Sleep and Weight Loss – what’s the connection?

The words that strike fear. How many millions of wasted time and money go into these two words. What makes it worse is that there doesn’t seem to be a specific way of achieving it, although from reading advertisements and articles by experts you’d be sure there was. The result is that most people feel that it’s not worth it – so is it?

My problem with obesity

The other annoying (or so I find it) aspect is that some people seem to manage it without trying (it seems) while the rest of us work at it yet feel like we’re playing with a yo-yo, only to end up back where we started. , I guess if you’re talking about being 200 lbs overweight it’s different than the doctor saying that you could do with losing 30 lbs, right?

The Global Problem of Obesity

While this isn’t your problem directly its useful to know where you sit in the overall picture. It also sets the scene when it comes to the ‘cultural norm’, that is, our reference point.

The Obesity Pandemic

Almost everyone now agrees that obesity is now pandemic, affecting millions of people worldwide. In rich countries, between 10% and 20% of people are obese, and the problem is not unknown even in poor countries. 

Obesity in the USA

In the United States, the National Institutes of Health and the surgeon general have acknowledged the importance of the problem and are developing public health strategies to curb the epidemic. In the United States, in 1999, 27% of adults had a body mass index >30 kg/m2, almost double the prevalence of 20 years earlier.

The estimated mortality from obesity-related diseases in the United States is approximately 300,000 annually and growing.

For American children and adolescents aged 2-19 years, the prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents. Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds.

Obesity in Canada

There is recent evidence that there have been large increases in the national prevalence of overweight and obesity in Canadian children and adults over the last 2 decades, similar to the increases observed in other industrialized nations.  

In Canada, almost 1 in 7 children and youth is obese. Rates vary based on sociodemographic factors such as age, sex, socioeconomic status and place of residence. Overall, the rates of excess weight do not seem to be growing as fast as in the adult population.

Although the causes of this are not well defined, lack of physical activity may be an important factor. Nationally representative measured height and body mass data are not systematically collected in Canada. Measured data from the 1981 Canada Fitness Survey (CFS) are available.

Obesity in the UK

Adult obesity in England has risen from 15% in 1993 to 29% in 2017. Men are more likely than women to be overweight or obese. However, obesity levels among women (30.0%) are slightly above those of men (27.4%) These proportions vary by age, as the collection of charts below shows.

The UK has one of the highest rates of childhood obesity in Europe. In 2018, around one in 10 children aged four to five were classified as obese, and around one in five children aged 10 to 11 were obese.

Is obesity a disease?

Obesity is a condition of excessive body fat that results from a chronic energy imbalance whereby intake exceeds expenditure. Excess body fat increases the risk of premature death from chronic diseases such as coronary heart disease, stroke, type 2 diabetes mellitus, gallbladder disease, Obstructive Sleep Apnea (OSA) and some cancers.

What is the medical cost of Obesity in Canada?

The direct medical costs attributable to adult obesity in Canada alone are estimated to have been $1.8 billion in 1997, or 2.4% of total direct medical costs. The public health burden of obesity and related disorders is therefore great.

The has been a dramatic increase in the prevalence of  as can be seen in the obesity surveillance maps for Canadian adults (aged ≥ 20 years) from 1985 to 1998.

Is Obesity a problem in Canada

The Canadian surveys included the 1985 and 1990 Health Promotion Surveys and the 1994, 1996 and 1998 National Population Health Surveys.  

The prevalence of adult obesity in each of the samples was calculated (defined as BMI ≥ 30 kg/m2) and statistically weighted to be representative of the Canadian population for the year each survey was conducted.

Given that individuals (particularly obese individuals) tend to underreport their body weights,  the prevalence of obesity reported here should therefore be considered conservative.

The increase in Obesity in Canada

Above – Prevalence of obesity among Canadian adults in 1985, 1990, 1994, 1996 and 1998. calculated from self-reported heights and weights from the 1985 and 1990 Health Promotion Surveys and the 1994, 1996 and 1998 National Population Health Surveys.

The maps clearly show the progression of the obesity epidemic across the country. Over the 13-year span considered here, all provinces experienced increases in the prevalence of obesity. By 1998, only Quebec and British Columbia had prevalence below 15%, although they were not far behind, both had a prevalence of obesity of 12%.

The overall national prevalence of obesity increased across the surveys, more than doubling over the 13-year period: 5.6%, 9.2%, 13.4%, 12.7% and 14.8% for the years 1985, 1990, 1994, 1996 and 1998 respectively.

Canadian population and Obesity

In 1998, the adult population of Canada was 22.2 million; thus, the prevalence of obesity in that year translates into 3.3 million obese Canadians. Canada 2020 population is estimated at 37,742,154 people at midyear according to UN data. Canada population is equivalent to 0.48% of the total world population. Canada ranks number 39 in the list of countries (and dependencies) by population.

According to recent guidelines,  adults are classified as being of normal weight with a body mass index (BMI) of 18.5–24.9 kg/m2 , overweight with a BMI of 25.0–29.9 kg/m2 and obese with a BMI ≥ 30 kg/m2.

BMI (Body Mass Index) 

BMI is a simple calculation using a person’s height and weight. The formula is BMI = kg/m2 where kg is a person’s weight in kilograms and m2 is their height in metres squared. A BMI of 25.0 or more is overweight, while the healthy range is 18.5 to 24.9. BMI applies to most adults 18-65 years.

In the future, mortality related to obesity is expected to exceed that of smoking. Numerous diseases are caused or made worse by obesity.

These include type 2 diabetes; hypertension; dyslipidemia; ischemic heart disease; stroke; obstructive sleep apnea and snoring, asthma; non-alcoholic steatohepatitis; gastroesophageal reflux disease; degenerative joint disease of the back, hips, knees, and feet; infertility and polycystic ovary syndrome; various malignancies; and depression to name but a few.

In summary, Canada has, as have other developed countries, recently experienced a major epidemic of obesity, with the population prevalence more than doubling between 1985 and 1998. In 1998, the problem of obesity was nationwide, because it did not appear to be limited to one province or region.

Obesity and Obstructive Sleep Apnea

In adults, excess weight is the strongest risk factor associated with obstructive sleep apnea. Each unit increase in BMI is associated with a 14% increased risk of developing sleep apnea, and a 10% weight gain increases the odds of developing moderate or severe obstructive sleep apnea by six times.

The effect of tongue, neck and throat on Obstructive Sleep Apnea.

Pharyngeal (throat) and tongue fat are important in OSA and snoring causation due to its effect on the upper airway. In view of the epidemic proportion of society suffering from OSA and snoring an understanding of its effect and then management could provide significant improvement in OSA and therefore cardiovascular disease, diabetes, poor sleep and excessive daytime sleepiness to name but a few.

OSA and an increase in obesity

Excess body weight contributes to sleep apnea by causing increased pressure on upper airways, leading to collapse and decreased neuromuscular control from the fatty deposits. These fatty deposits contribute to decreased lung volume and make it more difficult to breathe.

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