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What Is Obesity?

Overweight and obesity are labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems.

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the "body mass index" (BMI). BMI is used because, for most people, it correlates with their amount of body fat.


Obesity And Co-Morbid Conditions

Research has shown that obesity places you at greater risk for the following conditions.

  • Coronary heart disease
  • Type 2 diabetes
  • Cancers (endometrial, breast, and colon)
  • Hypertension (high blood pressure)
  • Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
  • Stroke
  • Liver and gallbladder disease
  • Sleep apnea and respiratory problems
  • Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
  • Gynecological problems (abnormal menses, infertility)

Obesity Facts And Trends

According to recent studies, about a third of all Americans are obese. The good news is that the upward trend of the previous thirty years leveled off towards the end of the the first decade of this century. The upward trend was slightly higher among men than women.

Hispanics and blacks both have a higher prevalence of obesity than whites, with the greatest prevalences of obesity for both blacks and whites being found in the South and Midwest, and the lowest in the West and Northeast.


Sleep Apnoea

"Apnea" is a Greek word that literally means "without breath". Sleep Apnoea (SA) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. These pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.


There are three forms of sleep apnea :

  • Centrll Sleep Apnoea (CSA) conisitute 0.4% of all cases. In central sleep apnea, there is some problem in the brain  and it fails to signal the lungs to breathe. The respiratory air way itself is normal and there is no blockage in it. 

  • Obsstructive Sleep apnoea (OSA),( 84%).  It is caused by a blockage of the airway, usually when the soft  tissue in the rear of the throat collapses and closes the air way during sleep.  . 

  • Complex or mixed sleep apnea (i.e. a combination of central and obstructive)  15% of cases 

With each apnea event, as the Oxygen supply gets interrupted, the brain rouses the sleeper.The arousal is usually only partially, just enough to signal breathing to resume. As this happens very frequently through out the entire sleep time, the net result, is extremely disrupted and a poor quality sleep for the patient.

Regardless of type, an individual with sleep apnea is rarely aware of having difficulty breathing because it only occurs during sleep doesn't trigger a full awakening. A family member or bed partner is usually the first to notice signs of sleep apnea.


Sleep apnea is seen more frequently among men than among women, particularly African-American and Hispanic men. It is very common, as common as type 2 diabetes. According to the National Sleep Foundation it affects more than 18 million Americans. Risk factors include being male, overweight, and over the age of 40, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and health care professionals, the vast majority of sleep apnea patients remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences

How it is diagnosed?.

Symptoms of sleep apnoea may be present for years without being noticed during which time the sufferer may become conditioned to the daytime sleepiness and fatigue which occur as a result of spersistant sleep disturbance. A major symptom, if present, is extremely loud snoring, sometimes so loud that bed partners find it intolerable. Other indications that should lead to suspicion of sleep apnea include obesity, persistent daytime sleepiness, bouts of awakening out of breath during the night, and frequently waking in the morning with a dry mouth or a headache. But it uncommon to find all of these symptoms in any single patient and hence form an inconclusive basis for diagnosing sleep apnoea. A definitive diagnosis is made only through a sleep study in a sleep laboratory or a home sleep study, a test also called Polysomnogram. It also shows how severe the problem is.


Sleep Apnoea is a potentially dangreous medical condition. Left untreated, it can give way to serious life-shortening diseases like high blood pressure, heart disease, stroke, traffic accidents caused by falling asleep at the wheel, type 2 diabetes  and depression etc

Sleep apnoea's association with obesity:

Excessive weight is closely associated with obesity. 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. Compared to normal-weight adults, those who are obese have a sevenfold increased risk of developing obstructive sleep apnea.However this association of obstructive sleep apnea with obesity becomes less significant after the age of 60. Convesrsely weight loss has been associated with improvement in Obstructive sleep Apnoea.

Sleepapnea is a growing problem in the U.S as is obesity. In adults, the most common cause of obstructive sleep apnea is excess weight and obesity. This is because of large mass of soft tissues of the mouth and throat in obese persons. During sleep, muscles of throat and tongue become more relaxed, and may falls listlessly blocking the the respiratory airway. But this is not the only mechanism involved. There are some biochemical pathways too that significantly contribute to this condition in obese individuals.


As a general measure of how level of obesity determines the occurance of sleep apnoea, a person's neck circumference is taken into consideration. Obese men with a neck circumference of 17 inches or greater, and women with a neck circumference of 16 inches or greater are more likely to have sleep apnea. 

Medical consequences of sleep apnoea:

A rather more distressing aspect of of this matter is that not only does obesity have an association with sleep apnea, but sleep apnea as well as resultant poor sleep, tends to cause people to eat more.

Research indicates there is a relationship between hunger and satiety hormones and sleep deprivation, though the exact biochemical pathways involved are not clear as yet. 

People disgnosed with sleep apnea usually have high blood pressure, diabetes, and high cholesterol levels, all of which can be made worse with sleep deprivation. So in a way obesity and sleep apnoea re-infornce eath other, one suppeting the other: Obesity, especially morbid obesity can lead to sleep apnea, which, itself, then causes derangements of hormones that control eating habits, leading to more weight gain, worsened blood pressure, glucose intolerance, worsened apnea and the net result is a viscious cycle of obesity leading to sleep apnoea and sleep apnoea leading to obesity goes on.

Due to diffences in anatomy, children have some specific reason too for sleep apnoea that often include enlarged tonsils or adenoids and some dental deformaties. Less common causes include a tumor or growth in the airway, and some serious birth defects such as Down syndrome and Pierre-Robin syndrome that cause enlargement of structures such as the tongue and jaw. Although childhood obesity may cause obstructive sleep apnea, it's much less commonly associated with the condition than adult obesity.


Please be aware that this  this information is intended for educational purposes .It is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. 

*Disclaimer: Results are typical but not guaranteed. Your actual results may vary. Real CalMWM patients shown with permission.

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