The Relationship Between Insomnia and Weight Gain

Dr. Christopher McGowan
June 29, 2022

Even though there has been some evidence of decline in recent years, sales in the weight loss industry are still estimated to be around $50 billion a year. Decades of specialty food products and exercise equipment promised that dieting and exercise alone would lead to weight loss. Research in recent years, however, has shown that there are a lot of different factors that play a role in both gaining weight and losing weight. One factor that surprises a lot of people is the impact of insomnia on weight gain.     

Facts About Insomnia   

Insomnia is a term that is often used in the population at large to describe any kind of sleep problem, but in medical circles it is used to refer to a specific sleep disorder. Though different people can have slightly different needs, the minimal sleep duration recommended by experts is seven hours of sleep each night. When doctors diagnose insomnia, they consider the following criteria: 

  1. a person has difficulty falling asleep, difficulty staying asleep, or has poor sleep quality
  2. the sleep problems exist even with adequate opportunities for sleep 
  3. sleep deprivation is causing daytime difficulties or distress
  4. sleep loss happens for at least a month and at least three times a week

Estimates about the overall prevalence of insomnia vary between 6% and 30% of the population, but certainly almost everyone experiences difficulty sleeping from time to time. When it is frequent and severe enough to be diagnosed, insomnia can have significant effects on quality of life. Indeed, research about insomnia has uncovered links to a wide range of psychological concerns like depression, anxiety, relational problems, and absenteeism at work. Additionally, there is mounting evidence that insomnia is also linked to a higher risk for heart disease, high blood pressure, insulin resistance, and type 2 diabetes.

There are many different possible causes of insomnia, but they tend to fall into one of four different categories: lifestyle factors, medications or drug use (including alcohol), mental health issues, or problems with physical health. Researchers believe that emotional or physiological hyperarousal during the day may be making it difficult to initiate sleep or get actually restful sleep. Studies further indicate that this physiological hyperarousal is related to metabolic activity. This is also why insomnia is now believed to be connected to weight gain.    

How Does Insomnia Affect Weight?   

In many recent studies, researchers have noticed that the effect of sleep deprivation on the body is similar to what happens when the endocannabinoid (eCB) system is activated. The eCB system is an important part of how the brain regulates energy levels and appetite, and it also has an impact on the parts of the brain involved with motivation and reward. These studies consistently show that sleep-deprived people have higher eCB levels than people who regularly get enough sleep. This means that they are more likely to be hungry for longer periods of time; and because it is essentially pleasure eating, that often involves higher calorie or otherwise unhealthy foods that contribute to weight gain. 

Another area of research related to insomnia and obesity involves our circadian rhythms, the internal process that governs our sleep-wake cycle. Circadian rhythms are also thought to regulate energy metabolism because of the differing energy needs at day and at night. This is most likely due to changes in the balance of hormones that influence appetite; reduced sleep tends to elevate ghrelin, the hunger hormone, and reduce leptin, the satiety hormone. 

When these two factors are considered, the connection between lack of sleep and obesity begins to get clearer. Chronic sleep deprivation disrupts a person’s circadian rhythms and therefore the body’s energy metabolism—and this means a tendency to feel hunger for a longer period of time during the day. At the same time, elevated eCB levels means an additional tendency toward high calorie foods that provide the most pleasure. Over time, a calorie surplus will lead to weight gain.  

Treatment for Insomnia       

The good news is that these trends can be reversed, in part, by getting more sleep each night. While more sleep won’t necessarily lead to immediate weight loss, the changes to ghrelin, leptin, and eCB levels can make a significant difference in modifying eating habits and food intake. There are, of course, plenty of other reasons to want to treat insomnia. Below are some common methods for treating a medical diagnosis of insomnia: 

  • Therapy: Cognitive behavioral therapy (CBT) is considered a first line treatment in part because it doesn’t have the health risks that can accompany some forms of sleep medicine. This kind of therapy typically covers sleep hygiene education and stimulus control to reduce anxiety. It may also include techniques like sleep restriction and relaxation exercises. 
  • Medication: Doctors may prescribe certain medications for patients with chronic insomnia that haven’t had success with other treatments. Examples include benzodiazepines, melatonin agonists, and orexin receptor antagonists. Many of these medications are controlled substances due to their potential for abuse, and so they are not intended to be prescribed over the long term. 
  • Supplements, etc.: There are also a variety of nontraditional methods that are sometimes used to induce sleepiness or maintain restful sleep for longer than normal. Examples include over-the-counter sleep aids, antihistamines, and melatonin supplements.     

Strategies for Weight Loss

Getting a good night’s sleep is beneficial for overall health and wellbeing as well as for any weight loss goals. Each new study that comes out seems to confirm that poor sleep health is connected to weight gain in a number of ways. As noted, though, reversing the trend and losing weight will require more than just keeping to a sleep schedule. And even though a proper diet and regular physical activity are important factors, for most people they won’t lead to lasting weight loss.    

As the nation continues to struggle with obesity, a different approach is needed. This is why True You Weight Loss offers non-surgical weight loss solutions that are specifically designed to promote long-term, sustainable weight loss. One of the most effective procedures is called endoscopic sleeve gastroplasty (ESG); it involves endoscopically reshaping the stomach so that it has reduced volume. The effect of reducing stomach volume means that the person gets full more quickly; over time, being able to eat less helps promote longer term healthier eating habits.

Contact True You Today

If you’ve been trying to lose weight without success, the truth is that there are probably numerous reasons, including lack of sleep. To make a lasting change, however, you’ll likely need to make a number of changes. At True You, we understand how challenging it can be to lose weight. That’s why we are committed to helping you find the freedom you’ve been looking for. To learn more about how we can help, please contact us today to request a consultation

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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