SLEEP, PEPTIDES AND WEIGHT CONTROL

Almost everyone on a cruise gains weight.  Typically, five pounds for a two-week sail.  There are exceptions.  If you get seasick, for one.  There are a few with a strong mind.  You can try to lose weight on tours.  Sleep, I learned, helps reduce gain.

I've tended to increase from 5-8 pounds on a cruise.  I allow this to happen because it turns out that I can lose them all in a week or two when I get home.  Makes a case for this type of weight gain being mostly water.  We always get the full alcoholic drinks package, have at least two meals a day (we tend to skip breakfast by enjoying a nightlife, whereby you wake up just before lunch).  But two large meals, snacks and 10 drinks/day add up calories, especially when one doesn't exercise much, like me on a ship.  I'm still hesitant to use the wellness centers from those pandemic days.

There was one exception.  We took a 52-day Seabourn cruise from Sydney to Honolulu.  I did not gain any weight?  Why?  We tended to sleep from 8-10 hours per day.

Sleep can be the solution to watching your weight.  

• 
  It's medically proven that your body produces leptin after a long night's sleep.
• It reduces hunger.
• Regulates long-term energy balance, signaling the brain about fat stores and suppressing appetite.
• If you don't sleep well, this leads to lower leptin levels in your system, making you hungrier.
• Your body also produces ghrelin, which does make you hungrier.  Leptin neutralizes ghrelin.
• 
  The chemicals that help and hurt are peptides.
• Amino acids are strings of peptides.  
• That is, peptides are short proteins about 2-100 amino acids long.  
• Any length 100-peptides long and over is an amino acid.
• Oligopeptides are 10-20 long and polypeptides are longer than 20 long.
• 
  Your body makes peptides.  For example, insulin is a 51-amino acid-long peptide.
• Peptide drugs have advantages.
• They can be sent to where they need to go in your body.
• Have fewer side effects.
• Are safer because your body breaks them down and can be recycled.
• 

  Peptide therapy can be by mouth, external application on skin, squirting them in your nose and injection.
• Peptides are not steroids.
• Peptides are also naturally found in many foods, such as meat, fish, beans, soy and other seeds.
• There are more than 100 peptide drugs currently FDA-approved for cancer, myeloma, HIV, diabetes, osteoporosis and pain.

Those new weight-loss drugs mimic the effects of peptides.

• Wegovy (semaglutide), Saxenda (liraglutide) and Zepbound (tirzepatide) are now approved for chronic weight management, while Ozempic (semaglutide), Victoza (liraglutide), and Mounjaro (tirzepatide), earlier used for type 2 diabetes, are now also used for weight loss.

• 
  These drugs suppress appetite, slow gastric emptying and block fat absorption.
• Combined with diet and exercise, patients can lose 15-20% of their body weight.
• Many fear injections.  There are now pills that will further increase there usage for weight control.  Soon to come will be

However, while the Biden administration was set to approve Medicare and Medicaid to cover weight loss drugs, including Wegovy and Zepbound, President Donald Trump killed this benefit, theoretically saving tens of billion dollars over time...but compounding the problem of obesity in the USA.  However, some of these treatments remain insured for type 2 diabetes.

How fat are Americans? I hesitate showing this entire table, but this just shows how terrible we are.  Note that the only countries more obese than us are Pacific islanders.  Here, someone typically passes out seat belt extensions to incoming airplane passengers.

#	Country	Income group	% obesity
1	American Samoa	High income	70.29
2	Nauru	High income	69.65
3	Tokelau		67.05
4	Cook Islands		66.05
5	Niue		63.71
6	Tonga	Upper-middle income	63.37
7	Tuvalu	Upper-middle income	57.73
8	Samoa	Lower-middle income	52.83
9	French Polynesia	High income	47.02
10	United States	High income	41.64
11	Qatar	High income	40.79
12	Bahamas	High income	39.78
13	Palau	High income	39.10
14	Federated States of Micronesia	Lower-middle income	39.02
15	Kuwait	High income	38.88

17	Saudi Arabia	High income	38.13
18	Marshall Islands	Upper-middle income	38.09
19	Saint Kitts and Nevis	High income	37.59
20	Puerto Rico	High income	36.46
21	Hungary	High income	36.43
22	Kiribati	Lower-middle income	36.08
23	Malta	High income	36.02
24	Argentina	Upper-middle income	35.53
25	Croatia	High income	34.80
26	Georgia	Upper-middle income	34.34
27	Jordan	Lower-middle income	34.20
28	Chile	High income	34.10
29	Belize	Upper-middle income	33.62
30	Iraq	Upper-middle income	33.35
31	New Zealand	High income	32.99
32	Bahrain	High income	32.91
33	Egypt	Lower-middle income	32.48
34	Mexico	Upper-middle income	32.22
35	Poland	High income	32.19
36	Australia	High income	32.05
37	Uruguay	High income	31.64
38	Slovakia	High income	31.42
39	Paraguay	Upper-middle income	30.76
40	Czechia	High income	30.72
41	Ireland	High income	30.70
42	Brunei Darussalam	High income	30.22
43	Greece	High income	30.06
44	Panama	High income	29.88
45	Palestine	Lower-middle income	29.77
46	Lebanon	Lower-middle income	29.53
47	North Macedonia	Upper-middle income	29.11
48	United Arab Emirates	High income	29.02
49	Nicaragua	Lower-middle income	28.68
50	Canada	High income	28.16
51	Libya	Upper-middle income	28.08
52	Uzbekistan	Lower-middle income	27.88
53	Lithuania	High income	27.87
54	Barbados	High income	27.78
55	United Kingdom	High income	26.94
56	Oman	High income	26.79
57	Syrian Arab Republic	Low income	26.71
58	Fiji	Upper-middle income	26.62
59	Serbia	Upper-middle income	26.44
60	Turkey	Upper-middle income	26.22
61	Cyprus	High income	26.18
62	Latvia	High income	25.72
63	Slovenia	High income	25.66
64	Costa Rica	Upper-middle income	25.55
65	Brazil	Upper-middle income	25.05
66	Kyrgyzstan	Lower-middle income	24.96
67	Bermuda	High income	24.47
68	Antigua and Barbuda	High income	24.40
69	Greenland	High income	24.37
70	Russian Federation	High income	24.34
71	Bulgaria	High income	24.08
72	Dominican Republic	Upper-middle income	24.02
73	Israel	High income	23.81
74	Iceland	High income	23.64
75	Peru	Upper-middle income	23.62
76	Honduras	Lower-middle income	23.59
77	El Salvador	Upper-middle income	23.44
78	Bolivia	Lower-middle income	23.41
79	Estonia	High income	23.37
80	Germany	High income	23.08
81	Ecuador	Upper-middle income	23.06
82	Trinidad and Tobago	High income	22.99
83	Guatemala	Upper-middle income	22.62
84	Mongolia	Upper-middle income	22.46
85	Bosnia and Herzegovina	Upper-middle income	22.41
86	Albania	Upper-middle income	22.27
87	Moldova	Upper-middle income	22.01
88	Portugal	High income	21.97
89	Finland	High income	21.88
90	Montenegro	Upper-middle income	21.35
91	Andorra	High income	21.06
92	Luxembourg	High income	20.99
93	Norway	High income	20.93
94	Saint Lucia	Upper-middle income	20.87
95	Venezuela		20.82
96	Ukraine	Upper-middle income	20.77
97	Seychelles	High income	20.58
98	Tajikistan	Lower-middle income	20.57
99	Pakistan	Lower-middle income	20.49
100	Azerbaijan	Upper-middle income	20.39
101	Belarus	Upper-middle income	20.13
102	Tunisia	Lower-middle income	19.92
103	Armenia	Upper-middle income	19.81
104	Belgium	High income	19.79
105	Suriname	Upper-middle income	19.67
106	Turkmenistan	Upper-middle income	19.60
107	Spain	High income	19.39
108	Saint Vincent and the Grenadines	Upper-middle income	19.23
109	Jamaica	Upper-middle income	19.21
110	Cuba	Upper-middle income	19.19
111	Kazakhstan	Upper-middle income	19.07
112	Grenada	Upper-middle income	19.06
113	Austria	High income	18.81
114	Colombia	Upper-middle income	18.58
115	Dominica	Upper-middle income	18.38
116	Iran	Upper-middle income	18.26
117	Solomon Islands	Lower-middle income	18.13
118	Guyana	High income	18.10
119	Italy	High income	17.97
120	Malaysia	Upper-middle income	17.70
121	Sweden	High income	17.18
122	Vanuatu	Lower-middle income	17.04
123	Papua New Guinea	Lower-middle income	16.61
124	Singapore	High income	16.09
125	Algeria	Upper-middle income	16.03
126	Denmark	High income	15.70
127	Eswatini	Lower-middle income	15.62
128	Switzerland	High income	15.07
129	Netherlands	High income	15.05
130	Afghanistan	Low income	14.88
131	South Africa	Upper-middle income	14.50
132	Morocco	Lower-middle income	13.79
133	Maldives	Upper-middle income	13.23
134	Mauritius	Upper-middle income	13.07
135	Liberia	Low income	13.05
136	Taiwan	High income	12.44
137	Thailand	Upper-middle income	12.10
138	Sudan	Low income	11.74
139	Gabon	Upper-middle income	11.41
140	Namibia	Upper-middle income	10.65
141	Yemen	Low income	10.49
142	Mali	Low income	10.24
143	France	High income	10.18
144	Sao Tome and Principe	Lower-middle income	10.06
145	Gambia	Low income	9.77
146	Cameroon	Lower-middle income	9.69
147	Bhutan	Lower-middle income	9.61
148	Mauritania	Lower-middle income	9.25
149	China	Upper-middle income	8.94
150	Lesotho	Lower-middle income	8.82
151	South Korea	High income	8.82
152	Cabo Verde	Lower-middle income	8.79
153	Botswana	Upper-middle income	8.76
154	North Korea	Low income	8.65
155	Nigeria	Lower-middle income	8.52
156	Comoros	Lower-middle income	8.31
157	Equatorial Guinea	Upper-middle income	8.08
158	Cote d'Ivoire	Lower-middle income	7.95
159	Guinea-Bissau	Low income	7.86
160	Chad	Low income	7.71
161	Japan	High income	7.63
162	Benin	Lower-middle income	7.41
163	Philippines	Lower-middle income	7.34
164	Sri Lanka	Lower-middle income	6.76
165	Haiti	Lower-middle income	6.73
166	Tanzania	Lower-middle income	6.73
167	Angola	Lower-middle income	6.53
168	Indonesia	Upper-middle income	6.53
169	Mozambique	Low income	6.50
170	Burundi	Low income	6.36
171	Djibouti	Lower-middle income	6.35
172	Central African Republic	Low income	6.33
173	Kenya	Lower-middle income	6.32
174	Guinea	Lower-middle income	6.16
175	Somalia	Low income	6.07
176	Laos	Lower-middle income	6.06
177	Togo	Low income	5.88
178	Zimbabwe	Lower-middle income	5.73
179	Myanmar	Lower-middle income	5.67
180	India	Lower-middle income	5.38
181	Ghana	Lower-middle income	5.37
182	Zambia	Lower-middle income	5.34
183	South Sudan	Low income	5.32
184	Nepal	Lower-middle income	4.97
185	Madagascar	Low income	4.63
186	Niger	Low income	4.51
187	Congo	Lower-middle income	4.38
188	Democratic Republic of Congo	Low income	4.38
189	Uganda	Low income	4.25
190	Burkina Faso	Low income	4.17
191	Senegal	Lower-middle income	4.06
192	Malawi	Low income	3.21
193	Cambodia	Lower-middle income	3.12
194	Bangladesh	Lower-middle income	2.97
195	Eritrea	Low income	2.93
196	Sierra Leone	Low income	2.79
197	Vietnam	Lower-middle income	1.97
198	Rwanda	Low income	1.84
199	Timor-Leste	Lower-middle income	1.58
200	Ethiopia	Low income	1.10

Prevalence of obesity (BMI ≥ 30kg/m²)

Amen.

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