The introduction is also posted on Spotify as a podcast by “Gerry at The Health Equation”

You can search Spotify for “Gerry at The Health Equation”

Or use the link below

https://podcasters.spotify.com/pod/show/gerrygaj

Below is the specific link

Gerry Gajadharsingh writes:

“When we talk about weight management, diet and exercise inevitably take centre stage. As a clinician, I also see how stress powerfully influences both weight gain and weight loss. But increasingly, I’m struck by how often one overlooked factor quietly underpins struggles with weight control: sleep.

The American Heart Association has even added sleep to its list of “life’s essentials” — elevating it alongside nutrition and activity in its guidance for cardiometabolic health. This recognition reflects a growing body of evidence linking poor sleep with obesity, metabolic dysfunction, and reduced effectiveness of weight-loss interventions.

What strikes me most in reviewing this evidence is that sleep is not just rest — it is regulation. It governs appetite, metabolism, mood, energy, and even our ability to stick with healthy routines.

For patients and clinicians alike, it may be time to view sleep as the third pillar of weight management, alongside diet and exercise. By prioritizing healthy sleep, we may unlock better adherence, healthier food choices, and more sustainable weight outcomes.

I have been offering individualised the spoke Metabolic Balance nutritional plans to certain patients over the years and also sharing some of the principles with many patients. In regard to weight loss patients are often surprised to learn that good quality sleep is critical for weight management. Looks like the research is catching up.

 Below, I’ve curated and adapted highlights from a recent Medscape article by Marilynn Larkin, which synthesizes the latest research on sleep and obesity.

Why Sleep Matters in Weight Control

For more than two decades, epidemiological studies have shown that insufficient sleep is associated with obesity. In fact, adults sleeping less than seven hours a night are nearly twice as likely to be overweight or obese compared to those who get the recommended 7–9 hours.

This connection is not just statistical. Randomized controlled trials reveal that inadequate sleep doesn’t just predict weight gain — it can also undermine weight-loss maintenance, even when individuals are on medications like liraglutide.

“I strongly believe that getting enough sleep could help tackle our society’s obesity epidemic,” says Esra Tasali, MD, Director of the UChicago Sleep Centre. “Remarkably, more than one third of US adults are not getting enough sleep on a regular basis, which strongly increases their risk for chronic conditions.”

The Sleep–Obesity Cycle

Christopher Kline, PhD, at the University of Pittsburgh, notes that sleep and obesity have a bidirectional relationship: poor sleep predisposes to weight gain, and obesity in turn worsens sleep quality.

Pathways linking sleep loss to obesity include:

  • Insulin sensitivity:Sleep deprivation reduces the body’s ability to use insulin effectively, promoting fat storage.
  • Appetite hormones:Lack of sleep may disrupt ghrelin (hunger hormone) and leptin (satiety hormone), encouraging overeating.
  • Food choices:Brain imaging and feeding studies show poor sleep lowers resistance to calorie-dense, processed foods.
  • Lifestyle adherence:In weight-loss programs, poor sleepers stick less closely to caloric and exercise goals.
  • Reduced activity:Fatigue fuels sedentary behaviour, lowering energy expenditure.
  • Sleep apnoea:Obstructive sleep apnoea, common in obesity, sabotages weight-loss efforts and independently increases cardiometabolic risk.
  • Metabolism & muscle:Shortened sleep slows resting metabolic rate and increases the risk of sarcopenic obesity (low muscle, high fat).

Laboratory studies echo these findings, showing that sleep restriction triggers hunger, snacking, and loss of control eating compared to normal sleep.

Can Improving Sleep Boost Weight Loss?

Here the evidence is more nuanced. While treating sleep apnoea with CPAP doesn’t appear to improve weight loss directly, sleep extension interventions show promise.

In one study led by Dr. Tasali, overweight adults were coached on sleep hygiene with the goal of increasing nightly sleep to 8.5 hours. Without changing diet or exercise, participants slept an extra 1.2 hours on average — and consumed 270 fewer calories per day, leading to weight reduction.

Other research emphasizes that not just duration, but sleep quality matters. Variability in bedtime, poor satisfaction, late sleep timing, and low efficiency all predict less weight loss during behavioural programs. Similarly, poor baseline sleep has been shown to reduce fat mass loss and impair long-term weight-loss maintenance.

Practical Steps for Better Sleep

While research continues, experts agree that clinicians can help patients improve sleep immediately by reinforcing good sleep hygiene:

  • Keep a consistent sleep schedule
  • Make the bedroom dark, cool, and quiet
  • Establish a calming evening routine (reading, bath (not too hot), music)
  • Maximize morning light exposure, and reduce screen/blue light use at night
  • Stay active and exercise during the day
  • Avoid late-night eating and alcohol close to bedtime

Importantly, clinicians should actively ask about sleep when supporting lifestyle changes. As Kline puts it:

“For some individuals, poor sleep could be an important factor that gets in the way of attempted behaviour modification.”