Weight Care Guide For Sleep Apnea

WEIGHT CARE GUIDE FOR SLEEP APNEA

BY DR. CAROLYNN FRANCAVILLA, MD

INTRODUCTION

WHO AM I?

Hi! I’m Dr. Carolynn Francavilla, MD, a board certified Family Physician and Diplomate of the American Board of Obesity Medicine.

I’ve been helping patients lose weight to treat and prevent medical problems for the last 10 years, and I’m taking what I’ve learned from them to you!

While I am a doctor, I am not YOUR doctor. This guide is meant to be informational in nature only, not medical advice. Please seek out care from your physician for your specific needs.

SLEEP APNEA

If you have sleep apnea, you may have been told that losing weight will help. Here are some key pieces of information: Weight loss of 10-15% CAN sometimes cure sleep apnea.

Just because you lose a lot of weight does not mean you should assume your sleep apnea is cured! You should follow up with your physician for testing.

If you lose significant weight, you may need your CPAP adjusted.

People at a normal BMI can have sleep apnea too! It’s not all about weight.

Use this guide as a way to explore what healthy weight loss can look like! If you want more information on weight and health check out my podcast The Dr. Francavilla Show!

3 STEP

P

E N O

DO I NEED TO LOSE WEIGHT? IS THERE A HEALTH CONDITION THAT WOULD BE IMPROVED WITH WEIGHT LOSS?

ST

E

QUESTIONS TO ASK

CONSIDER WEIGHT LOSS PROGRAM

ST

E ST

P

T

E R H

E

DO I HAVE A BAD RELATIONSHIP WITH FOOD OR MY BODY? DO I CURRENTLY HAVE OR HAVE I HAD AN EATING DISORDER?

PROCEED WITH CAUTION, YOU NEED MORE SUPPORT!

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O

CONSIDER WEIGHT LOSS PROGRAM

T

W

DO I HAVE RISK FACTORS TO DEVELOP HEALTH PROBLEMS FROM MY WEIGHT?

EP

FIVE PARTS OF WEIGHT CARE UNDERLYING CAUSES

01

LOOKING FOR EXPLANATIONS FOR WHY SOMEONE STRUGGLES MORE WITH THEIR WEIGHT THAN OTHER PEOPLE.

NUTRITION PLANS

02

NUTRITION PLANS SHOULD BE CUSTOMIZED SO THEY WORK FOR YOU! THEY SHOULD BE SOMETHING YOU CAN DO LONGTERM AND IMPROVE YOUR HEALTH.

EXERCISE

03

WE ALL LIVE LONGER AND BETTER WITH MORE EXERCISE. MOST PEOPLE WILL NOT LOSE WEIGHT FROM EXERCISE ALONE, BUT IT IS KEY TO MAINTAINING WEIGHT LOSS.

BEHAVIOR CHANGE

04

CHANGING YOUR RELATIONSHIP WITH FOOD AND YOUR BODY IS KEY. WORKING ON HABITS AND SYSTEMS HELP WITH LONGTERM SUCCESS,

MEDICATIONS

05

ANTI-OBESITY MEDICATIONS ARE LIFE CHANGING FOR MANY PEOPLE. MEDICATION MAKES IT SO MUCH EASIER TO FOLLOW A PLAN FOR HEALTH.

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CAUSES

A key step in treating obesity is finding underlying causes.

Why do so some people struggle with their weight more than others?

Everyone has two things happen when you try to lose weight: 1-Your metabolic rate slows down 2-The hormones regulating appetite make your feel hungrier AND less full This is why people plateau and struggle to keep losing weight. This can make you feel like a failure and make it hard to stick with your plan. This is also why medications or surgery can be very helpful as they help normalize your hunger and fullness signals!

Then we all have additional things that can make it hard to lose weight and easy to gain it: DIABETES INSULIN RESISTANCE PCOS SLEEP APNEA BINGE EATING DISORDER GENETICS MEDICATION SIDE EFFECTS MICROBIOME HYPOTHYROID DEPRESSION STRESS MENOPAUSE LOW TESTOSTERONE ALCOHOL ABUSE AND SO MANY MORE

NUTRITION There is no best nutrition plan for weight loss. This is why you will meet some people who swear by keto, and some people who swear by plant-based. And there’s data to show people can get healthier and lose weight with both of these extreme ways of eating. The more someone sticks to a nutrition plan, the more likely they are to lose weight and improve their health. So, as you choose a plan, make sure it’s something you feel like you could stick with longterm. If it’s something you are just going to suffer through for a few months, you are unlikely to continue those patterns of eating and you probably won’t get many health benefits.

Find the nutrition plan the works for you!

EXERCISE

For most people, exercise alone likely won’t lead to significant weight loss. But in order to keep weight off exercise is the secret sauce! The national weight control registry is a database of people who have lost 30 pounds or more and kept it off more than a year. It shows that 90% of people who have done so are now moving an hour a day! Mostly just by walking- but any type of exercise counts. In an ideal world you would do a mixture of cardio, strength training, flexibility, and balance.

It’s recommended that all Americans get 150 minutes of cardio a week and do at least two days of strength. But if you lose weight and want to keep it off, you will be shooting for closer to 300 minutes a week! Don’t get overwhelmed by this number. If you’re not doing any movement now start with something and gradually increase over the course of 6 to 12 months. You can split this movement up however you want! If you want to walk your dog three times a day for 20 minutes, or ride your bike for 30 minutes after work and then do yoga for 30 minutes before bed that works. You can also workout at a higher intensity to get more bang for your buck!

BEHAVIOR This covers everything from changing your relationship with food and your body to creating longterm habits and solutions. Exploring thought traps like “black and white thinking”, “traditions”, and “people pleasing” is one part.

Recognizing and changing emotional eating is another.

Figuring out habits and accountability that work for you and don’t lead to yo-yo diet and exercise is another.

I can’t over-emphasize the power of letting go of blame and judgement towards yourself.

It’s not your fault, it's biology.

MEDICATION There are many medications available to treat obesity.

These medications work in various ways, but mostly on appetite. They make it easier to eat smaller portions or eat less often. They all work best with a nutrition plan and regular exercise. Currently, it’s expected that most people will need to take a medication for many years or even forever when it works for them. When you lose weight hunger goes up and fullness goes down, many people cannot have longterm weight loss without medications or surgery.

Medications are life changing for many of patients!

Medications are chosen based on medical conditions, insurance coverage, side effects, and effectiveness. *Because of the popularity and success of newer medications there are many people selling and advising “compounded” versions of these meds. I only recommend FDA approved and regulated medications for my patients, these so -called “compounds” are unregulated. Please be safe with your choices!

ACTION

WEIGHT GRAPH

WEIGHT

GRAPH WHAT HAS HAPPENED TO YOUR WEIGHT OVER TIME. WHAT TRIGGERED WEIGHT GAIN? WHAT NUTRITION OR EXERCISE WORKED IN THE PAST TO LOSE WEIGHT? WHY DID YOU REGAIN?

AGE

OLIVIA WILSON

WORKBOOK

ACTION

FOOD LOG

WHAT DO YOU EAT IN A TYPICAL DAY? NUTRITION PLANS THAT WORK LONGTERM WORK FOR YOUR LIFE. I PREFER TO TWEAK WHAT YOU EAT, RATHER THAN GIVE YOU A PLAN THAT YOU CAN ONLY DO SHORT TERM. THE FIRST STEP IS LOOKING AT WHAT YOU ARE DOING NOW. WRITE YOUR TYPICAL DAY AND THEN HOW OFTEN YOU EAT SOMETHING DIFFERENT AS A TREAT OR SPECIAL OCCASSION.

Breakfast

Snack

Lunch

Snack

Dinner

Snack

Drinks

Special occasions or treats?

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ACTION

EXERCISE THE GOAL FOR ALL AMERICANS IS 150-300 MINUTES A WEEK WITH 2 DAYS OF STREGNTH TRAINING. TO MAINTAIN A WEIGHT LOSS, YOU MAY NEED TO GET CLOSER TO 300 MINUTES PER WEEK. HOW WILL YOU GET THERE? LET’S BRAINSTORM WHAT COULD WORK FOR YOU!

WHEN? BEFORE WORK? LUNCH BREAK? AFTER WORK? 10 MINUTES 3X A DAY?

WHAT? WALK? YOGA? CROSSFIT? DANCE? SWIM? WEIGHTLIFT? VIDEOS? GROUP CLASS?

WHERE? HOME? THE GYM? OUTSIDE? ONLINE?

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WORKBOOK

ACTION

CHALLENGES? WHAT THINGS GET YOU OFF TRACK WITH YOUR WEIGHT GOALS? THIS HELPS DETERMINE WHAT BEHAVIOR CHANGE TOOLS YOU NEED FOR LONG TERM SUCCESS.

IDEAS: TIME, HUNGER, EMOTIONAL EATING, FAMILY, WORK, INJURIES, FATIGUE, SUPPORT SYSTEM, STRESS, VACATIONS...

TEN THINGS THAT GET IN YOUR WAY 01 02 03 04 05 06 07 08 09 10

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YOUR GO TO

MEDICATIONS

PHENTERMINE

CONTRAVE

DAILY PILL THAT HELPS SUPPRESS APPETITE

COMBINATION PILLS THAT ARE TAKEN TWICE DAILY AND HELP WITH HUNGER AND CRAVINGS

INJECTABLES

QYSIMA

THESE MEDICATIONS ARE SHOTS YOU GIVE YOURSELF. THEY WORK ON HORMONES TO IMPROVE FULLNESS AND WEIGHT LOSS.

COMBINATION MEDICATION WITH PHENTERMINE AND TOPIRIMATE TO HELP WITH APPETITE

METFORMIN

VYVANSE

THIS IS A DIABETES MEDICATION THAT IS SOMETIMES USED FOR PEOPLE WITH PREDIABETES TRYING TO LOSE WEIGHT

THIS MEDICATION IS FOR BINGE EATING DISORDER

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WEIGHT CARE EIGHT

01

PEOPLE CAN BE HEAL THY AT DI FFERENT S I ZES .

02

PUT HEALTH FIRST; IS THE CHANGE HELPING YOU LIVE LONGER OR BETTER?

03

WHATEVER YOU DO TO LOSE WEIGHT, YOU HAVE TO KEEP DOING.

04

PROGRESS NOT PERFECTION

05

THERE IS NO ONE RIGHT WAY OF EATING.

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WEIGHT CARE EIGHT

06

EXERCI S E I S S OMETHI NG EVERYONE NEEDS F OR HEALTH. I T S HOULD NOT FEEL LI KE A PUNI S HMENT.

07

BE NICE TO YOURSELF. WEIGHT IS NOT YOUR FAULT, IT’S BIOLOGY.

08

MEDICATION OR SURGERY IS NOT CHEATING!

THE WEIGHT EIGHT ARE MY GUIDING PRINCIPLES FOR HEALTHY WEIGHT LOSS

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WANT MORE? THE PODCAST I hope this guide got you thinking about what real, comprehensive weight loss programs look like! The Dr, Francavilla Show is everywhere you listen to podcasts and on youtube! This is your go to resource for all things weight and health. I put my years of patient experience in to real,

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Take Care,