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How Does Sleep Affect Weight Loss?

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How Does Sleep Affect Weight Loss?

— By Dawn Sweet, Ph.D.

Good sleep quality can reduce ghrelin and increase leptin, the hormones implicated in hunger and satiety.

Sleep is an important part of a weight loss and weight management program as well as a modifiable risk behavior. Poor quality sleep and lack of sleep are implicated in an elevated risk of developing cardiovascular disease, type 2 diabetes, and even poor cognitive functioning.1,2 Hormonal pathways, ghrelin and leptin, for example, can be disrupted during periods of sleep loss, leading to unwanted weight gain and its associated health risks. When sleep is lacking, our brains experience a stronger reward response to food, thus increasing our desire for food.3

Lifestyle changes (dietary and exercise) are key aspects of successful weight loss. While these changes account for a large portion of weight loss/maintenance success stories, they could be optimized via good quality sleep. Sleep, as part of a weight loss and weight management strategy, can help reduce ghrelin and increase leptin.

How Does Sleep Affect Weight Loss?

A 2021 study4 supports sleep as a modifiable risk factor for metabolic syndrome, obesity, and diabetes. During periods of poor sleep or sleep loss, leptin regulation is disrupted, thus increasing one’s risk of unwanted weight gain and developing type 2 diabetes. While several early studies found evidence for leptin and ghrelin dysregulation playing a key role in BMI increases5,6, there does seem to be some inconsistencies relative to leptin reductions. For example, previous research has found reductions6, no changes7, or increases.8 Sleeping for five to six hours per night was associated with reduced leptin and an elevated risk of obesity compared to sleeping for seven to eight or nine to 10 hours per night.

In a group of postmenopausal women, less than six hours of sleep per night was associated with reduced serum leptin9 while in a study of healthy men10, leptin levels returned to normal during a recovery sleep period following a period of sleep deprivation. In the context of glucose regulation, there is an inverse relationship. Too little or too much sleep may increase the risk for unwanted weight gain and type 2 diabetes.4 There is evidence to suggest that HbA1c levels increase when sleep duration is shortened or extended compared to normal sleep duration.11

The inconsistencies in the relationship between leptin and weight gain may be attributed to not accounting for the role of stress in the study designs. There is a robust correlation in the research between poor quality sleep and stress. While poor quality or reduced sleep duration can lead to leptin reductions, stress likely mediates this relationship.

Implications for Clinical Practice: Strategies for Improving Sleep Quality

Because sleep is a modifiable risk behavior, working with patients on stress management and sleep hygiene may be good starting points. When tired and stressed, patients may engage in emotional eating, opting for unhealthy foods that are higher in saturated fat and sugar.12, 13 Working with patients to identify triggers for stress and developing adaptive coping mechanisms can help them avoid emotional eating. Additionally, working with patients to develop good sleep hygiene habits, e.g., going to bed at the same time each night, adding exercise to their daily routine, and keeping electronics out of the bedroom, to name a few, can help patients optimize their chances for improved sleep quality.14

Partnering with patients to develop sustainable lifestyle changes can help them eat healthy and sleep better.  Following a Low Calorie Diet (LCD) or Very Low Calorie Diet (VLCD) that includes lean proteins, fruits, and vegetables should also be considered as part of an overall healthy eating plan. To ensure nutritional needs are being met, pre-packaged, nutritionally formulated meal replacement products offer convenience and satisfy daily recommendations for vitamins and minerals.

Sources:

1 The National Sleep Foundation

2 Sleep is essential to health: an American Academy of Sleep Medicine position statement

3 Sleep restriction increases the neuronal response to unhealthy food in normal-weight individuals

4 The role of sleep curtailment on leptin levels in obesity and diabetes mellitus

5 Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index

6 Short sleep duration is associated with reduced leptin levels and increased adiposity: Results from the Quebec family study

7 A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men

8 Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men

9 Short sleep duration is associated with decreased serum leptin, increased energy intake and decreased diet quality in postmenopausal women

10 Sleep loss reduces diurnal rhythm amplitude of leptin in healthy men

11 The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: A systematic review and meta-analysis

12 Stress in America: The state of our nation

13 Stress and obesity

14 Centers for Disease Control and Prevention: Tips for better sleep

About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.

About Robard: For 45 years, Robard Corporation’s medical obesity treatment programs and nutrition products have been utilized by physicians, surgeons and hospitals across the United States to successfully treat patients living with obesity. To learn more about us and how we can help your practice and patients, visit us online at www.Robard.com, email us at info@robard.com, or call (800) 222-9201.

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