Tired of Obesity: The Link Between Fatigue and Body Weight

Dr. Christopher McGowan
December 18, 2020

If you are trying to get in shape, you have probably said at one time or another that you are tired of being overweight. It turns out it might be more accurate to say you are tired from being overweight. Though the links between obesity and fatigue are complex, increasingly research shows that adding pounds can mean losing sleep.

Can Obesity Make You Tired?

Obesity, defined as having a body mass index (BMI) over 30, is tied to a startlingly wide range of health conditions. Type 2 diabetes, heart disease, depression, and more are all generally worsened by having too much cushioning around your midsection. What has been more recently confirmed is that being overweight can actually contribute to what is called excessive daytime sleepiness or EDS. This condition of being chronically tired turns out to be a multi-faceted problem with many contributing factors linked back to obesity.

What are The Side Effects of Being Overweight?

Losing some quality sleep is far from the most severe side effect of being overweight. The list of medical conditions linked to being overweight includes some of the most serious and deadly you can face. High blood sugar levels, type 2 diabetes, increased risk of heart attack and stroke, and a long list of digestive issues all list obesity as a risk factor. Lowered mood, decreased physical activity, metabolic problems, and even certain kinds of cancer are all more likely if you are carrying excess body weight.

Poor Sleep Quality and Obesity 

Many of the connections between obesity and chronic fatigue arise from your inability to get good sleep if you are carrying too much extra body weight. Though decreases in physical activity, poor diet, and even body chemistry changes from having too much body fat, can all contribute to lowered daytime energy levels, the largest culprit is not getting enough good sleep. 

Much of the blame for poor sleep quality can be chalked up to a condition called obstructive sleep apnea. This blockage of your upper airway when you sleep is one of the most easily addressed effects of obesity, but until it is solved, it is one of the central causes of EDS.

Does Being Overweight Cause Sleep Apnea? 

Perhaps one of the most direct consequences of being overweight is poor sleep quality due to obstructive sleep apnea. This condition, which is extremely highly correlated to being overweight, involves your airway being closed off or restricted while you sleep. As frightening as it may sound, when you have sleep apnea, your body can actually run out of oxygen for several seconds or even as much as a minute at a time. This can happen multiple times during a single night of sleep. When your oxygen levels get too low, your body mounts an emergency response that will guarantee you wake up quickly and begin breathing again. 

The primary way this failure to get good sleep links to ESD is quite obvious. Even if you are putting in several clock hours in bed each night, you may not be getting as many hours of quality sleep as you expect. This alone would be enough to make you tired during the day, but the effects of sleep apnea go deeper. 

In order to wake you up suddenly to get air flowing again, your body produces large amounts of cortisol, adrenaline, and other hormones that are related to the stress response of running out of air. These hormones can have corrosive effects on your overall health over time if levels remain high. The constant state of your body feeling like it has just survived a close call will eventually begin to wear you down and contribute to lower energy levels. 

If sleep apnea were the only link between excessive daytime sleepiness, the use of a CPAP machine, the most common direct treatment for sleep apnea, would eliminate the fatigue felt by many overweight people. Many people who begin using a CPAP report improvements in sleep quality and overall energy levels almost immediately, but research has shown that many obese people still report being chronically tired even when the sleep deprivation of obstructive sleep apnea has been taken out of the picture. 

This research suggests there are other factors beyond the raw hours of sleep or quality of sleep a person receives that can cause EDS. Obesity is complex, and it has many ways of negatively affecting your overall energy levels. 

Depression and Daytime Sleepiness

Sleep apnea is far from the only problem you can encounter when it comes to weight gain and tiredness. Research has shown strong links between excess body fat and depression. Factors ranging from social pressure and low self-esteem to isolation can contribute to depression in people with high levels of body fat. Other physiological factors can affect mood as well, even though these are not as readily identified. Changes in blood sugar, metabolic levels, and even lowered levels of physical activity can all contribute to mental health problems. 

Beyond the obvious negative effects depression can have on your quality of life, mental health challenges can further contribute to lack of sleep. Depression creates a host of sleep problems including difficulty falling asleep, lowered quality of sleep, disturbed sleep patterns, and more. 

The cyclical effect of depression causing sleep disorders and lack of sleep contributing to depression can create a dangerous downward spiral. The same is true of how depression affects your daytime activities. People who are depressed tend to have lowered levels of physical activity, which leads to lowered levels of lean muscle mass that is built and maintained while exercising. Since regular, moderate exercise is linked to improvements in mood and increases in metabolism, being depressed can make it harder for you to exercise when you need it most. Without the exercise needed to burn calories, weight loss and the improved sleep quality it can bring can be even harder to achieve.

Inflammation Can Contribute to Fatigue

Though less well understood than some other ways obesity can contribute to sleep disorders, chronic, low-grade inflammation has been linked with lowered sleep quality. Increased body mass, especially in people who have a BMI over 30, is highly correlated to chronic inflammation. The specific ways in which inflammation works against you is not as direct as the problems caused by sleep apnea, but over long periods of time, the effects can begin to add up. 

Chronic inflammation has far-reaching effects throughout your body, with circulatory, pulmonary, and other organ function all being impacted. Increased inflammation is also linked to high blood pressure, problems regulating your blood sugar levels and other regulatory functions of the body that are also associated with poor sleep quality. 

Though harder to measure than raw hours of sleep, the cumulative effect of inflammation on your body is likely a significant contributor to the overall fatigue felt by people who are overweight. Inflammation damages organs and tissues throughout the body, and this damage takes energy to repair. 

Diet and Lifestyle Changes

One of the most overlooked areas where you can make direct changes to improve your quality of life, and your quality of sleep, is in your diet. What you eat, and when you eat it, has a profound effect on the quality of sleep you get. Studies have shown that diets high in carbohydrates can lead to lowered quality of sleep. This is in addition to the effects that high-carb diets can have on increasing weight gain in people who do not maintain a high level of exercise. Eating large amounts of food at one time, especially large portions of food containing high glycemic index sugars like sucrose (table sugar), can spike your blood sugar and cause dips in energy levels hours after you have eaten. 

Timing is also important when it comes to what you eat. Consuming food within 30-60 minutes of going to sleep can have a detrimental effect on how long it will take you to fall asleep, as well as contribute to poor sleep patterns.

Getting an appropriate amount of physical activity is a lifestyle change that can have profound effects on your quality of sleep. Working out may seem like an impossible task if you are already fighting against the twin troubles of excess body weight and lowered energy levels, Thankfully, you don’t have to be able to run a marathon to feel improvements in energy levels. Even moderate amounts of walking can begin to have an effect on your overall health within a very short time. 

Before you begin any program of physical activity, be sure to seek medical advice to ensure you are healthy enough to begin the program of exercise you are considering. It can feel daunting to begin to add exercise into your daily life, but the more physical activity you add the easier it will be to continue increasing your level of fitness. Gains may be small at first, but they can compound over time if you are consistent.

Will Losing Weight Help Stop Fatigue?

Research suggests dropping pounds is highly correlated with lowering your levels of daytime fatigue. The most obvious sleep quality benefit from weight loss is in reducing the severity of sleep apnea. Removing excess body fat from around the upper respiratory tract results in the majority of cases of sleep apnea being significantly eased or even cured. This one change can go a long way to improving overall daytime energy levels.

The strict loss of pounds is only part of the picture when it comes to fighting off EDS and restoring your natural energy levels. The increase in physical activity, improved eating habits, and other lifestyle changes necessary to achieve lasting weight loss can all contribute to better sleep habits, which in turn will have a positive effect on your quality of rest and resulting daytime energy. 

The downward spirals of sleep disorders contributing to depression, lowered metabolism, and other risk factors for weight gain—which further erodes your sleep quality—can seem daunting. Though it can be difficult to start new habits, these cyclical effects work in reverse as well. Lowered body mass can improve sleep, which in turn gives you more energy to increase activity levels, further improving your sleep quality. It can be hard to get the ball rolling, but once you do, these effects can dramatically change your quality of life over time. 

Treating Sleep Problems Related to Obesity

If you are overweight and have been experiencing the lowered quality of life excessive daytime sleepiness can bring, it may be time to take a closer look at the role body weight could be playing in preventing you from getting good sleep. Sleep apnea can be helped almost immediately by using a CPAP machine, but there is more to overall health than this one treatment.

It can be tempting to look for a quick and easy solution to solving tough problems. Chronic sleep disturbances and weight gain are both examples of this. While there might seem to be short-term benefits of using sleep medicine in an attempt to fix chronic fatigue, real freedom can only come if the underlying conditions like excess body weight are addressed. Similarly, some people look into weight loss surgery hoping for a quick fix that can solve problems with excess body weight once and for all.

At True You Weight Loss, we work with you to understand all the factors that contribute to weight gain and help you start down a path to effective long-term solutions rather than quick fixes. Weight loss procedures and other services we provide are tools we use to help you get control of excess body weight, but our ultimate goal is giving you the freedom of the higher quality of life found at a healthy weight you can live with.

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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