Live data from Hacker News

Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

atsjournals.org

121–130 of 136 posts

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#121

Earlier quoted context omitted.

Thermodynamics doesn't lie. Operate at an energy deficit and I guarantee you'll lose weight. Is it going to feel horrible? Hell yes.

Thermodynamic doesn't lie... but it isn't even close to being the most important factor at work. A Pound is 3,600 calories. I can easily eat 1,800 calories over my maintenance requirement. Do you think in one year I am going to gain 180 pounds or .5 pounds per day?

Thermodynamics is only involved at the simplest levels. Hunger and satiation are regulated primarily with leptin, not thermodynamics. Fat storage is controlled primarily with insulin which is itself regulated by various endocrine system components. Thermodynamics is only involved at a level far below complex systems control dynamics.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#122
post #23

Earlier quoted context omitted.

I'd just like to chime in as someone who has lost and kept off about half his bodyweight, that yeah, losing significant amounts of weight is a very demanding undertaking. It requires a significant lifestyle change, large investments of time, is emotionally and cognitively draining, and to top it all off does not positively impact your quality of life nearly as much as is touted. To be successful at it requires a leve…

I couldn't agree with this more. It is possible for me to lose and keep off weight if I literally devote all my energy towards it. It's important to remember that everyone is different. Some people would struggle to gain 100 pounds, others could do it easily, and most people understand that. But for some reason when it comes to losing weight instead of gaining, understanding goes out the window.

I appreciate people commenting and trying to offer advice, but I think you missed the point of my post. Imagine this: Someone offers a group of 100 people a huge prize (that they all desperately want) to gain 100 pounds as quickly as possible. If we checked back in on these people in 3 months, I guarantee that some of them would have added 100 pounds, but some of them wouldn't be even close. What would you say to the people who weren't able to gain weight? Would you tell them about how it is just simple thermodynamics and lecture them on physics? I'm guessing you wouldn't. We all understand that it will be harder and easier for different people. Losing weight is the exact same.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#123
post #76

Earlier quoted context omitted.

Not sure why downvoted, maybe a bit harsh...but this is the absolute truth. I'd argue that exercise itself doesn't even play a huge role, though it does help. Eat less calories until you start losing weight. I understand there are mental hurdles to this simple mantra, but its truth is unchanged.

And this doesn’t help when one’s body switches into “starvation mode” lowering one’s BMR making it even _harder_ to lose weight. One’s microbiome can also substantially affect one’s BMR. Neither your comment nor your parent comment add anything except noise to this discussion. Weight, health, and fitness are all _correlated_, but sometimes in ways that aren’t intuitive and that western society’s fat-shaming (of which…

I don't mean to fat shame, apologies if it comes off as such. My own weight fluctuates a lot, as I go through periods of something akin to depression. When I'm overweight, I know what needs to be done, yet for whatever reason, don't do it.

That said, we are not adding noise. We are giving the physics level truth. It's like being told an answer, and being told to show the proof, in my opinion. The answer is to eat less calories, but working the problem isn't so simple. There are a ton of variables into how or why someone can't follow this regime, some valid, some probably not.

Starvation mode is vastly overstated.

I wonder why people in starving nations don't have this magical starvation mode, or glandular problems, or microbiomes that make them fat. Are we exceptional?

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#124
post #84
post #43

Earlier quoted context omitted.

Losing weight is hard (speaking from experience), but ultimately it's still just a question of physics. Eat less, eat food which will fill you for longer (breakfast: porridge, lunch: fruit, nuts, etc.), and eat a reasonably healthy meal you've cooked each night. Meanwhile, eat smaller portions and do some exercise. Your body can't defy the laws of physics, so you will lose weight. It is that simple. Overthinking it a…

I think overthinking and coming up with bad excuses is just a symptom, not a cause. First the human does something their rational mind didn't want to, because the rest of the brain outvoted it, and then the mind comes up with an explanation to feel more in control. I'd actually be surprised if there's much correlation between understanding physics and having one's weight under control.

Zero correlation. And everyone can learn calculus, but some people will have to put in a LOT more effort than others.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#125
post #26

Earlier quoted context omitted.

I'd just like to chime in as someone who has lost and kept off about half his bodyweight, that yeah, losing significant amounts of weight is a very demanding undertaking. It requires a significant lifestyle change, large investments of time, is emotionally and cognitively draining, and to top it all off does not positively impact your quality of life nearly as much as is touted. To be successful at it requires a leve…

Is the main inhibitor just the sensation of hunger being miscalibrated with your calorie goals? Instead of using mind over matter, what techniques exist for eliminating the sense of hunger?

For me personally, I'm always hungry, and my body is apparently really good at storing excess food as fat. The only truly successful method for reducing hunger that I've ever discovered is fasting. After fasting for a few days, I'm no longer hungry. Unfortunately, it's not the most convenient thing to do.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#126

I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…

>In reaction to that, it is important to understand that for many people weight loss is neither practical nor maintainable and for that reason it is critical that we continue to advance our treatment of things like sleep apnea. Sorry, but I have to call BS on that. Having lost ~50 lbs last year (after my blood pressure started getting scary), I can tell you it's all about planning and self-discipline. You plan a diet…

You have been probably been very busy over the last year maintaining a very healthy lifestyle(which is awesome).

So what the studies say of everyone who starts a diet some will successfully lose a significant amount of weight. And of those success stories every single study that's followed them for 5-10 years shows that almost everyone regains almost all the weight.

The most famous of these studies was "The Biggest Loser". But are others, but they all show the same effect.

I've tried finding a study that showed sustained long term weight loss through diet, and there aren't any.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#127

I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…

I'd just like to chime in as someone who has lost and kept off about half his bodyweight, that yeah, losing significant amounts of weight is a very demanding undertaking. It requires a significant lifestyle change, large investments of time, is emotionally and cognitively draining, and to top it all off does not positively impact your quality of life nearly as much as is touted. To be successful at it requires a leve…

I know what it takes. I haven't done it, but a couple of my friends have, and they've described the herculean effort required. The things people usually expend their effort on

* Maintaining relationships with friends, family, and loved ones

* Excelling at their job

* Reducing bad habits(like drinking, tv watching, smoking, etc)

* Pursuing hobbies

* Raising children

And all of them have had to make significant sacrifices across the board to maintain their weight.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#128

I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…

On topic: losing weight has a positive effect for sleep apnea. This is interesting, but something I had intuited from the small sampling of those I know with sleep apnea and weight problems. There are other factors that seem causal, like smoking, that would be interesting to hear about. Off topic: losing weight is hard to do for many people.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#129
post #105
post #7

Earlier quoted context omitted.

If literally not being able to breathe isn’t enough, people being dickheads probably isn’t going to do it. Please think harder.

Well you don't have to be "a dick" to shame somebody. Just tell them the truth and help them realize the toll they take on society and themselves when they choose certain actions over others. When they come to realize and understand the truth they will feel the shame they ought to feel...and thus pay a small part of the cost to others that they have incurred. Do you believe that a smoker that has thrown a cigarette o…

Fat people already know they’re fat. “Telling them the truth” isn’t useful, to you or to us.

Being fat isn’t selfish, it’s just self-destructive. Same as smoking (in private, where no other party is exposed to any smoke). Your “and burns a house down” example is an attempt to conflate the two.

Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat

#130
post #105
post #7

Earlier quoted context omitted.

If literally not being able to breathe isn’t enough, people being dickheads probably isn’t going to do it. Please think harder.

Well you don't have to be "a dick" to shame somebody. Just tell them the truth and help them realize the toll they take on society and themselves when they choose certain actions over others. When they come to realize and understand the truth they will feel the shame they ought to feel...and thus pay a small part of the cost to others that they have incurred. Do you believe that a smoker that has thrown a cigarette o…

> Their obesity exacts great cost to the medical system that we all have to bear, it takes from their productivity that they could offer to others (society and their own family) and benefit from themselves in a multitude of ways.

This complaint runs into a more fundamental dispute: freedom versus collectivism. In a purely libertarian world, everyone would be absolutely free to do whatever they want. In a completely socialist world, one is only free to do what they want insofar as it has no negative effect on others, or if it does, they should compensate others for the harm they cause.

There are problems with both extremes. Absolute freedom can lead to anarchy which will effectively prevent people from coordinating and building anything collectively. But forcing individuals to adhere to a strict cost/benefit analysis for every action stymies creativity and personal freedoms.

When considering a ban on a particular individual behavior (e.g., eating too much), it's perfectly reasonable to talk about the larger social harms (e.g., increased medical costs). But it's also important to consider the freedoms that are being taken away by such a policy (e.g., the freedom to eat what you want).

Western society has never solely been focused on maximizing overall social well-being, it has also balanced ideals of individual freedom with it. China, in contrast, has focused almost entirely on collective well-being over individual freedom. Many people (myself included), would prefer to live in a less successful but free country rather than a more successful authoritarian one.

Post reply on HN