The Ten Commandments of Weight Loss - IV

IV - Remember to Rest; Accept Weight Loss Plateaus

I am going to write about rest (sleep) and weight loss plateaus under the fourth commandment for weight loss.

1. Remember To Rest

For most of us, when we think about weight loss, the first thing that comes to mind (besides diet) is exercise. Tiring, relentless, joint wearing and muscle aching exercise. Welcome to the fourth commandment: rest and sleep are very important for weight loss!

Before you hurry up to take a nap, though, I must clarify that I am not talking here about the sleeping beauty diet, which was, at one point, Elvis Presley's favorite method of losing weight. No. I am talking about respecting you body's circadian rhythms, and making sure your body gets the rest that it needs.

How Does Insufficient Sleep Cause Weight Gain?

It has been noticed for a while that people who are sleep deprived, or who experience frequent disturbances in their circadian clocks, tend to gain weight. I have seen this happen to many of my patients. Some think that a lot of the weight gain associated with having children is related to the more or less inevitable lack of sleep that new mothers experience for weeks, and sometimes for months after giving birth (early termination of breast feeding is another important cause). I have also seen this happen too often to young people who either study or party hard (or alternate between the two), staying up late and going to sleep after midnight, and then having to wake up for the next day after only five or six hours of sleep.

Besides individual obesrvations like the above, though, we now have numerous, well conducted, epidemiological and laboratory studies showing that chronic sleep deprivation and irregular sleep patterns, including shift work, are associated with weight gain. Here is just a small sampling of some of the findings that point to obesity being a chrono-biological disease:

• Even a single night of sleep deprivation increases the appetite for junk food and decreases frontal cortex activity in the brain, where rational decisions are made. What would a hungry, irrational brain choose to eat? Potato chips, donuts, and other similar calorie disasters.
• Short (2 nights) sleep duration in young, healthy men lowers leptin levels and increases ghrelin levels. Ghrelin is an appetite stimulant hormone, while leptin is a hormone that tells the brain when to stop eating. More ghrelin + less leptin = weight gain.
• Short sleep duration was found to be associated with weight gain as early as preschool ages.
• More than 50 studies have found a significant connection between short sleep (less than 6 hours per night) and increased obesity risk.
• There is at least one publication that went as far as to quantify the beneficial effect of sleep on body weight: for each additional hour of sleep (over 5 hours), the body mass index (BMI) decreases by 0.35 kg/m2. For a 200 lbs. person, sleeping an additional three hours a night could lead to losing 7 lbs. of body weight. Not too shabby!
• Going to bed late at night results in weight gain during adolescence and early adulthood. A recent study from UC Berkeley of more than 3,300 youths and young adults found that for every hour of going late to bed, the body mass index went up an average of 2.1 points over 5 years. That is a 12+ lbs weight gain for a 140lbs, 5ft 4in female! To make matters worse, exercise, screen time and the number of hours slept did not mitigate this BMI increase.

Tips For Better & Longer Sleep

Four in 10 Americans get less than the recommended amount of sleep, compared with only one in 10 who did so 70 years ago. Chances are even those who do not live in the United States share this unfortunate feature with the Americans. Here are a few tips on how to make sure you get the sleep you need to lose weight:

• Take time and read the sleep hygiene tips from the National Sleep Foundation. But don't stop at reading them, put them in practice. Starting tonight!
• Remove the TV from the bedroom, if you have one. I don't think I need to say more about this, it is self-explanatory :-)
• Do not keep your smart phone, tablet or laptop in the bedroom at night. They make noises (also known as notifications) which can disrupt your sleep, and their screens emit blue light, which is one of the most efficient ways to wake your brain up.

If you are 18+ years old, you need 8 hours of sleep every night to avoid sleep-debt induced weight gain.

Last but not least, if you snore at night, if your neck size is over 18 in, if you have high blood pressure and you wake up tired despite sleeping at least 7 hours, make sure you talk to your doctor to get tested for sleep apnea. This is a serious health condition that is often associated with obesity, and can (and should be) treated.

2. Remember Weight Loss Plateaus Will Happen. Celebrate Them!

Nothing frustrates people who have invested effort and time in losing weight the right way more than stubborn plateaus. It seems like no matter how little they eat and how much they exercise, the weight stays the same.

Why Do Plateaus Happen?

There are many theories and possible explanations for why weight loss plateaus happen. The most likely mechanism involves an adaptive slowing of the basal metabolic rate, in the context of eating less food and having less body weight to support (plateaus occur, by definition, after some weight has been lost). The net result is that your body needs fewer calories to keep you alive and to support your activity level.

Whatever the exact mechanism, do not give in to discouragement. Plateaus are perfectly fine, and they should be expected. Look at them as a break your body takes to allow for the new weight level to "sink in". Enjoy the progress so far, and remind yourself that, just as the weekly rest prepares you for the challenges of the new week, the plateau makes you ready for the next phase of weight loss. And do take time to celebrate, and share your success with others.

How Long Should I Expect A Plateau To Last?

It depends. I've seen plateaus that lasted 1-2 weeks, and I've seen some last over 6 months. Generally though, if you have been on a plateau for more than a month, and still have weight you want to lose, it is a good idea to take action.

What Can I Do to Start Losing Weight Again?

The most effective way to break through a plateau is to further reduce the caloric intake and/or increase the number of calories burned through exercise. Here you must be careful to avoid reducing your food intake too much. For most adults, this means staying above 1,000, preferably over 1,200 calories a day. If your daily caloric intake (assuming you estimated it with reasonable accuracy) is already at or close to this level, it is better to increase your exercise level to overcome a weight loss plateau.

Dr. Gily Ionescu MD, MS.