Using a generalized estimating equation model, inferences on intervention effects at each visit were not affected when the analysis was weighted to account for missingness. Of 264 participants, 96 had complete data, and another 97 had monotone missing data. Percentage of ILI (solid bars) and DSE (open bars) participants without OSA and with mild, moderate, and severe OSA at 10 years compared with their OSA severity at baseline. The estimated effect of weight change on change in AHI was 0.68 in the ILI group (P P ≤ 0.0001), that is, a 0.68 and 0.54 improvement in AHI, respectively, for every kilogram of weight loss. The dashed line indicates the diabetes support and education group; the solid line indicates the intensive lifestyle intervention group. Hey, I am just as guilty as every other woman in that I find it hard to be specific about what I need from my husband but here’s what I did. If he is doing this just to make you feel less worthy, it will be easier to drop him and you lose the ‘weight’ immediately. Perhaps he wants you to live a long and healthy life so that he can enjoy more of you. Now that you understand where he is coming from, take ownership and accountability if he is coming from a good place. Another way that obesity can contribute to sleep apnea is by reducing lung capacity. As a result, losing weight can be an important step in treating sleep apnea. Sleep AHEAD is the longest randomized controlled study to date evaluating the effect of ILI for weight management on the severity of OSA. Because weight measurements from Look AHEAD study visits were rarely missing (3% at 1 yr, 5% at 2 yr, 7% at 4 yr, and 1% at 10 yr) among Sleep AHEAD participants, it was possible to include baseline weight and weight change to improve the imputations. Look AHEAD compared the long-term health effects of an intensive lifestyle intervention (ILI) focused on weight loss versus diabetes support and education (DSE) (16–18). We previously reported the effect of weight loss on OSA severity at 4 years in adults with overweight/obesity and type 2 diabetes enrolled in the Sleep AHEAD (Action for Health in Diabetes) study (11). Improvement in OSA severity over the 10-year period with ILI was related to change in body weight, baseline AHI, and intervention independent of weight change. At the same time, poor sleep can also play a role in weight gain, exacerbating the serious health risks of both obesity and sleep apnea. It can affect the body’s metabolism, such as by increasing insulin resistance and blood sugar levels. Sleep apnea stresses key systems of the body, including the pulmonary, metabolic, and cardiovascular systems. Other evidence suggests that any weight gain related to CPAP therapy is primarily from fluid retention rather than fat buildup. One recent analysis found that people who use a CPAP machine for over five hours per night were not more likely to gain weight. The multiple imputation analysis created five data sets with imputed values for missing AHI measurements assuming a multivariate normal distribution for baseline AHI, baseline weight, change in AHI, and change in weight. ILI participants received a group behavioral weight loss program developed for individuals with obesity and type 2 diabetes with the goal of at least a 10% weight loss in Year 1 (see online supplement) (17). Tuomilehto and colleagues (15) evaluated the effects on OSA severity of a 12-week, very low-calorie diet and 1-year lifestyle intervention focused on weight reduction, healthy diet, and physical activity in obese adults with mild OSA. As a result, individuals who had an AHI The missing PSG data in 49.2% of participants at 10 years is another limitation of our study. The 16-site Look AHEAD study reported weight loss in its DSE group at 8–10 years, particularly in older participants (22, 39). The known weight loss with aging in older adults may have contributed to weight reduction in all participants unrelated to the intervention. However, Kline and colleagues (33) reported that changes in cardiorespiratory fitness in the Sleep AHEAD cohort over the course of the 4-year intervention did not influence OSA severity before and following adjustment for weight change. For the analysis using probability of missingness as a weight, participants with nonmonotone patterns of missingness were excluded. Remission of OSA at 10 years was most likely to occur in ILI and DSE participants who had mild and moderate OSA at baseline. Seventy-one had nonmonotone missing data patterns, including 24 with no follow-up data. Estimates from the multiple imputation analysis did not differ meaningfully from the analysis ignoring missing data. Missing data analyses suggested that the missing AHI data did not distort the results. Change in weight was added in model 2, and changes in waist circumference were added in model 3. "We needed to make a change if we wanted to live a long, happy, healthy life together and maybe someday start a family," said the 25-year-old. Stephanie, who lives in Duluth, Minnesota, says she and her husband of two years woke up one morning in January 2020 and decided something had to change. And that concludes the article on my husband told me to lose weight. Experts say if it’s based on a concern for your partner’s physical and emotional well-being, wanting your partner to change their lifestyle is very legitimate. One of the most underrated tools for losing weight and even having some sort of sanity is sleep. Recently, the husband of one of the sisters, Mykelti, has been turning heads with his incredible weight loss transformation. Dr. Nene recently revealed that he found out in last year's health checkup that he was not fit and after that he changed his lifestyle. Losing weight as a couple is about so much more than fitting into smaller clothes, it’s about creating a healthier, happier, and more connected life together. Dining Out WiselyA healthy lifestyle doesn’t mean you have to stop eating out; it just requires planning. For instance, medications known as GLP-1 agonists have become a key part of the conversation around weight loss. The Link Between Sleep Apnea and Teeth Grinding Obesity is an important risk factor for OSA and is characterized by the abnormal accumulation of fat in the body, including the upper airway.Similar to the results of Tuomilehto and colleagues (15), the improvement in OSA severity in the ILI group was still present at 4 years, despite an almost 50% weight regain (11).Obstructive sleep apnea (OSA) is a relatively common sleep disorder characterized by repetitive narrowing or obstruction of the upper airway, including the nasal cavity, pharynx, and larynx, during sleep.I promise you; you will feel a lot more empowered when you realise the power to change is always within you.Although it is less invasive than other types of bariatric surgery, a disadvantage is that long-term complications occur relatively frequently due to foreign substances in the body 25,26.Setting tangible, shared targets such as cooking three new healthy recipes each week or completing a local 5K walk makes the journey more engaging.The 10-year Sleep AHEAD results represent the longest longitudinal study examining the effects of an intensive lifestyle intervention with weight loss on OSA severity.Liraglutide is contraindicated in pregnant women and patients with a history or family history of medullary thyroid cancer . However, the decrease in AHI in the ILI and DSE groups from 4 to 10 years seemed greater than what might be expected from the reduction in weight in both groups over this time period (Table 2 and Figure 2). The number of participants in the Sleep AHEAD cohort was insufficient to compare cardiovascular mortality and event rate in the two groups. The Look AHEAD study (in a sample of more than 5,000) reported that ILI did not reduce cardiovascular events over a median follow-up of 9.6 years, but the ILI group, compared with the DSE group, had greater reductions in HbA1c and many cardiovascular risk factors (39). Obesity is an important risk factor for OSA and is characterized by the abnormal accumulation of fat in the body, including the upper airway. Your daily habits and environment can significantly impact the quality of your sleep. Sleep Foundation and SleepFoundation.org are not affiliated with the National Sleep Foundation, an independent nonprofit based in Washington, DC. Whether you need expert sleep advice for your insomnia or you’re searching for the perfect mattress, we’ve got you covered. Isn’t your husband supposed to be the one who loves you unconditionally? As an overweight person, I know exactly how you feel. She emphasised that she has never been to a plastic surgeon and that she lost all her weight through exercise and dieting. After giving birth to her daughter, she then suffered from postpartum depression which made her unhealthy eating habits spiral out of control, according to China Press. Battling postpartum depression, Park, who was a fitness and yoga instructor, decided to get back in shape and divorce her husband. Before we were married, he was real committed to losing weight and keeping it off, but at some point he gave up. She lives in a small beach town on the Atlantic coast of Florida with her husband and two kids. "Be open to changing your mindset that this isn’t just you dieting, this is now your life and who you are going to be going forward. You have to know you’re going to alter your life in a way where this is your new normal." So what advice would the Engbloms give to others who are just starting out on a weight-loss journey? The duo has made daily tasks like drinking water, movement and making healthier food choices part of a routine they hope to keep up for the rest of their lives, rather than planning to follow a restrictive diet to get fleeting results. Stephanie says step one was cutting out little things that added up to an unhealthy lifestyle. Stephanie and Brandon shared their keys to sustainable weight loss with TODAY. The couple says sustainability was key as they mapped out a plan for better health. Various therapeutic options exist for patients with overweight or obesity, including diet, behavioral modifications, exercise, pharmacological treatments, and surgical procedures. Regular check-ups can help track your body weight and give you an opportunity to talk with your doctor about healthy habits. While treating OSA may improve sleep and promote a healthier weight, it is unlikely to be sufficient as a sole means of weight management. There are multiple approaches to losing weight that can be a component of treatment for sleep apnea. Perhaps he has had an A-HA moment where he wants to focus on health and longevity. Or have you always been overweight? Did you gain weight recently? Strange suggestion, well, normalising feeling upset when something someone close to us comments on our weight. Probability of missingness was found to vary by clinic and visit but not by baseline AHI or weight. Based on the mixed-effects model of the nonimputed data, the previously reported greater weight loss in the ILI than in the DSE Sleep AHEAD participants at 1, 2, and 4 years was attenuated but still present at 10 years (Table 2). These analyses supported our decision to treat the AHI measurements as missing-at-random, so that the mixed-effects analysis of covariance models used to obtain adjusted mean changes for AHI and weight were not biased by the missing PSG data. Baseline AHI, intervention group, and follow-up weight measurements were not predictive of a missing PSG, although, as expected, study site and follow-up year were. We addressed the impact of these missing data using multiple imputation and weighting for the probability of missingness. Comparing ILI and DSE participants who had severe OSA at baseline, more than twice as many DSE participants continued to have severe OSA at 10 years (Figure 4). In both groups, remission at 10 years was most likely to occur in participants who had mild and moderate OSA at baseline (Figure 4). At 10 years, only 6.3% of ILI compared with 17.5% of DSE participants had a worsening of OSA category from baseline (Figure 3). At 10 years, 60.9% of the ILI participants had an improvement in their OSA category from baseline compared with the 47.6% improvement of DSE participants (Figure 3). It is crucial to understand that these are not a substitute for healthy habits but are designed to work alongside diet and exercise. As a team, you might research options and decide to speak with a healthcare professional about whether medical assistance is appropriate for either of you. For example, your husband might want to focus on reducing his waistline, while you may aim to build strength through resistance training. Setting tangible, shared targets such as cooking three new healthy recipes each week or completing a local 5K walk makes the journey more engaging. Mykelti’s Husband Tony Padron On Amazing Weight Loss Journey: Reveals Stunning Fitness Transformation Tony’s weight loss journey has not gone unnoticed by the fans of the show.Photos of actress Madhuri's husband are also going viral on social media.Throughout the 10-year study, all Sleep AHEAD participants and their primary care providers were sent letters reporting the results of every sleep study.The 41 participants who did not have OSA (AHI A substantial number of PSGs were not obtained during follow-up (17.0% at 1 yr, 20.5% at 2 yr, 37.5% at 4 yr, and 49.2% at 10 yr; Figure 1).Difference in body weight between all ILI and DSE participants was 10.2 ± 1.0, 6.6 ± 1.0, 4.3 ± 1.0, and 3.6 ± 1.1 kg at 1, 2, 4, and 10 years, respectively (P values ≤ 0.001).Effective personalized therapeutic options for weight loss in overweight or obese patients with OSA should be designed and applied according to the patient’s individual circumstances.The results using the automated software program to score the PSGs at baseline and the follow-up visits were similar to those of the manual scoring (Figure E2)."Stephanie puts it pretty well when she tells people if you’re going to lose weight, you can’t do it from a place of motivation because motivation is a very fleeting experience," Brandon explained. At the 10-year assessment, 15.7% of participants (8 ILI and 13 DSE participants) reported obtaining treatment with positive airway pressure compared with 5.9%, 9.0%, and 11.5% at the 1-, 2-, and 4-year visits, respectively. The PSGs were unsuccessful or could not be scheduled in 2–3% of participants in the two groups. We were unable to contact 15% of the remaining participants in each group, and 22% of participants in each group who were contacted declined to have a 10-year PSG. Eleven participants (9%) in the ILI group and 20 participants (14%) in the DSE group were deceased or had withdrawn from Look AHEAD. The 10-year PSGs were obtained in 54% of ILI participants and 48% of DSE participants. As gastrointestinal side effects are common, caution is needed for use in patients with inflammatory bowel disease or gastroparesis.One recent analysis found that people who use a CPAP machine for over five hours per night were not more likely to gain weight.At 10 years, only 6.3% of ILI compared with 17.5% of DSE participants had a worsening of OSA category from baseline (Figure 3).The 10-year PSGs were obtained in 54% of ILI participants and 48% of DSE participants.To our knowledge, this is the longest randomized trial assessing the effects of weight loss on OSA severity.Did you gain weight recently?Percentage of ILI (solid bars) and DSE (open bars) participants without OSA and with mild, moderate, and severe OSA at 10 years compared with their OSA severity at baseline.As an overweight person, I know exactly how you feel. From 122-123 kg to 88 kg: Kiran Mote's Incredible Weight Loss Story with FFD Figure 1 shows the number of ILI and DSE participants completing assessments over the 10 years. No differences in ILI and DSE participant characteristics at baseline were noted (Table 1). Diagram showing the number of Sleep AHEAD (Action for Health in Diabetes) participants in the ILI and DSE groups who completed assessments over time. The 41 participants who did not have OSA (AHI A substantial number of PSGs were not obtained during follow-up (17.0% at 1 yr, 20.5% at 2 yr, 37.5% at 4 yr, and 49.2% at 10 yr; Figure 1). In Years 2–10, all sites offered a monthly group meeting at which members weighed in, reviewed diet and activity records, and participated in a lifestyle modification session (21). Estimated mean (SE) changes in body weight (kg) and AHI at Years 1, 2, 4, and 10. Difference in body weight between all ILI and DSE participants was 10.2 ± 1.0, 6.6 ± 1.0, 4.3 ± 1.0, and 3.6 ± 1.1 kg at 1, 2, 4, and 10 years, respectively (P values ≤ 0.001). Behavioral strategies for weight loss were not presented, and participants were not weighed at the sessions. Details of the Look AHEAD and Sleep AHEAD study designs, participant characteristics at baseline, intervention, and outcomes have been previously published (9–11, 16–21). Successful treatment of overweight and obesity requires a number of approaches to resist maintaining the body’s homeostasis. Increasing weight is accompanied by various pathophysiological changes in the body. According to a survey conducted by the Ministry of Health and Welfare, the obesity rate in Korea increased from 31.7% in 2007 to 38.3% in 2020 based on a body mass index (BMI) ≥25 kg/m2, and this proportion is expected to continue increasing with the spread of Western lifestyles 6,7. Therefore, the purpose of this paper is to review pharmacological and surgical management strategies for obesity that are currently commonly used in overweight or obese adult patients with OSA. As previously reported, 38.7% of the 264 participants had mild OSA, 35.2% had moderate OSA, and 26.1% had severe OSA at baseline (9). This automated PSG scoring program was validated for sleep stage and respiratory event scoring in an independent multicenter study (25). To further address the possible effect of interscorer variability on the results, all PSGs, including those obtained in the first 4 years, were rescored for conventional sleep variables by an automated PSG scoring software program (YRT Limited). AHI was the average number of apneas and hypopneas per hour of sleep and was used to classify OSA severity as mild (5 ≤ AHI see online supplement for more details). The 10-year Sleep AHEAD results represent the longest longitudinal study examining the effects of an intensive lifestyle intervention with weight loss on obstructive sleep apnea severity. However, overall OSA severity across the 10-year period was reduced with ILI, and this improvement was related to change in body weight, greater severity of OSA at baseline, and lifestyle intervention independent of weight change. Compared with the control group that received several healthy lifestyle counseling sessions, participants receiving the active intervention had greater weight loss and greater improvement in apnea–hypopnea index (AHI), a measure of OSA severity, at 1 year and 4 years. The overall reduction in OSA severity over the 10-year period in the ILI versus DSE groups was related to change in body weight, baseline AHI, and intervention arm, independent of weight change. The 10-year Sleep AHEAD results represent the longest longitudinal study examining the effects of an intensive lifestyle intervention with weight loss on OSA severity. Adopting an unhealthy lifestyle had taken its toll on me. Treatment of diet-induced obese mice with blood-brainbarrier (BBB)-permeable HDAC6 inhibitors profoundly reduces food intake and leadsto potent weight loss without affecting the muscle mass. Janelle Brown, one of Kody’s wives, has also been making headlines for her weight loss journey. The intervention was stopped after a median 9.6 years owing to futility for the Look AHEAD primary outcome. Similar to the results of Tuomilehto and colleagues (15), the improvement in OSA severity in the ILI group was still present at 4 years, despite an almost 50% weight regain (11). At baseline, 87% of the 305 participants enrolled in Sleep AHEAD had OSA (AHI ≥ 5 events/h) (9). Find a weight loss program that takes people through a biblical process of committing that aspect of your life to the Lord and ask Him to give you strength and wisdom. Therefore, the results may not apply to younger adults and adults who do not have type 2 diabetes mellitus. Although awareness of OSA and its consequences is steadily increasing (44), only 15% of participants were receiving treatment for OSA at the 10-year follow-up. We speculate that this may have been related to an aging effect on OSA severity. Mean ± SE weight losses of ILI participants of 10.7 ± 0.7, 7.4 ± 0.7, 5.1 ± 0.7, and 7.1 ± 0.8 kg at 1, 2, 4, and 10 years, respectively, were significantly greater than the 1-kg weight loss at 1, 2, and 4 years and 3.5 ± 0.8 kg weight loss at 10 years for the DSE group (P values ≤ 0.0001). "We were both over 300 pounds, Brandon had just gotten diagnosed with sleep apnea and I was just feeling awful. My whole body ached every day." The thought that my husband told me to lose weight can be debilitating. In any case, it will be interesting to see how these weight loss journeys progress and what other changes the Sister Wives cast members decide to make in their lives. Sleep AHEAD enrolled Look AHEAD participants at 4 of the 16 Look AHEAD sites to compare the effect of weight loss on OSA severity in ILI and DSE participants (9, 10). Sleep AHEAD was an ancillary study of Look AHEAD, a randomized controlled trial in adults with type 2 diabetes and overweight/obesity. What started with a simple change to Stephanie Engblom's coffee order has turned into a combined weight loss of nearly 200 pounds for Stephanie and her husband, Brandon. While lifestyle changes are the foundation of sustainable weight management, it’s also worth discussing all available tools. As suggested by previous studies, diet and physical activity may alter the symptoms and possibly the severity of OSA (26–31). In contrast, at 10 years, 34.4% of ILI participants and 22.2% of DSE participants had remission of their OSA. Remission at 4 years was five times more common in ILI participants (20.7%) than in DSE participants (3.6%) (11). Based on automated scoring results, 8% of ILI participants and 15% of DSE participants had remission of their OSA at 10 years. The results using the automated software program to score the PSGs at baseline and the follow-up visits were similar to those of the manual scoring (Figure E2). In a video shared on his YouTube channel, Madhuri's husband told that to get fit, he first stayed away from alcohol and focused on eating vegetarian food. Madhuri Dixit's husband Dr. Shriram Nene usually stays away from the limelight. Setting Common GoalsBegin by outlining what you both want to achieve, looking beyond simple weight loss to broader lifestyle improvements. Effective personalized therapeutic options for weight loss in overweight or obese patients with OSA should be designed and applied according to the patient’s individual circumstances. For overweight or obese patients with OSA, diet, exercise, or behavioral modifications for weight loss should be performed first. The treatment of OSA patients with overweight or obesity must involve weight control. After bariatric surgery, an average weight loss of 44.5 kg was observed, and the highest rate of weight loss was seen in the patients who underwent Roux-en-Y gastric bypass. Regardless of whether you did gain weight – ask yourself if you have been eating nutritious food to be at your most optimised self. I once heard a famous psychologist mention that being overweight is a sign of depression. The weight will melt when you least expect it. Not to lose weight but to feel empowered. Sign up for a yoga or a weight-lifting class to feel powerful. The Connection Between Sleep Apnea and PTSD According to a study conducted by Blackman et al. , the AHI of 134 subjects who took 3.0 mg of liraglutide for 32 weeks decreased by an average of 12.2 events/h (from 49.0 to 36.8), whereas the AHI of 142 subjects in the placebo group decreased by an average of 6.1 events/h (from 49.3 to 43.2). Substantial caution is required before use because patients with OSA often have high blood pressure 21,22. Its use is contraindicated in pregnant women and patients with uncontrolled hypertension, and because naltrexone is an opioid antagonist, it cannot be used in patients taking opioids. The naltrexone-bupropion complex was approved by the FDA in 2014 as an obesity treatment. Liraglutide is contraindicated in pregnant women and patients with a history or family history of medullary thyroid cancer . Stress, eating on the run and overwork are factors in weight gain. At the end of the day, no one wants the person they love to self-destruct or fall into unhealthy patterns that will ultimately ruin the relationship. I would recommend that you leave him because fundamentally, we will all gain and lose weight as we age. Perhaps what your husband said is traumatic to you because it has links to your inner child. An example of mindfulness could be expressing gratitude to your husband that he is willing to speak to you about this matter. However, if there is no significant weight loss despite these treatments, pharmacological or surgical management can be very helpful for weight loss and the improvement of OSA.A husband needs to care for his wife and live with her in an understanding way.Tony Padron, Mykelti’s husband, has been on a journey to shed some pounds and he’s not shy about sharing it with the world.At 10 years, 60.9% of the ILI participants had an improvement in their OSA category from baseline compared with the 47.6% improvement of DSE participants (Figure 3).The thought that my husband told me to lose weight can be debilitating.Not to lose weight but to feel empowered.According to a study conducted by Blackman et al. , the AHI of 134 subjects who took 3.0 mg of liraglutide for 32 weeks decreased by an average of 12.2 events/h (from 49.0 to 36.8), whereas the AHI of 142 subjects in the placebo group decreased by an average of 6.1 events/h (from 49.3 to 43.2). The results may have been influenced by the 41 participants who were withdrawn from the study following the baseline PSG because they did not have OSA (AHI 11). Throughout the 10-year study, all Sleep AHEAD participants and their primary care providers were sent letters reporting the results of every sleep study. Changes in healthy lifestyle behavior that were not monitored may have affected the AHI independent of weight. The increased remission from Year 4 to Year 10 in DSE participants may be related to the weight loss that occurred in this group over that time period. Statistical Analysis Insufficient sleep can affect hormones that regulate hunger and appetite.We addressed the impact of these missing data using multiple imputation and weighting for the probability of missingness.Look AHEAD compared the long-term health effects of an intensive lifestyle intervention (ILI) focused on weight loss versus diabetes support and education (DSE) (16–18).Strange suggestion, well, normalising feeling upset when something someone close to us comments on our weight.Your daily habits and environment can significantly impact the quality of your sleep. He enjoys educating his patients on nutrition, cancer screening, and weight issues, as he is acutely aware of how obesity can lead to significant morbidity and in particular sleep apnea, fatty liver, cancer, and cardiac issues. The greater improvement in OSA severity with lifestyle intervention in the first 4 years was no longer present at the 10-year follow-up, and the greater weight loss in the lifestyle intervention group than in the control group observed in the first 4 years was attenuated at 10 years. To assess the potential impact of missing data by weighting for the probability of missingness, we used a generalized estimating equation model, limited to participants whose missing data was monotone, that is, with no observed data from visits following the first visit with missing data. Of particular note, the change in AHI from baseline at 10 years was not different between the two groups. We found good agreements in interscorer and intrascorer reliability of the PSG scoring over this 10-year study. Epidemiological studies reported that the severity of OSA decreases with aging, independent of weight (41, 42), and the prevalence of OSA, which increases with aging in young and middle-aged adults, remains relatively constant after 55 years of age (43). This article reviews the pharmacological treatments approved by the Food and Drug Administration (FDA) and surgical management for obese patients with OSA. In addition, if abdominal fat, especially visceral fat, accumulates, the chest volume decreases and the functional residual capacity during breathing decreases, which can reduce the quality of sleep 5,8,9. Obesity is a disease caused by the abnormal accumulation of fat in the body, and it is attracting attention as a critical risk factor for OSA 4,5. However, their results are relatively unsatisfactory, and pharmacotherapy and bariatric surgery are generally implemented in obese patients with OSA. Of these, diet, behavioral modifications, and exercise constitute the first-line management for obesity. It means you have no interest in practising self-care by feeding yourself nutritious food and working out to keep your mind and body healthy. As we get older, we unfortunately WILL gain some weight due to our age and lifestyle. Again, it is not easy to hear that my husband told me to lose weight. These findings indicated that weight loss was also more effective in the liraglutide group than in the placebo group . In addition, body weight decreased by an average of 5.7% and 1.6% over 32 weeks in the liraglutide group and placebo group, respectively. A significant positive correlation between weight loss and AHI reduction was confirmed . According to a study conducted by Winslow et al. , the AHI decreased from an average of 44 to 14 events/h after 28 weeks in 22 patients taking 15/92 mg of the phentermine-topiramate complex, whereas the AHI decreased from an average of 45 to 27 events/h in 23 patients in the placebo group. Your source for TV and Entertainment news. With all the drama and turmoil in the Brown family, it’s refreshing to see some of the cast members focusing on their health and well-being. Tony Padron isn’t the only one from the Sister Wives cast who’s been focusing on their health and fitness. As the husband of one of Christine and Kody Brown’s eldest children, he’s been on the show for over ten years. This section collects any data citations, data availability statements, or supplementary materials included in this article. We also assessed whether the patterns of missing PSG results were related to change in AHI. To address this limitation, we evaluated the relationship between the probability of missing PSG results and available covariates. Obesity is a major risk factor for obstructive sleep apnea, and weight loss reduces the severity of obstructive sleep apnea. As OSA becomes more common with the increasing prevalence of obesity in modern society, weight loss must be considered as a treatment for overweight or obese patients with OSA. This guide describes the complex relationship between weight and sleep apnea, including when to see a doctor and how to take steps to improve overall health. Excess body weight is a large contributor to obstructive sleep apnea (OSA), which involves repeated lapses in breathing during sleep. My husband knows that when I utter that word, it is time to back off and keep his thoughts to himself. I needed him to help with learning new workout moves, choosing healthier options when we date and also reminding me constantly of my goals. I can bet you with all that weight I gained he thought to himself how to tell your girlfriend she needs to lose weight. When I gained 25 pounds when we dated, I told my boyfriend back then (now husband) that I needed support from him. Due to the relatively high frequency of long-term complications, band removal or corrective surgery is required in 30%–40% of patients within 10 years, and the frequency of this procedure has rapidly decreased in recent years 25,26. Although it is less invasive than other types of bariatric surgery, a disadvantage is that long-term complications occur relatively frequently due to foreign substances in the body 25,26. Furthermore, the frequency of subsequent weight gain due to gastric volume expansion is relatively high during long-term follow-up 11,25. However, there is a possibility of complications, including leakage along the ablation edge, stenosis, and the development or exacerbation of gastroesophageal reflux disease. Sleeve gastrectomy and adjustable gastric banding are intake restriction procedures, and biliopancreatic diversion and duodenal switch inhibit absorption 12,25. Dr. Nene lost 18 kg of weight by changing his lifestyle and getting rid of the habit of drinking alcohol. Personalized diet aur health guidance ke liye qualified health professional se consult karein. Yeh Mifflin-St Jeor Equation ka upyog karta hai, jo age, gender, weight, height, aur activity level ke aadhar par aapka Basal Metabolic Rate (BMR) aur total daily calorie needs batata hai. Calorie Intake Calculator ek scientific aur personalized health tool hai jo aapki daily calorie requirement ko accurately calculate karta hai. Instead, it's been about revamping their entire lifestyle into something they can keep up with forever. Love her as much as you can and reframe the conversation into you wanting her to live a long and healthy life together so you can do more things. It can also be from serious physical or psychological health issues. Multiple studies have investigated whether pharmacological treatment, such as the phentermine-topiramate complex and GLP1 receptor agonist (liraglutide), can improve OSA through weight loss. The weight loss effect in both groups was higher than that (1.3%) observed in the group that did not take the drug 21,22. Although the mechanism through which it induces weight loss has not been accurately identified, it is thought to act on the hypothalamus and mesolimbic dopamine circuits to cause satiety and increase energy consumption . Both groups showed a higher weight loss effect than the 2.6% weight loss observed in the group that did not take the drug . It delays gastric emptying, so that food passes more slowly from the stomach to the small intestine, and acts on the central nervous system to suppress appetite and induce weight loss . Although this procedure has a favorable effect on weight loss, at 70% in 2 years and 60% in 10 years, sleeve gastrectomy is performed more often in Korea, where the incidence of gastric cancer is high, because gastric endoscopy is difficult after Roux-en-Y gastric bypass. General contraindications to bariatric surgery include psychiatric disorders, obesity due to endocrine disorders, and conditions placing patients at high risk for general anesthesia. In Western countries, bariatric surgery is indicated for patients with a BMI of ≥40 kg/m2 or those with a BMI of 35–40 kg/m2 with serious comorbidities such as cardiovascular disease, diabetes, and OSA 12,24. Bariatric surgery can be considered if no significant weight loss occurs with non-surgical treatment such as diet, exercise, behavioral therapy, or pharmacological management. In a related study, the group taking 3.0 mg of liraglutide daily showed an average weight loss of 8.0%, while the group taking 1.8 mg showed an average weight loss of 4.7%.Personalized diet aur health guidance ke liye qualified health professional se consult karein.The known weight loss with aging in older adults may have contributed to weight reduction in all participants unrelated to the intervention.For this reason, sleep specialists typically recommend weight loss in people with OSA who are overweight or are obese.Sleep Foundation and SleepFoundation.org are not affiliated with the National Sleep Foundation, an independent nonprofit based in Washington, DC.All data generated or analyzed during the study are included in this published article.Perhaps he wants you to live a long and healthy life so that he can enjoy more of you.Therefore, the purpose of this paper is to review pharmacological and surgical management strategies for obesity that are currently commonly used in overweight or obese adult patients with OSA.Remission at 4 years was five times more common in ILI participants (20.7%) than in DSE participants (3.6%) (11). Excessive sleepiness may lead sleep apnea sufferers to exert less physical activity during waking hours. Daytime sleepiness is one of many sleep apnea symptoms, resulting from disruptive, fragmented sleep. Sleep apnea can also deplete the energy needed to maintain a healthy weight. Overall, these factors mean a person’s OSA risk increases in relation to body weight. In the last 20 years, the prevalence of sleep apnea has risen in the United States. She may feel unattractive or even rejected because her husband may not be initiating romance as he was before. If the relationship is healthy and he is meeting your needs and encouraging you and loving you and you are focusing on what is most important, I think the old statement, “Love is blind” is true. An important ingredient of any marriage is the need for husbands and wives to please each other. On one hand, it’s not wrong for a woman to want her husband to look attractive. What do you do when you have absolutely no attraction to your husband? Balancing Strength and CardioA balanced routine incorporating both cardio and strength training is ideal for overall health. Experiment with creating healthy versions of your favourite dishes by using less oil, leaner proteins, and more vegetables. Meal Planning and Cooking as a TeamCooking together is one of the most effective ways to manage your health. Making shopping a joint activity encourages better choices and transforms a mundane chore into an opportunity to plan your healthy week. In addition, the Diabetes Prevention Program, which recruited older adults at risk of diabetes, also reported a decrease in weight at the 10-year assessment in the control group (40). Although OSA severity of the ILI and DSE participants did not differ at the 10-year follow-up, the greater improvement in the ILI group over the decade may have resulted in symptomatic improvement and a possible decrease in cardiovascular risk. However, change in waist circumference at 10 years was not an independent predictor after weight change was included in models. Neck circumference and waist circumference were not predictors of AHI change at the 4-year follow-up after weight change was included in the models (11). Exercise training in sedentary adults who were overweight and obese improved AHI independent of weight loss (32). Weight loss alone is rarely able to fully resolve sleep apnea, especially in people with severe OSA. In addition, losing weight may help address some symptoms and complications of OSA, such as daytime sleepiness and cardiovascular problems. Without dietary changes, decreased activity levels can lead to additional weight gain. As a result, losing weight can be an important step in treating sleep apnea.The 16-site Look AHEAD study reported weight loss in its DSE group at 8–10 years, particularly in older participants (22, 39).I once heard a famous psychologist mention that being overweight is a sign of depression.Yeh Mifflin-St Jeor Equation ka upyog karta hai, jo age, gender, weight, height, aur activity level ke aadhar par aapka Basal Metabolic Rate (BMR) aur total daily calorie needs batata hai.Sleep AHEAD was an ancillary study of Look AHEAD, a randomized controlled trial in adults with type 2 diabetes and overweight/obesity.The FFD team took the time to thoroughly study my case and created a tailored plan, which was fantastic.What happens when he gains weight? As gastrointestinal side effects are common, caution is needed for use in patients with inflammatory bowel disease or gastroparesis. A GLP1 receptor agonist (liraglutide) was approved by the FDA in 2014 as a treatment for obesity. Therefore, in patients with OSA who have cardiovascular disease or are suspected of having contraindications, caution is required before using the drug 17,18. It is contraindicated in pregnant women and in patients with cardiovascular disease, hyperthyroidism, glaucoma, and hypersensitivity to sympathomimetic amines, and mentally unstable patients. This reduces the ability to exhale forcefully, making the airway more susceptible to narrowing. This results in less space for airflow and a greater risk of lapses in breathing during sleep. Excess weight often causes enlarged tissue and fat deposits around the airway. In Years 2–4, intervention consisted of at least one on-site visit per month and a second contact by telephone, mail, or e-mail. In Year 1, participants were prescribed portion-controlled diets with liquid meal replacements, frozen food entrees, and snack bars for the first 4 months (with reduced use from months 5 through 12). No difference in OSA severity was present between ILI and DSE groups at 10 years. A husband needs to care for his wife and live with her in an understanding way. A husband needs to be patient and verbally express his love and affection for his wife. "Stephanie puts it pretty well when she tells people if you’re going to lose weight, you can’t do it from a place of motivation because motivation is a very fleeting experience," Brandon explained. Now, she's learned it's about finding sustainable ways she enjoys moving her body. Stephanie used to think in order to lose weight, you had to do intense workouts at the gym every day of the week. To me, if you are serious about losing weight and keeping it off for the long haul, something has to be changed at the very core about the way you think about food. My final thought is that there are a number of weight loss programs available, most of which don’t work in the long run-a person loses weight but then ends up putting it back on, plus more. Obviously a husband can’t lose weight overnight, but if he is seeking to please his wife, then he can make an effort to look sharp and attractive. Tony’s weight loss journey has not gone unnoticed by the fans of the show. Pool of sweat by the end but it felt great.” The picture shows Tony looking incredibly fit and toned, and it’s clear that he’s been working hard to achieve his weight loss goals. In recent months, Tony has been sharing pictures of his weight loss journey on social media and the fans can’t get enough. People who follow the weight loss journey know that losing 18 kg is not that easy. Therefore, orlistat showed a weight loss effect of approximately 3% compared to the placebo group . Orlistat, which was approved by the FDA in 1999, induces weight loss by reducing fat absorption through the inhibition of the action of pancreatic lipase. In order to achieve effective weight loss and minimize side effects from drugs, it is necessary to properly adjust the dose of the drug and to confirm the patient’s medical history and target weight. Obstructive sleep apnea (OSA) is a chronic disease caused by intermittent partial or complete collapse of the upper airway during sleep. When the body weight increases, adipose tissue accumulates in the pharynx, which can narrow the diameter of the upper airway and lead to dysfunction of the pharynx dilator muscles. The weight on the outside is a manifestation of how you feel inside. I know you might feel better if you think my doctor told me to lose weight and that is okay because he comes from a medical standpoint I promise you; you will feel a lot more empowered when you realise the power to change is always within you. Tony Padron, Mykelti’s husband, has been on a journey to shed some pounds and he’s not shy about sharing it with the world. Photos of actress Madhuri's husband are also going viral on social media. Not only this, he also got his father rid of diabetes medicine. He said, 'About 9 to 10 months ago, I changed it and I became a complete vegetarian, quit drinking. Not only this, his body fat has reduced by 16 percent. “My husband tells me to lose weight! She now runs her own YouTube and Instagram account, where she has been sharing weight loss tips, recipes, and photos of herself and her daughter. She has kept a healthier lifestyle since then, while single-handedly raising her daughter. However, her life turned upside down as her husband would often insult her for gaining weight during the pregnancy. FFD was offering hope so I enrolled in FFD's type 2 diabetes reversal program - HTP immediately. It was then that I realized a serious change was urgently needed. Genetic depletion of Hdac6 in Agouti-related protein (AgRP)-expressing neurons or administration with BBB-impermeableHDAC6 inhibitors results in a lack of such anti-obesity effect. The mechanisms underlying theinhibition of leptin receptor (LepR) signaling during obesity are still elusive. Not to mention how much fasting has boosted my mental health. The weight just melted off. Maybe try googling weight watchers recipes to lose weight and see what comes up. When is the last time you prioritise your self-care by eating healthy? Like sleep apnea, OHS can cause low blood oxygen levels and cardiovascular problems like heart failure. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source , and nearly 90% of people with OHS also have obstructive sleep apnea. More research is needed to better understand the relationship between specific forms of OSA treatment and weight loss. Working closely with your doctor can help tailor your approach to weight loss and track its impact on OSA over time. However, some people may improve enough to no longer need other sleep apnea treatments, like CPAP therapy. These results showed a higher weight loss effect than the weight loss of 1.2 kg that occurred in the group that did not take the drug 14,15. Although the exact mechanism of topiramate’s weight loss effect has not yet been identified, animal experiments have suggested that it may be due to increased energy consumption resulting from the increased activity of lipoprotein lipase in brown fat and skeletal muscles . The phentermine-topiramate complex, which was approved by the FDA in 2012, acts on the central nervous system to inhibit appetite and induce weight loss. OSA is a chronic disease, and improvement in OSA severity with weight loss, if sustained long term, would increase the advocacy and acceptance of this treatment option. To our knowledge, this is the longest randomized trial assessing the effects of weight loss on OSA severity. Change in AHI over the 4-year follow-up was related to the amount of weight loss and intervention, independent of weight loss. In those participants with OSA at baseline, weight and AHI were significantly reduced in the ILI group versus the DSE group at 1 year (10). Short-term randomized controlled trials have reported reductions in OSA severity following weight loss, and two studies have assessed the effects of weight loss over a 4-year follow-up (3–15). You could try a different type of workout, introduce new healthy recipes, or shift your focus to non-scale victories like improved energy levels. Handling Plateaus TogetherWhen you hit a weight-loss plateau, it is important not to get frustrated. Encouragement Without CriticismThe weight-loss journey can be emotional, so your support for one another is paramount. Cardiovascular exercise is vital for heart health, while strength training builds lean muscle, which boosts your metabolism. Please check your link or data and try again. My blood sugar levels normalized, and I no longer needed diabetes medication. As I started following the plan, I began to see remarkable changes. The FFD team took the time to thoroughly study my case and created a tailored plan, which was fantastic. The results were qualitatively similar when these participants were removed from the analysis (Table E2 in the online supplement). Over the 10-year period, three ILI and five DSE participants received bariatric surgery. At 10 years, 34.4% of ILI participants and 22.2% of DSE participants had remission of their OSA. Improvement in AHI from year 4 to year 10 occurred in 38 of 52 (73%) ILI participants and 38 of 51 (74%) DSE participants. For many people, improvement in OSA symptoms is proportional to the amount of weight that they lose. Research has found that taking steps to lose weight may decrease the number of lapses in breathing that affect people with OSA. Insufficient sleep can affect hormones that regulate hunger and appetite. While excess weight has long been known to be a risk factor for OSA, an increasing amount of evidence suggests that the relationship is reciprocal. Research suggests that a weight gain of 10% can cause a person’s chances of OSA to be about six times higher. Stephanie says journaling has also been a way to stay accountable to herself for her health goals. Stephanie and Brandon found greater success in having each other as weight-loss partners. "You can have really good meals that are based heavily in different types of protein and not feel like you're missing out or depriving yourself of a meal you really want to have." They still enjoy their favorite dishes like pizza and tacos, with a healthier spin. "I have early memories of trying fad diets like Weight Watchers or low-carb and I would initially lose a little bit of weight, but I would never be able to keep it off long-term. I’d always gain it back plus five pounds." OSA can cause a variety of symptoms and/or complications, such as excessive daytime sleepiness, reduced concentration, hypertension, type II diabetes, and stroke. Obstructive sleep apnea (OSA) is a relatively common sleep disorder characterized by repetitive narrowing or obstruction of the upper airway, including the nasal cavity, pharynx, and larynx, during sleep. Join our Sleep Care Community — a trusted hub of sleep health professionals, product specialists, and people just like you. It is important to see a doctor if you have possible signs or symptoms of sleep apnea.