Can Weight Loss Cure Sleep Apnea?

Obstructive sleep apnea, or OSA, can kill you.  When a person with obstructive sleep apnea is asleep, their airway becomes intermittently occluded, or “blocked off”, resulting in them being unable to breathe.  Of course, they are asleep at the time, so when their body is struggling to breathe they don’t know it.  It can be frightening to watch a person with OSA as their body chokes against a blocked airway, trying to get the next breath of air, over-and-over throughout the night.

While struggling to breathe, the oxygen level will drop, sometimes to a dangerously low level, and their CO2 level will rise to a toxic level causing acidosis, or a high level of acid in their bloodstream.  The low levels of oxygen result in chronic headaches due to the brain not getting enough oxygen, and the repeated effort to breathe during the night often results in a tired feeling throughout the next day.  Over time these processes cause damage to the heart and other organs with one of the worst results being a heart attack during the night.

Obesity is the #1 Known Cause for Obstructive Sleep Apnea

Obesity is the number one known cause of obstructive sleep apnea and all patients with a body mass index (BMI) greater than 30 should take a sleep apnea screening survey.  Other signs of OSA include chronic snoring, morning headaches, daytime sleepiness, and a spouse or friend reporting that the person struggles to breathe while they sleep.  Anyone with a high probability for OSA should undergo formal sleep apnea testing.

The standard treatment for OSA involves wearing a specially fitted mask at night while sleeping, which blows air while they breathe in.  This dramatically decreases inappropriate airway occlusion or apnea.  The person sleeps better at night, is safer, and has more energy during the day.  For people whose obstructive sleep apnea is due to excess weight, weight loss is always recommended.  Significant weight loss will often result in a dramatic improvement in apnea, and sometimes even cure it.  For the improvement to last, of course, the weight loss must be permanent, and in many patients, surgery offers the best hope.

Amphetamine-like and other stimulant drugs have been used for a long time to suppress appetite and facilitate weight loss. However, significant sustained weight loss has not been achieved with these drugs, and rapid weight gain usually occurs when these drugs are discontinued. There are many side-effects and health risks associated with use of weight-loss drugs and there is also some potential for these types of drugs to be abused.Phentermine and Fenfluramine have been available for about 25 years. In the absence of a reduced-calorie diet and regular exercise, these pills are ineffective. The combined use of these two drugs has never been approved by the FDA.Fenfluramine (Pondimin®) and dexfenfluramine (Redux®) are considered hazardous. People who used these drugs needed to engage in regular physical activity in order to develop sustained weight loss. Weight regain occurs once these drugs are stopped; in other words “yo-yo” dieting is common with these drugs. In high doses both have caused brain cell damage in experimental animals. Some people developed primary pulmonary hypertension while taking these drugs and this was related to damage to heart valves. In 1997, both drugs were removed from the market by the FDA because serious damage to heart valves was discovered in many users.Phentermine has not been associated with heart-valve damage. However, it can raise blood pressure and is dangerous if used by anyone who is hypertensive or taking blood pressure medicine.Any patient who is considering bariatric surgery for weight loss, and who has taken these medications in the past, should discuss the need for an ultrasound of the heart, an Echocardiogram, prior to surgery to ensure that the heart function was not damaged by these drugs.Orlistat (Xenical®) works in the intestine by blocking the absorption of dietary fat. This drug is generally taken three times per day with meals. A low-fat diet is necessary for Xenical® to work! If you eat high fat food, you will usually develop severe intestinal symptoms, diarrhea or very foul smelling flatus (gas). These symptoms can be prevented by strict adherence to a very low-fat diet. The amount of weight lost with this drug is usually small, and weight regain will occur when the drug is discontinued. Studies may be developed where this drug is used in combination with the Lap-Band® for improved long-term weight loss.Sibutramine (Meridia®) is an appetite suppressant that seems to have minimal effectiveness in most people. This drug may increase heart rate and blood pressure, or cause insomnia, headache, constipation, and dry mouth. Life-threatening interactions with certain antidepressant and migraine medications may occur. It should be avoided by pregnant women and by nursing mothers.If you are serious about weight loss, avoid the pills and talk with an expert weight loss specialist at The N.E.W. Program. Click the button below to schedule an appointment.

When bariatric surgery is performed in centers that measure long-term results, most patients are found to have little risk of developing significant mineral or vitamin deficiencies if they follow the nutritional and supplement guidelines. The two main procedures performed worldwide are the gastric Sleeve and Gastric Bypass result in significantly weight loss, around 75% of excess weight, but carry some risk for developing nutritional deficiencies if you don’t follow a healthy diet and don’t take your vitamin and mineral supplements as directed.

The fact is, however, many patients struggling to lose weight are already deficient in Vitamin D and other nutrients before they have surgery. Vitamin D is important in absorption of calcium and is also important in maintaining a healthy amount of calcium in your bones. After surgery, adequate intake of calcium is important. Foods with high calcium content include milk, cheese, cottage cheese, yogurt, broccoli, tofu, greens and eggs. These healthy foods should make up a part of the weekly diet for all patients.

As an additional precaution, all gastric bypass and gastric sleeve patients should take between 2,000 and 5,000 IU (International Units), or about 100 micrograms of supplemental Vitamin D per day. In addition, Dr. Q recommends patients take 1000-to-2000 mg of supplemental calcium daily. This can be in the form of calcium carbonate (such as TUMS®), or calcium citrate. Calcium citrate has better absorption than calcium carbonate and may be advantageous for people who have had kidney stones in the past.

Calcium deficiency can result in osteoporosis and osteopenia — or weakening of the bones.  Although most patients after a gastric bypass will not develop calcium deficiency, the change in calcium absorption is unpredictable, so all patients should have their calcium levels evaluated annually.

Numerous studies have shown that successful weight loss after bariatric surgery improves arthritis and decreases joint pain. Patients should support these positive results through careful attention to nutrition and appropriate Vitamin D and Calcium supplementation.

By now, everyone is aware that excess weight will threaten your health.  It’s in the newspaper and on television, the internet and radio.  Hardly a week goes by where a new report on the hazards of excess weight doesn’t hit the national media.

The media has focused on adverse health consequences associated with excess weight, but the truth is that the primary problem caused by severe obesity is the inability of many overweight people to live life to the fullest.  The more overweight a person is, the more difficult it becomes to enjoy normal activities; to walk up stairs comfortably, to easily get in and out of a car and to sit in a booth at a restaurant are some of the constant restrictions felt by obese people every minute of their lives. 

What can be done?  How can this excess weight be controlled and how can a severely overweight person experience that healthy feeling, that “normal life” again?  Of course, the answer is permanent weight loss.  But, how is this achieved?  Fortunately, the truth is finally being published in the major medical journals and reported in the national media.  The truth is that for people suffering from severe obesity, the only highly successful method to achieve substantial permanent weight loss is through weight loss surgery.  This has been demonstrated over and over again in scientific studies (as opposed to the misleading reports promoted by diet companies).  So, knowing the truth about weight control for people 80 pounds or more overweight, what are the key questions?  The questions are obvious; “Is weight loss surgery safe?” and “Where should I go for surgery?”

The Gold standard for weight loss surgery is Laparoscopic, or minimally invasive, weight loss surgery.  At The N.E.W. Program Laparoscopic Gastric Bypass has been performed safely in patients weighing over 700 pounds.  Almost every patient who has surgery for weight loss is able to have surgery successfully using these minimally invasive techniques.  The need to perform these surgeries by the traditional, large-incision method generally indicates that the surgeon is poorly trained in laparoscopic surgery and probably should not be performing weight loss surgery at all.

With Laparoscopic Gastric Bypass, Laparoscopic Sleeve Gastrectomy and Laparoscopic Gastric Band surgery, the complication rate should be very low.  The vast majority of patients should never need to be in the intensive care unit (ICU) after surgery and should be able to go home after only one night in the hospital.  Recovery should take about one week.  Finally, the mortality rate from this surgery should be well below 1 out of 200, or less than 0.5%.  In over 2000 procedures, there has never been a single death due to a leak or other complication after weight loss surgery at The N.E.W. Program.

After thinking through these facts, it is clear that severely obese people who wish to gain permanent control of their weight should consider surgery.  Of course, before deciding on which surgeon to see, be sure to ask about their statistics, and write them down.  If the surgeon ends up performing open, large-incision surgery more than 2% of the time, be wary.  And of course, don’t be afraid to ask about that surgeon’s mortality rate, complication rate and the chance of ending up in the ICU.  Always remember, it’s your life.  If done right, surgery for weight loss can be done safely and effectively, with a fast recovery.  The long-term goal is to improve your health and help you to regain that healthy feeling, that “normal life” again.

An article titled “Are Diet Pills the Answer to Weight Loss Struggles?” was recently posted in the Harvard Medical School Adviser.  This article posted a question about weight-loss pills; “Do they work? Are they safe?”

The answer given was that advertising claims such as “Exercise in a bottle” are, “for the most part” too good to be true.  Well, I have one comment and that is Shame on the Harvard Medical School Adviser for trying to come off as so objective that it cannot even render a definite opinion on this clear-cut subject.

The article explains that claims on nutrient and herbal products are not required to be verified by the FDA.  The FDA can, and has in some extreme cases, removed these products from sale; an example is the ban on the sale of Ephedra in 2004 after several deaths. Unfortunately, there are numerous other ephedra-like supplements that are playing off the frustration that so many people have with the commonly available, traditional, strict diet plans.  People that are desperate to lose weight often seem willing to blow large amounts of money on just about anything that promises a quick-and-easy solution to their problem.

Even after the ban on ephedra, these ephedra-like compounds such as ephedrine, norephedrine and methylephedrine, are available on the Internet and in stores, as are supplements containing caffeine and caffeine-like compounds such as guarana, yerba mate and others.  These compounds are highly concentrated and are, in my opinion, drugs. None of these drugs has ever been truly tested for effectiveness and the claims made are simply ridiculous.  Not only that, but there are potential adverse health consequences for taking these ineffective drugs that have never been identified.

So, why are these drugs allowed to be sold?  The standard answer is because there is an FDA loophole that allows herbal remedies that don’t claim to cure medical conditions to be sold.  The real answer is that these drugs are Big Business!  This is a $200,000,000.00 (that’s 200 Million Dollars) per year market in America alone.  Bottom line, the snake oil salesmen are alive and well in America; in fact they are richer than ever before.

It’s time that legitimate medical professionals start to confront these frauds in terms that are appropriate.  Identify them for what they are, scams that waste your money and provide false hope and may, in fact, hurt people in the end.  Rather than stating that “people should be cautious about using” these drugs, as is stated in the article, the medical community should state unequivocally that these drugs have never been shown to have any benefit whatsoever, and in fact may be quite dangerous and until their safety and efficacy has been shown, people should never take these supplements, under any circumstances, period.