One casual observation I’ve seen during countless Zoom and FaceTime sessions with old friends and acquaintances is that many seem to have gained significant weight. I admit that just by seeing their faces onscreen is not an objective way of documenting weight gain. But from what I’m seeing and hearing from patients during our video sessions, many are telling me that they have gained significant weight in the past 4 to 6 weeks. Some of the reasons why people are putting on pounds are pretty obvious, but some are not.
Here are 7 reasons why you may be gaining weight during the pandemic and what you can do about it.
1. Less Physical Activity
This is the most obvious change for everyone. Since I’ve been doing more video teleconferencing for meetings and patient encounters, I’ve been sitting dramatically for longer periods of time. When I’m seeing patients, I’m often getting up, walking around, greeting patients, walking over to my secretary or another staff member to ask a question. Now, everything is done in front of a computer.
Sitting for long periods without regular breaks has been found to lead to less productivity and creativity. Regular 5 to 10 minute breaks every 45 to 60 minutes is important not only to increase productivity but also to create a sense of time-limited urgency, like catching up on all your work and loose ends before going on vacation. Everyone has different needs regarding how long to work in-between breaks. The important point is that you need to take the time for regular breaks.
One new routine (and now ritual) that our family started is a short walk outside along with our dog, Louie. We’ve been doing it after every dinner, as well as after lunch if I can join them. This was a custom I remember doing while growing up in South Korea. It brings back fond memories of my childhood. If you Google health benefits of walking after dinner, you’ll see countless articles and studies supporting this activity, especially with glucose control.
2. Less Sun Exposure
Many people have jobs that already requires working indoors, but now it’s even a greater proportion, especially with the pandemic lockdowns. Sunlight is a crucial component of your internal circadian clock. It resets the daily 24 hour rhythms of the body, optimizing all body functions, as well as to prepare you for optimal sleep at night. In fact, it’s been recently discovered that every cell in your body has genes for a 24-hour clock.
In addition, sunlight is a major factor in your body’s ability to make vitamin D, which is a hormone that significantly influences all areas of your body. Not surprisingly, the average American is Vitamin D deficient, hovering around the mid to upper 20 (nanograms/mL) range, where 30 is considered “normal.” However, it’s been shown that you need to reach a Vitamin D level of above 50 to 60 to benefit from a lower risk of heart disease, cancer, depression, bone fractures, and diabetes. The lower threshold of 30 was set to prevent rickets, which is bowing of the legs during childhood development. Additionally, the interaction of vitamin D along with various B vitamins is needed for optimal gut biome health, as it relates to neurotransmitter production, such as serotonin.
3. More Screen Time at Night
This problem is the flip side of #2. Too much of the wrong type of light at the wrong time. With the advent of the light bulb over 100 years ago and now with LED phones and computer screens, we are all immersed with artificial light. What’s worse, LED lights tend to have colder, bluer colors, which is known to increase wakefulness, as well as to lower an important sleep hormone, melatonin. Normally, melatonin begins to rise about 2 hours before your normal sleep time.
So if you normally go to bed at 11 PM, and use your computer until bedtime, you’ll be less drowsy when to go to bed at 11 PM. It may take a little longer to fall asleep, whereas you still have to wake up at the same time in the morning to go to school or work. This leaves you a little sleep deprived. Many teenagers have this much worse off.
This is why it’s important to avoid screens about 2-3 hours before bedtime. Don’t stay up 2 hours later just so you can watch a movie. If you must work on the computer, make sure to use a program or setting that cuts down on the blue light intensity. This is still not ideal since time spent working or browsing YouTube will fill your thoughts with stress, fear, or anxiety. More media at night will also tend to increase food intake as well.
4. Poor Sleep
Many families I’ve seen are now able to eat dinner much earlier. But for some individuals and families, dinnertime is later, regardless of whether or not food is cooked at home or ordered out. My strongest recommendation for better sleep is to avoid eating, snacking, or drink alcohol within 3-4 hours of bedtime. I can’t stress how important this is. The most important reason is that the latter has been shown to increase weight. Having persistent stomach juices lingering after a recent meal or snack can come up into the esophagus or throat, leading to reflux symptoms. This will cause multiple subconscious arousals since the sensation of acid in your throat will cause you to wake up slightly to swallow more often. If juices go into your windpipe, you’ll cough more often at night.
Given that the vast majority of people in the US are either overweight or have crooked teeth, it’s likely that they will have undiagnosed obstructive sleep apnea (OSA) or upper airway resistance syndrome (UARS). OSA, where one stops breathing repeatedly through the night while sleeping, is more commonly seen in overweight people but is also can be seen in young, thin women who don’t snore. UARS is a variation of OSA, where the duration or severity of obstructions doesn’t lead to the lowering of oxygen levels or breathing pauses longer than 10 seconds. In UARS, you can stop breathing 25 times every hour but still don’t have OSA. For both OSA or UARS, the vacuum forces created by inhaling against a closed throat will suction your normal stomach juices into the throat.
Another major issue that most doctors don’t typically consider is that modern human faces and mouths are shrinking. Over 100 years ago, most people had their third molars come in normally. Over the years, more and more people need their impacted 3rd molars (wisdom teeth) removed. Now there seems to be an increasing rate of 3rd molar agenesis, where at least one or more 3rd molars fail to erupt at all. We’re just finishing up analyzing our data looking at publicly available college yearbook faces and we found significant changes over 50 years, with modern faces being more narrow and taller. If you look at younger adults these days, they tend to have more narrow, triangle-shaped jaws, with more recessed and sloping side facial profiles. We have some amazing medical, dental, and surgical innovations, but this finding seems to imply that we’re treating a moving target. As our jaws get smaller, more health conditions will arise, needing different treatment options.
5. Ordering Out More
Many singles, couples, and families are using this opportunity to cook more at home, but others are ordering more food for delivery or take out. Whenever I do pick up some food to take out, business seems to be to booming. I have a friend who owns and runs a restaurant who says the takeout and delivery business is very good.
While convenient, eating out is almost always less healthy than a home-cooked meal, since you know the exact ingredients that are used. Restaurants will give typically give you their typical large-sized entrées, which is always a problem for people practicing portion control. I don’t even need to mention the downsides of eating fast-food.
6. Stuffy Noses
I can’t emphasize how important it is to breathe regularly through your nose. The nose and sinuses make nitric oxide which helps kill bacteria, viruses, and fungi, it also increases oxygen uptake in the lungs by about 10%. There are studies showing that nitric oxide can kill the coronavirus (from past pandemics, not COVID-19). Mouth breathing will cause you to breathe faster and more shallowly, leading to a mild form of hyperventilation. This will cause anxiety and increase your stress response.
Many people are probably not able to see their doctors during the current spring allergy season (mainly due to trees) because of the lockdown. Allergies will cause stuffy noses, sneezing, runny, itchy and watery eyes, and general misery with sleep problems. If you have nasal allergies, it’s important to address it properly, starting with conservative methods (such as nasal saline, allergy avoidance measures in the bedroom) to medical treatment (medications or allergy shots).
This pandemic and associated public health consequences are a major source of stress and anxiety. This can lead to hunger for more unhealthy foods (sugary, starchy foods), eaten later at night. Watching the news too much, or spending hours on the internet reading about various conspiracy theories, or local/state/federal government mismanagement problems are additional sources of emotional and physical stress.
Stress can come from multiple sources, including psychological, physical, or physiological origins. Breathing problems at night is a physiological form of stress. Physical stress is aggravated by a lack of physical exercise. Psychological stress comes from the intense fears and anxiety over the uncertainty of this pandemic. The bottom line is that stress leads to weight gain. Then weight gain increases your risk of obstructive sleep apnea. Obstructive sleep apnea aggravates acid reflux, which causes swelling in the throat with more obstructed breathing. The vicious cycle continues. Dr. Robert Saplosky’s book, Why Zebras Don’t Get Ulcers is an excellent primer to read about stress.
Even I have to make enormous efforts to remove myself from the constant talking heads and chatter throughout mainstream media. We all have enough information overload coming from our schools, workplaces, and other various organizations. This is why it’s important to implement various relaxation/stress reducton measures to counteract these unhealthy conversations.
You may identify with one or all of the above situations. Regardless, if you are gaining weight, go down each of the 7 areas that I mentioned and apply some of the recommendations so that you can begin to stop and reverse any further weight gain.
Which one of these scenarios do you identify with? Please leave your comments in the text box below.
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Originally posted on 7 Ways You Can Prevent Putting on Pounds During This Pandemic via Sleep Apnea Treatment