Your Diet

August 2004, "Is Fatigue Making you Fat?"

A good night's sleep may be your best weapon in the battle of the bulge.
By Elizabeth O'Brien Moore

Like a lot of women, Diane Mongauzy was overcommitted, overtired and overweight. After gaining 65lbs. with her first set of twins in 2000, the Issaquah Wash., mother of five had lost only 30 before becoming pregnant six months later with another pair of twins. That pregnancy left her 75 lbs. overweight. "My life is ballistic,"says Mongauzy, 34. "I usually have a little one in bed with me at night, so I get disrupted sleep. Dieting was the last thing on my mind."

The connection? Studies have show that sleep deprivation, compounded by a stressful lifestyle, may boost bloodstream levels of the fight or flight hormone cortisol - essential in an emergency, harmful over time. "Cortisol is associated with a rise in insulin, which makes fat breakdown more difficult," explains Jana Klauer, M.D., a weight reduction and nutrition expert at the New York Obesity Research Center at St. Luke's - Roosevelt Hospital Center. In response, the body craves sweet or fatty foods. In the city that never sleeps, Klauer reports that 70 to 80 percent of her clients struggle with this issue.

Get Some Sleep
"Good health is a troika," says the National Sleep Foundation's Marcia Stein. "Diet, exercise and sleep, and sleep is where people try to cheat - and they can't." According to the NSF, more than 60 percent of Americans report sleep difficulties, and only 35 percent are getting the recommended eight hours nightly, with most getting fewer than seven. It's especially tough on women, who, in addition to stress-related sleeplessness, contend with sleep disturbances related to PMS, pregnancy and menopause.

With the deck stacked against them, how can women combat the weight gain and get the rest their bodies need? The first step may be the hardest. "We need to find a simpler way of life," says Klauer. "Try going to bed just a half an hour, maybe even 15 minutes, earlier. Many times just by doing this you'll feel more energetic in the morning."

But when your new baby is waking you up every other hour or you're working two jobs and doing laundry at midnight, getting to bed earlier can seem impossible. Experts advise women to do something that's not easy for many of them: Ask for help. Have a family member or a friend pitch in with the laundry, housekeeping or meal preparation. That worked for Mongauzy, who has lost 57 lbs. on the Curves program. "I have someone help me clean my house," she says. "My mom and dad live nearby. There's no way I could have done it without them."

Even when you do manage to get to bed at a decent hour, sometimes sleep just won't come. Klauer tells her clients to create a calming, sleep friendly environment. "Take a bath and prepare yourself for bed," she says. "You need to put yourself into a more relaxed frame of mind," Old-fashioned cures like a glass of warm milk can be a soothing nightly ritual (and milk contains natural sleep inducer tryptophan). And turn off the late-night TV!

If your insomnia is unexplained and your doctor has ruled out any medical or psychological causes, he may prescribe sleeping pills for a short time. (A combination of medications and behavioral or psychotherapeutic approaches works best.) If you think you have a true disorder, such as nocturnal sleep related eating disorder ( you eat while you're asleep) or nocturnal eating syndrome (you wake frequently to eat), a visit to a sleep specialist is invaluable. (Find a center at

Get Smart About Food
As you work on adapting to a new, regular sleep schedule, try to establish an eating schedule as well. "Sleep deprivation makes you more vulnerable to poor choices," says Karen Miller-Kovach, M.S., R.D., chief scientific officer at Weight Watchers International. "Setting up a routine decreases your vulnerable time. Just say, 'I eat breakfast at 8'. If you eat regularly, you never get hungry."

The alternative - giving in to temptation - can exacerbate feelings of fatigue, which can increase inappropriate cravings, which can… you get the picture. "This is really tough for women," says Elizabeth Somer, M.A., R.D., author of Food & Mood and the Food & Mood Cookbook. "We've dieted so much that a lot of women have lost touch with what real hunger feels like."

Often, what some people interpret as hunger is actually a cut to get some sleep, but many chug coffee to stay awake, then wind up not being able to sleep at night. (Caffeine, found in chocolate and soft drinks too, can linger in the body for up to 12 hours.) Or they'll overload on simple carbohydrates, like refined sugar in candy or soda, for a burst of energy, only to crash a few hours later, when they'll go for another boost. "You're not helping yourself by managing your problem without addressing it," says Miller-Kovach.

Instead, opt for high-fiber complex carbs, like air-popped popcorn or an apple, which fill you up and break down more slowly, providing you with a longer, steady energy flow. Because most cravings last less than 15 minutes, says Klauer, these snacks can carry you through the rough spots.

As a producer at a FOX affiliate in Kansas City, Mo. - one of her three jobs - Charla Wells, 25, joined Weight Watchers and learned to overhaul her snacking habits. "I always felt like I should be eating something to stay awake," she says. "I swap things. Now I'd rather have carrots than chips, because if I had chips I'd want another bag an hour later."

But even the best of intentions can come undone when the vending machine full of high-fat, high-sugar snacks is your only option. That's why traveling with healthful portable alternatives is essential. "Have a nutrition survival stash," says Somer. "Never leave the house without packing your briefcase, gym bag, diaper bag with baby carrots, string cheese, apples."

Get Moving
Though exercise may be low on the to-do list of the chronically exhausted, people may not know they're robbing themselves of not only the calorie-burning and muscle-building benefits but also a good night's sleep - especially the kind of deeper, more restful sleep that comes from regular activity. "Slow-wave sleep is a restorative kind of sleep," says Klauer, "when growth hormone is released in the body, which benefits muscle strength and muscle mass." Exercise also provides an energy boost during waking hours. When Linda Gottlieb, 43, a Miami mother of two, started the exercise program at Duke University's Diet & Fitness Center, she was worn out from caring for her special-needs son and dealing with the stress of an impending divorce. "For me, exercise has been a job," she says. "But I hated the feeling of waking up sick because I binged. I have much more energy now, I'm happier, less depressed. My body moves better."

Sleep, diet and exercise: Improve the first and the rest follows. Just ask Charla Wells, who reached her weight loss goal of 80 lbs. "I don't let anything interfere with my sleep time now," she says. "If I have to go to bed at 9, I go to bed at 9. I have incorporated exercise back into my schedule. I'm making better food choices. I'm so happy with where I am, I will live this way forever."

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