once the experiment ended; humans, it emerged, behave the same way. The body, on this model, has a weight it gravitatesgravitate: To tend or drift towards someone or something, as though being pulled by gravity — 被吸引 toward — its set pointset point: the body weight that a person's biology tends to return to — 体重定点 — and "obesity results from the initial elevationelevation: The act of raising from a lower place, condition, or quality to a higher; said of material things, persons, the mind, the voice, etc — 升高 of the set point to an abnormalabnormal: Of or pertaining to that which is irregular, in particular, behaviour that deviates from norms of social propriety or accepted standards of mental health — 异常的 level," explains Dr. Lee Kaplan of the Obesity and Metabolismmetabolism: The chemical processes that occur within a living organism in order to maintain life — 新陈代谢 Institute, who consults for more than one pharmaceuticalpharmaceutical: Of, or relating to pharmacy or pharmacists — 制药的；药学的 companypharmaceutical company: a company that makes and sells medicines — 制药公司. For some patients, the set point appears to malfunctionmalfunction: Faulty functioning — 故障, driftingdrift: To be carried slowly by a current of air or water; to move gradually and aimlessly. — 漂流；漂移；逐渐偏离 upward until excessexcess: An amount that is more than necessary, permitted, or desirable. — 过量；过剩；超额 weight begins to compromisecompromise: An agreement reached by each side making concessions; a middle state between conflicting alternatives. — 妥协；折中；和解 health.

Whenever a person tries to push their weight much below that set point, food noise will kick inkick in: to start taking effect; to begin operating — 开始起作用, and the pattern looks partly physiologicalphysiological: Of, or relating to physiology — 生理的: as weight falls, metabolism slows so less food is needed to maintain the new figure, yet the brain simultaneouslysimultaneously: at the same time — 同时地；同步地 starts compellingcompel: To force or oblige someone to do something; to bring about an action through irresistible pressure. — 强迫；迫使 its owner to eat more than the smaller body can burn. That asymmetryasymmetry: Absence of symmetry or proportion between the parts of a thing, or a distinction that produces such a lack of symmetry — 不对称 is why diets almost always fail in the long runin the long run: over a long period of time; eventually — 从长远来看, and why food noise is not restricted to people with obesity — anyone whose weight has slipped beneathbeneath: In or to a lower position than; under or below. — 在……下面；在……之下 the body's preferredpreferred: Favoured — 偏好的 set point can hear it.

Decades earlier, Dr. Jules Hirsch and his Rockefeller and Columbia colleagues had glimpsedglimpse: To see or view briefly or incompletely — 瞥见 the same dynamic in volunteers, some of normal weight and some not, who lived in hospital on a strict low-calorielow-calorie: containing a small amount of energy from food — 低卡的 diet until they had shedshed: to get rid of something unwanted; to cause blood, tears, or light to flow or fall — 去除；流（泪）；脱落；散发（光） at least 10 percent of their body mass. They left thinner, but presented the physiological signature of starvationstarvation: A condition of severe suffering due to a lack of nutrition — 饥饿: depressed metabolism, vividvivid: (of perception) Clear, detailed or powerful — 鲜明的 dreams of food, and once no longer subjected to the enforcedenforce: To compel compliance with a law, rule, or obligation through authority or force. — 执行；强制实施；使生效 regime, they bingedbinge: To engage in a short period of excessive consumption, especially of excessive alcohol consumption — 暴饮暴食 so badly that the syndromesyndrome: A recognizable pattern of signs, symptoms and/or behaviours, especially of a disease or medical or psychological condition — 综合征 earned the name "semi-starvation neurosisneurosis: A mental disorder, less severe than psychosis, marked by anxiety or fear which differ from normal measures by their intensity, which disorder results from a failure to compromise or properly adjust during the developmental stages of life, between normal human instinctual impulses and the demands of human society — 神经症." It was, Dr. Rudolph Leibel said, "a perfect stormperfect storm: a rare combination of conditions that produces a very bad outcome — 完美风暴 for weight regainweight regain: the return of body weight that has been lost — 体重反弹."

Ms. Smith Parker eventually entered a clinicalclinical: Relating to the observation and treatment of patients; coldly efficient and detached, without warmth or emotion. — 临床的；冷静客观的；冷淡的 trial ofclinical trial of: a research study testing a specific drug — 对某药的临床试验 tirzepatide — marketed as Zepbound — at a Yale weight-loss clinic, and the voices simply vanishedvanish: to disappear suddenly and completely — 消失；消逝；不见踪影. When the clinical trialclinical trial: a research study where new drugs are tested on volunteer patients — 临床试验 closedclose: to (social) To finish, to terminate — 结束；终止 before FDA approval, the food noise returned with a vengeancevengeance: Revenge taken for an insult, injury, or other wrong — 复仇with a vengeance: with great force or intensity, often more than before — 猛烈地; she regained 40 pounds on spaghettispaghetti: A type of pasta made in the shape of long thin strings — 意面 and chocolate cupcakes. Switched onto Wegovy, which had cleared the regulatorregulator: A person or group that sets standards of practice, especially those established by law — 监管机构, she described her head as suddenly, almost startlinglystartlingly: In a startling manner; surprisingly; shockingly — 惊人地, empty.

Dr. Ania Jastreboff, who runs clinical trials for drug manufacturersmanufacturer: One that manufactures — 制造商 and sits on multiple scientific advisoryadvisory: Containing advice; advising — 提供建议的 boardsscientific advisory board: a group of scientists who advise a company on technical matters — 科学顾问委员会 for the pharmaceutical companies that fund them, suspects the GLP-1s are temporarily resettingreset: To set back to the initial state — 重置 the set point downwarddownward: Toward a lower level, whether in physical space, in a hierarchy, or in amount or value — 向下, so patients still feel hunger but the running commentarycommentary: A spoken or written explanation or discussion of an event, typically broadcast during the event or published alongside a text. — 评论；解说；评注 that once drove their behaviorbehavior: The way a living creature behaves or acts generally — 习性 dissolvesdissolve: To cause a solid substance to become part of a liquid; to formally end a partnership, assembly, or agreement. — 溶解；解散；解除. Stop the drug, and the original set point returns with the noise; Dr. Leibel likens the effect to aspirin on a fever — it suppressessuppress: To put an end to, especially with force, to crush, do away with; to prohibit, subdue — 压制 the symptom without curing the underlyingunderlying: Basic or fundamental — 根本的 cause.

The unresolvedunresolved: Not resolved — 未解决的 question, Dr. Daniel Drucker calls "the million or billion dollar question": what is being read as "set," and how are the new drugs editing it? Until that mechanism is characterizedcharacterize: To describe the distinctive nature or features of something; to be a typical feature of something. — 描述……的特征；是……的典型特征, obesity will keep being treated as something each patient must out-discipline alone. Oprah Winfrey, who co-wrote a book on the experience with Dr. Jastreboff, describes the silence as the single biggest surprise of her medication; Drucker draws the lesson bluntlybluntly: In a blunt manner; without delicacy, or the usual forms of civility — 直率地；不客气地: people who never had their brains driving their behaviordriving their behavior: controlling or strongly shaping how someone acts — 支配其行为 can afford to be judgmentaljudgmental: (chiefly of a person) Inclined to rashly pass judgment, critical — 爱评判的 — but, he insists, they should not be.