Food noise among U.S. adults: Psychometric evaluation and prevalence estimates from a nationally representative...

Background: Widespread use of GLP-1 medications has revealed not only their effectiveness in reducing food intake and body mass, but also the clinical relevance of a seemingly underrecognized cognitive-affective process, food noise, that may be highly distressing for some individuals. Although the concept has gained increasing attention in public discourse, empirical research on food noise remains quite limited. We aimed to provide an initial epidemiologic characterization of food noise among U.S. adults. Methods: Our study utilized data from a nationally representative sample of U.S. adults ( N =3 646) conducted in Fall 2025. Survey-weighted exploratory and confirmatory factor analyses were used to evaluate the structure of the Food Noise Questionnaire (FNQ; ref. 1). Food noise endorsement was estimated using three operational definitions. Survey-weighted linear regression was used to examine associations between food noise and sociodemographic and weight-related subgroups. Results: Exploratory factor analysis supported a strongly loaded one-factor solution explaining approximately 80% of the variance. Confirmatory factor analysis supported the one-factor structure, with factor loadings and model fit broadly consistent with the original FNQ validation study. Depending on the operational definition, approximately 4% to 9.5% of U.S. adults met criteria for food noise endorsement. Among adults with obesity, prevalence ranged from approximately 6% to 14%. Food noise scores were higher among women than men ( B =0.18, 95%CI[0.09, 0.26], p <.001), higher among younger adults, and progressively increased across weight categories, from overweight ( B =0.23, 95%CI[0.13, 0.32], p <.001) to class III obesity ( B =0.61, 95%CI[0.46, 0.76], p <.001), relative to normal weight. Conclusions: These findings provide an initial indication of the potential scope and public health relevance of food noise, suggesting that its occurrence is not negligible but is far from ubiquitous among adults with obesity. Further research is needed to establish clinically meaningful thresholds, determine the overlap of food noise with related constructs, and examine its underlying mechanisms.