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Most of us have heard “diet and exercise is the way to lose weight”…”diet and exercise to lose weight” over and over again. It is the false mantra of dieters. To help you in your weight loss plan, your real mantra should be: “sleep, diet and exercise is the real way to lose weight!”

The correct weight loss method is the following: sleep first, diet second and exercise third. These are the basics and are necessary to start your weight loss process but there are many other parts needed for successful weight loss. Even weight loss itself is just a piece of the whole picture, which also includes weight maintenance but the basic plan starts with sleep first, diet second and exercise third.

Several times a month a new study comes out discussing the benefits of proper deep, “restorative” sleep. Good sleep helps three major things that we take for granted: first, deep sleep decreases our cortisol, a stress hormone secreted by organs called adrenal glands, located above the kidneys. Second, deep sleep helps regulate our hunger hormones to make us both less hungry and more full and third, and possibly most important, deep sleep increases our metabolism.

It has been recently estimated that the average American sleeps only about 5.5 to 6 hours a night. We stay up late watching TV, reading, sending email or just surfing the Internet. What we really need is to get 7-8 hours of sleep per night. When we sleep at least 7 hours per night, we are less hungry, more full and have better metabolism.

According to the studies, when we start with a base of 7 hours of deep sleep and then cut calories with diet, we are less hungry in response to cutting those calories. Adding exercise to our weight loss plan and focusing on a baseline of 7 hours of deep sleep, we burn more calories and don’t just use exercise to counteract the decrease calories from short sleep. For example, with 4 miles of walking or running each day, we burn about 400 calories. With sleep at 8.5 hours, decreasing it to 5.5 hours a night, metabolism has been shown to decrease by the same 400 calories (on average). Therefore your walk of 4 miles (on a night of 5.5 hours of sleep), just brings us back to baseline and it will take additional exercise to burn additional calories.

Keep in mind there are several medical conditions that interfere with deep sleep. One is called sleep apnea. Sleep apnea is when you stop breathing in the middle of the night and your body wakes up to begin the breathing process again. This may happen infrequently or sometimes 60 to 120 times and hour. At a rate of 60 apneas per hour, you would stop breathing every minute. To diagnose sleep apnea, your physician can order a test that measures breathing while sleeping. If you are wake up, even gently, multiple times per hour, your body is not getting the true benefit of sleep. Another related sleep condition is called restless leg syndrome. In restless leg syndrome, your legs and or arms move during the night, preventing the good deep sleep. If you suspect you have a sleep problem that interferes with sleep or you are regularly very tired in the afternoon, please consult with your primary care or obesity medicine physician to see what testing, if any is right for you.

Several Tips for Better Sleep:
1. Go to sleep and wake up at the same time as often as possible, seven days a week
2. Your bed should be for sleep. It should not be for watching tv or for work.
3. Your bedroom should be like a cave: dark, cool and quiet.
4. Stop drinking caffeine by 2 pm
5. Avoid alcohol (it may help you fall asleep but the second half of the night will be much less restful and with frequent awakening)
6. Avoid bright light for 1.5 to 2 hours before bed, especially from a bright cell phone or computer screen
7. If you frequently lose track of time in the evening, set an alarm on your cell phone to remind you to go to bed on time

Craig Primack MD, FACP, FAAP
Obesity Medicine Certified; Vice-President of the Obesity Medicine Association
Scottsdale Weight Loss Center, Scottsdale, Arizona


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