CPAP'ers - Too Lazy to Lose Weight

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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ozij
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Post by ozij » Thu Aug 25, 2005 12:15 am

Sleeping With The Enemy wrote: If any of you disagree, I guess I would say there is lots of denial and rationalization going on here
Sleeping With The Enemy wrote:There is not amount of research you could quote me to support your rationalization that it is okay or healthy to be overweight.
That, in a nutshell, is the problem: Any one who disagrees is rationalizing, research is irrelevant.

The apostates are fat (eeewww), lazy, dishonest by implication, in denial (despite looking for information), wasting their energy regardless of the number of times a week they go to gym, or how long they've been doing it.

The true believers, on the other hand, those who focus on weight ("How fat are you?"), are honest, and this honesty gives them an inalienable right to attack others...

Oh, and they don't describe themselves as fat. They are, ahem, overweight.... "Fat" is reserved for "you".


O.

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lola
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Post by lola » Thu Aug 25, 2005 6:52 am

One at a time, and these will be my last posts on the topic. You're welcome to PM me if you need more information.
I want to agree with the premise that if you're overweight but exercise and are healthy, that's fine. The only thing that doesn't sit right with me on this is, if you're exercising enough to do good, you shouldn't be overweight unless you have some other underlying condition. If you get past the 20 minute warmup point with cardio exercise, that is when fat starts to burn off. You must get past the 20 minutes, though. If you are doing that three times a week, at least, then you have to burn off the extra pounds. If you say you are exercising but not losing weight, then what are you doing? Now if you're just bench pressing weights, okay. Muscle weighs more than fat and you're not doing a thing to burn off the fat by doing that. But if you are doing anything to work up a sweat for your cardiovascular system, you should be losing weight, too.
How's a carefully put together program by my personal trainer sound? Seriously, I do 50 minutes of cardio training 4 times a week, somestimes it's straight cardio to the right elevated heart rate (I know how the Krebs Cycle works, hehe), sometimes it's interval training. 3 times a week I do a weights routine that does raise the heart rate and break a sweat too, though not quite as much as cardio. I'm not a flimsy thing, the weights I do are closer to bodybuilding training than the "toning" most women go for. Building more muscle will cause your body's energy requirements to rise, muscle's high-maintenance. Also, I don't have a car, so I do a LOT of walking. So, I must be eating too much, right? Well...no. I actually recently did write down everything I ate over two weeks, including everything such as a 1/4 cup of juice to wash down a pill, etc. Showed it to my doctor (who has a big interest in nutrition and is quite slim herself) and she couldn't find anything to criticise. We figured out together that I actually have a calorie deficit of around 140 calories a day on average. Now, in a person who's become fat simply through poor lifestyle, that would possibly result in a very slow gradual weight loss. In people like myself who have a medical history of starvation and yo-yo dieting...not so much. All that famine training I did taught my body well how to make the most of every calorie it gets. My doctor's recommendation is that I actually try to eat just a little more to make up that deficit, say, an extra snack, so that my body will get used to the idea that it doesn't need to have any extreme reactions any more.

Taking in less energy than you expend is the theory behind most weight loss plans. But the body's not quite so simple and it's also very tricksy. It works like this (and this is even the simplified version leaving out the factors to do with hormones and enzyme regulation):

C - N - S1- S2 - S3 - I - H - E - V = 0

C = calories eaten
N = non-absorbed calories excreted in bowels
S1 = calories stored as fat
S2 = calories stored as carbohydrate
S3 = calories stored as protein
I = calories used in involuntary movement
H = calories used for heat generation and other metabolic processes
V = calories used in voluntary movement
E = calories excreted in urine (Examples: fat converted to glucose in the liver, incompletely burned triglycerides and albumin)

You only have manual controls on C and V, and when you deliberately vary C and V it causes feedback to the other parts of the system, none are independent of the other, they adjust to keep equilibrium as much as possible. So you can't say that the amount of energy stored as S1 is "whatever is left over", because there is no such thing as "left over" in a feedback-controlled homeostasis. Increasing V and decreasing C in order to affect S1 is unpredictable, because you can't control what, say, I and H and V will do in order to maintain that equilibrium. If you keep trying increasingly varying changes in V and C, you can really screw up your regulatory mechanisms even more.

This isn't a wacky new idea, it's there in detail in your average human biochemistry textbook. And it's not to say, of course, that we shouldn't bother with exercise to burn calories, because the benefits of exercise are far greater than mere calories expended. I'm looking forward to seeing how much I can improve my cardio and weights with the stacks of extra energy I will have after starting CPAP. (Positive thinking! )

This fat lady's NOT singing! And soon not snoring either. ;)

lola
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Post by lola » Thu Aug 25, 2005 6:54 am

I am a nurse and in my line of work I have seen tons or overweight people.
As someone who presumably has had an education in science and medicine and the scientific method, you should know that anecdotes aren't data. It doesn't matter that you've seen 500 fat people with diabetes, because you might not have seen the 5000 who don't. I've got a friend who's an oncology nurse and she's seen plenty of skinny people with diabetes, but that doesn't mean anything besides she's seen some skinny patients with diabetes. (One thing she's seen that's backed up by solid evidence is that fat people get cancer at the same rate as slim people with the exeption of a slightly raised risk for some endometrial cancers, but that fat people survive chemotherapy a lot better.)
Some of the risks of being overweight are type 2 diabetes and high blood pressure. There are many others:
The problem is that the studies that have come to these conclusions are often quite flawed. I recall one study which concluded that fat people have high risk of heart attack, but neglected to control for smoking! They so often conclude, incomprehensibly against their own data, that there is causality between being fat and being unhealthy. A quick search of PubMed and other medical journal databases will bring up an alarming number of articles that have conclusions such as: "Well, this study showed that fat people aren't really unhealthy. But they should lose weight anyway despite our own knowledge that this is a problematic issue." This is where the medicalisation of the "sin" of being fat comes into play and we get to go off into the land of ethics and sociology.

One big sign that the medical establishment knows that dieting is unsuccessful for so many people is the existence of weight loss surgery. Go to any (ethical) WLS clinic's website and it'll have a bit about how the surgery is intended for those for whom non-surgical methods have not worked. WLS is by no means a guarantor of weight loss and health, either.
Being healthy and overweight just don't fit together. This business about famine is just more rationalization on your part.
The business about famine is a well known biological phenomenon. Humans and other mammals, for better or for worse, evolved with a biomechanism that provides for the extra storage of energy-rich fat cells in times of trouble such as famines. The chemical messenger in the brain, Neuropeptide Y, is what causes the famine reaction to kick in. Animals who are showing symptoms of famine reaction (such as not losing weight despite a deficit in caloric intake) have rather a lot of it floating around the brain. We don't fully know how to control it, though there's a lot of research going on as to what receptors use it in what manner. We do know that Neuropeptide Y can directly act upon fat cells via the automatic nervous system, releasing hormones into the bloodstream that tell your body how much fat to store or burn. This forms part of the equation that I posted previously.

If you've decided that your health will be better by losing weight, then as I said, best wishes to you. I respect that you're an adult who can make their own decisions about their body. I only ask the same - my own decision isn't based on some recalcitrant desire to stay fat, it's based on sound biological facts and scientific evidence, not fairy tales I've made up so I don't have to get off the couch; and an examination and analysis of my medical history. To lose weight, I would have to undergo an extended period of starvation and malnutrition, and to stay slim, I would have to continue to eat in that manner. I do not believe this is a healthy or responsible path for me to take, as I would literally be destroying my healthy body to fit a societal expectation. If an already-slim person behaved in this manner, we'd bundle them off to the anorexia ward quick smart, yet fat people are encouraged/shamed into such unhealthy lifestyles. It is incongruous with "First, do no harm."
This fat lady's NOT singing! And soon not snoring either. ;)

Guest

Post by Guest » Thu Aug 25, 2005 6:54 am

I definitely think weight loss would help me. As far as I know, I never had a problem with snoring until the last few years when I gained weight. Same with my husband who is now about to have a sleep study. He does have enlarged tonsils and will have them removed, but he never snored like he does now and didn't seem to have a problem until the last year or so when he gained weight. I am trying to lose the weight. I have been on the CPAP for a week now and I don't feel like I am having good results. I am hoping that changes, therefore giving me a little energy to exercise more, etc.... For me, I used to be very athletic and very active. Over time, and kids, I am not as active and therefore gained weight. The sleep apnea has just worn me out. I can fall asleep at the drop of a hat and even while driving short distances. I am really hoping to eventually get a good night's sleep and that the increased energy will help me get active again.

SleeplessnTexas


Guest

Post by Guest » Thu Aug 25, 2005 6:56 am

I'm looking forward to seeing how much I can improve my cardio and weights with the stacks of extra energy I will have after starting CPAP. Wink (Positive thinking! Laughing )
I have been on the CPAP a week and patiently awaiting positive results! Wonder how much longer it will take?


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ozij
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Post by ozij » Thu Aug 25, 2005 7:17 am

I believe lola has really said it all in her last two post. I too will not post on this subject again, but I'ld like to quote lola, for all of us who are struggling for our health and well being, whether we posted on the subject, or just followed it.

I am adding an emphasis:
lola wrote:If you've decided that your health will be better by losing weight, then as I said, best wishes to you. I respect that you're an adult who can make their own decisions about their body. I only ask the same - my own decision isn't based on some recalcitrant desire to stay fat, it's based on sound biological facts and scientific evidence, not fairy tales I've made up so I don't have to get off the couch; and an examination and analysis of my medical history.

O.

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And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
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Good advice is compromised by missing data
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Sleepless on LI
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Post by Sleepless on LI » Thu Aug 25, 2005 7:45 am

I want to agree with the premise that if you're overweight but exercise and are healthy, that's fine. The only thing that doesn't sit right with me on this is, if you're exercising enough to do good, you shouldn't be overweight unless you have some other underlying condition. If you get past the 20 minute warmup point with cardio exercise, that is when fat starts to burn off. You must get past the 20 minutes, though. If you are doing that three times a week, at least, then you have to burn off the extra pounds. If you say you are exercising but not losing weight, then what are you doing? Now if you're just bench pressing weights, okay. Muscle weighs more than fat and you're not doing a thing to burn off the fat by doing that. But if you are doing anything to work up a sweat for your cardiovascular system, you should be losing weight, too.
Lola, please don't take that as an attack on you. If you read earlier in the thread, I was on the side of anyone who has extra weight and got very offended personally, even with my 11 lbs. to go, over the author of this post's attitude towards people who are not at their "perfect' size. My only point in saying this was to express my own UNRESEARCHED thoughts on the subject. You are very well informed as your answer shows and I found your post very interesting to read. However, please don't think I am one of these people who are bashing people who are more than their target weight. I am not. I just always figured that if you are exercising and eating right, UNLESS THERE IS SOME UNDERLYING CONDITION which is causing you not to, you should lose weight. And for all intents and purposes, after reading what you wrote, that still is my opinion. If your body doesn't work in the average way, and you have all these other apsects that you labeled by their first letter that don't react as they normally do in the person who is at a recommended weight, then perhaps you're not ill but your body does not behave in the "normal" way it should when it comes to all these variables. Maybe I'm still off base when I think that way, but it's the only thing that seems logical to me.
I am also the one who wrote that I couldn't care less if you weigh 90 or 350 lbs. I also don't care what country you came from, what perfume you wear or what color your hair is this week. If you're a good person, to me that's all that matters. So please don't take my post as one of negativity against "heavier" people. I don't call them "fat," or say "Ewwwwww," as Ozij wrote, or do anything in the least to separate people who have more weight from the others who don't. And I really don't want to feel I'm being put in that category. I have never held out prejudgices to anyone based on appearance. And at this stage in my life, I am not changing that now.
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ehusen
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Post by ehusen » Thu Aug 25, 2005 8:15 am

Kudos to everyone for not letting this thread get "ugly". So often people with conflicting view points start getting mean in these types of threads.

Guess I'll add my viewpoint as well here, for no particular reason.

One poster keeps talking about "flawed studies". Now that may be true but they then start discussing other studies and use those as a defence of their position. I find this interesting. Since now we have to take each and every "study" and make a decision about whether it's valid or not. When it gets to that point I'm about ready to give up on it.

So I'll just throw out my own opinion based very little on solid "facts" but just general observations and some study of those "studies".

We've got a lot more heavy people out there today. This is due to more food and less exercise. This IS a health issue. Now, personally, I believe that our sedentary lifestyle is a pretty bad health issue. More so than the weight even. I also believe all the high fat, high calorie, and processed food we eat is bad too.

Are we too body concious? Certainly. Do we spend too much time/money/sanity on weight loss? Definitely. But if you are morbidly obese, you ARE endangering your life. Heck, we are in a sleep apnea forum, for goodness sake. And I don't think anyone here would argue that excess weight can cause/excacerbate OSA, which we all know is a health risk.

Now, I can certainly understand some debate about what is "ideal weight". And being 10-30 lbs "overweight" maybe isn't such a huge issue. But come on, you have to admit that carrying a lot more weight than that is a danger and certainly reduces your quality of life in many cases. And even if it doesn't, the havoc on your joints, the lack of energy, and general quality of life must be pretty hard on the very obese.

I agree that focusing on "weight loss" only isn't the right approach. You need to focus on a healthy lifestyle. But eating the right amount of the right foods and getting some good cardio exercise pretty much results in getting to an optimum weight. (IMHO)

In my book, the argument isn't about whether or not being overweight is "bad for your health", it's about at what point are you considered "overweight" and endangering your health?

(I'm 40, male, and need to lose about 40 lbs. I'm the archetype canidate for sleep apnea...)

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Post by Sleepless on LI » Thu Aug 25, 2005 11:02 am

ehusen,

Very eloquently put. I happen to agree with everything you just wrote. And it is great to see, as you pointed out, people who can state conflicting viewpoints and not get "ugly."

I also thought the point about questioning the validity of the poster's studies and then using their own to controvert that person's point was a bit hypocritcal. You are much more observant that I am.

Bottom line, eat well, exercise and live happy. So you weigh more than you should? If it doesn't bother you, it doesn't bother me. If it doesn't compromise your health, that's fine. Once it starts to, and my best friend for over 30 years who is 48 just developed diabetes due to her excess weight and had a father who died of a heart attack at 47, then it's time to come out of denial that it's okay and do something before it's too late. I'm thrilled to say, she is doing something. Eating more carefully, treadmilling and lost 65 lbs. That is a good thing for HER HEALTH!!! Her husband loves her regardless of her extra weight or not.

Body image is in the eye of the beholder. There are many men out there who prefer a curvy woman to a Kate Moss stick figure and there are some who absolutely love large women. No one's right and no one's wrong. We are all entitled to like what we like. We live in America, thank goodness, where we are free to have our own opinions. But if health becomes an issue and you are heavy due to a sedentary and unhealthy eating lifestyle, you are definitely heading down a road that will lead to disaster. And I don't see how anyone can argue with that (although I'm guessing someone will).
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neversleeps
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Post by neversleeps » Thu Aug 25, 2005 1:17 pm

Sleepless on LI wrote:But if health becomes an issue and you are heavy due to a sedentary and unhealthy eating lifestyle, you are definitely heading down a road that will lead to disaster. And I don't see how anyone can argue with that (although I'm guessing someone will).


There are plenty of big, large, overweight, fat, obese, and/or morbidly obese (pick the term you find least offensive) people who readily admit it is unhealthy to be this way. We know we should be doing something about it and currently are not, or have tried numerous times and failed and given up (at least for the time being). This was addressed in the thread: Weight and OSA

We are not in denial. We know being overweight is bad for us and we know we can do something about it. We understand the problem and we understand the solution. Putting it into practice successfully and permanently is a whole different issue altogether. It's hard. It's so hard, in fact, that going through all the trials and tribulations of adjusting to CPAP therapy is a walk in the park compared to losing weight.

The strain extra weight puts on one's heart is undeniable and irrefutable. It is not a matter of opinion, it is a matter of fact. Everyone knows causing their heart to work overtime pumping blood through all those extra pounds of flesh is bad for them. The problem seems to lie in the perception that paying homage to this subject is akin to a personal attack on anyone who is overweight, fat, obese and/or morbidly obese. We've spent so many years on the defensive it has become second nature to us.

Weight and OSA are intrinsically linked and it is a logical subject to discuss here. The issue is not appearance, it is health. It is up to me if I should choose to improve my health (and potentially my OSA) by losing weight through controlling/changing my eating habits and exercising. If I choose not to lose weight, I do so while acknowledging I know full well it is possible to do, and I know it would result in being healthier.

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Post by Sleepless on LI » Thu Aug 25, 2005 1:29 pm

Another thing I've found is, I had 25 lbs. to lose. I have known for a while that I need to lose it. I would look in mirrors or my reflection in a store window and see I didn't look my best anymore. However, until you have that internal switch flipped, by whatever it is that causes that to happen, you will not start a weight loss program/lifestyle, nor will you be successful at it if you start it before that switch gets flipped. I don't know if it's the same for everyone, but just knowing you need to do it is not enough for me. I have to wait for the switch to be finally flipped and only then do I do what is right for me and start eating right and exercising, etc.

Odd how I can know I need to do it, it's blatant and staring me in the face, yet I won't do it until that time. Human nature can be weird..or is it just me that's weird???
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neversleeps
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Post by neversleeps » Thu Aug 25, 2005 1:40 pm

Sleepless on LI wrote:... However, until you have that internal switch flipped, by whatever it is that causes that to happen, you will not start a weight loss program/lifestyle, nor will you be successful at it if you start it before that switch gets flipped. I don't know if it's the same for everyone, but just knowing you need to do it is not enough for me. I have to wait for the switch to be finally flipped and only then do I do what is right for me and start eating right and exercising, etc.
WOW!!
You nailed that one!!!

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Post by Sleepless on LI » Thu Aug 25, 2005 1:43 pm

Thanks, Neversleeps. Guess you related to what I said and I'm not the only one like that.
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Post by WAFlowers » Thu Aug 25, 2005 2:00 pm

Sleeping With The Enemy wrote:Some of the risks of being overweight are type 2 diabetes and high blood pressure.
And some of the possible side-effects of sleep apnea are high blood pressure, insulin resistance (aka type 2 diabetes) and weight gain!

Weight gain can cause obstructive sleep apnea and sleep apnea can cause weight gain.

So what's the cause and what's the effect. We've got a positive feedback loop that is out of control, like a microphone too close to a speaker!
In conclusion, accumulating evidence provides support to our model of the bi-directional, feed forward, pernicious association between sleep apnea, sleepiness, inflammation, and insulin resistance, all promoting atherosclerosis and cardiovascular disease.
From: Sleep Med Rev. 2005 Jun;9(3):211-24.Sleep apnea is a manifestation of the metabolic syndrome.Vgontzas AN, Bixler EO, Chrousos GP. Department of Psychiatry H073, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
Main Entry: per·ni·cious
Pronunciation: p&r-'ni-sh&s
Function: adjective
Etymology: Middle English, from Middle French pernicieus, from Latin perniciosus, from pernicies destruction, from per- + nec-, nex violent death -- more at NOXIOUS
1 : highly injurious or destructive : DEADLY
2 archaic : WICKED
- per·ni·cious·ly adverb
- per·ni·cious·ness noun
synonyms PERNICIOUS, BANEFUL, NOXIOUS, DELETERIOUS, DETRIMENTAL mean exceedingly harmful. PERNICIOUS implies irreparable harm done through evil or insidious corrupting or undermining <the claim that pornography has a pernicious effect on society>.
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Sleeping With The Enemy
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Post by Sleeping With The Enemy » Thu Aug 25, 2005 11:52 pm

I'm just wondering exactly how overweight are those who are participating in this string?

I am 5'4" and weigh 210. Started out at 225.