I Have a Goal: CPAP Therapy + Diet + Exercise = Appetite Control – Say What?
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How Leptin and Insulin Signal Satiety Source for Graphic: Wiki.Brown.edu ____________________ |
I have been
stamping my feet and complaining for the last six weeks because of having to
wear a CPAP mask (Continuous Positive Airway Pressure, a therapy designed
for people who stop breathing during sleep, and, therefore, wake up several
times during the night. Sleep-deprived people can experience serious medical
problems, such as heart disease, high blood pressure, and obesity, among other
ailments).
I grumble every single night. My better half must be sick of my constant
kvetching...
But for the first time since I can remember, I’m getting good sleep
and waking up energetic and exercising regularly.
About four weeks into the CPAP therapy, I also noticed something else: my
appetite has started to regulate itself, which has been a total surprise to me
because I have always had an out-sized appetite. I never really knew
the difference between hunger and satiety – I would go from being starved to
being overly full (and it took a lot to get there). Yes, I would diet, but it
was a struggle because my body was fighting the diet every inch of the way
(excuse the pun) and the constant hunger just got to me eventually.
But now I’m beginning to recognize the satiety signals that my body gives
to me.
About six weeks ago, I started back at Weight Watchers, not too
optimistically, because I have done this chapter and verse numerous times
before (the last time discussed on this blog), only to put most of the weight
back on.
But this time I have started with the determination of losing the weight so that I can lose the CPAP, still my goal.
That’s a powerful reason to put up with constant hunger pangs.
But this time I have started with the determination of losing the weight so that I can lose the CPAP, still my goal.
That’s a powerful reason to put up with constant hunger pangs.
So when my appetite started normalizing, I just couldn’t believe it; I’m
not sure I still believe it, that I will discover that this is just an
aberration and that motivation is the real impetus.
I had read somewhere – God knows where – that sleep deprivation and
obesity were related. Was I sleep deprived because I was obese, or was I obese
because I was sleep deprived? Who knows?
I did a little research: I already knew about insulin resistance, but
then I stumbled upon the word “Leptin” (stay with me, I'm not trying to sell
supplements or anything), which is simply the hormone that regulates hunger
(among other functions, such as building bone).
There is an actual serious medical condition called Leptin
Deficiency (NIH article); people who suffer from this deficiency
are usually born at a normal weight, but quickly gain weight as babies because
they can’t quit eating. Without Leptin, there is zero appetite control, so
these poor souls become morbidly obese very quickly. (Please keep this in mind
before judging someone who is morbidly obese.)
This definitely is not me; I was a fairly skinny kid until I was five or
so and then just pleasingly plump. As a small kid, I don’t remember having a
remarkable appetite, one way or another.
I started noticing a change in appetite when I was about 10 – right
about the same time I started sleeping poorly. I never, in a million years,
connected the two, even when I grew up and older. My grandmother (who raised
me) certainly noticed my eating habits. To my embarrassment, she often told
people, “Jennifer eats like three men.” And I could (not so much anymore).
The research has taken me in different directions. First, I discovered
that low Leptin levels is often connected with obesity; even people with normal
appetites become hungrier as the day goes on – when Leptin is normally lower –
which is why even normal eaters are more likely to eat a bag of potato chips at
night, but not in the morning.
Then I stumbled across some studies that suggested that sleep deprivation
may lower Leptin levels even more (studies were done on CPAP users, with and
without CPAP therapy), but other studies contradicted that notion, and yet
others were inconclusive.
Very confusing, indeed.
Then I read an article on WebMD that makes perfect sense: that obese
people often create more than enough Leptin, but the hormone never reaches the
brain and appetite center; hence the term “Leptin Resistance.” In this
scenario, Leptin therapy would not work, much in the same way that insulin
therapy would not work with insulin resistant patients.
Leptin injections do work in people who are truly deficient in Leptin,
but injecting a resistant patient with Leptin would be pointless and, perhaps,
even dangerous.
(By the way, all those Leptin pills sold on late night TV and Amazon are
all bogus – the 21st century version of snake oil. Stay away. The only
thing that will get thinner is your wallet).
So, how to battle Insulin and Leptin resistance? All the research says:
eat a diet low in processed sugars, eat healthy food (we all know what those
foods are, blah, blah, blah, and they aren’t called “Twinkies”), exercise
regularly, and get plenty of sleep.
Off and on, I had been trying to eat well and exercise, but the sleep
component was always missing – until six weeks ago, I doubt if I had decent
night’s sleep in years.
So now that I’m sleeping fairly well (some nights, I rip off the CPAP
mask without knowing it), I can only hope that this is real and not just
extreme motivation at work.
Time will tell.
Meanwhile, this is an illuminating WebMD article on “Leptin Resistance.”
I’m sharing this because there may be others out there who might benefit
from knowing that there could be a connection between lack of sleep and
appetite.
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