The Pharmaceutical Journal
Vol 277 No 7423 p490
21 October 2006

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Can a shortage of sleep make you put on weight? more
Motivation: the gentle art of boosting an ego more
Recreational drug abuse extends its limits more
Actions and attitudes: the sense of responsibility is paramount more

Can a shortage of sleep make you put on weight?

In these days the health professions take a persistent interest in the growing problem of obesity that lies at the root of many chronic illnesses. According to a note in the BMJ’s 23 September issue, the obesity epidemic is out of control and none of the measures being undertaken show signs of halting the problem, let alone reversing the trend.

A feature in the 21 September issue of Nature draws attention to another element in the problem, apart from the well-recognised role of diet and exercise. This is sleep. There are links between poor sleep patterns and appetite. It has been found in the case of a 12-year-old overweight girl that she was accustomed to sleep for no more than seven hours a night. Within a month of starting to stay in bed for nine or 10 hours she began to lose weight and lost her craving for food.

Although sleeping and eating are two of our most elementary drives, in western societies we tend to deprive ourselves of sleep and gorge ourselves on food. Trials being carried out in the US seek to determine whether tired obese individuals lose weight if they increase their sleep by 1.5 hours each night. Ideally we spend a third of our lives sleeping and this is part of a good health regimen. In the US, the average length of sleep was between eight and nine hours a day in 1960, but it is now below seven hours. Most industrialised nations follow a similar pattern, which is believed to derive from computer, television and shopping habits.

It is known that sleep deprivation has effects on metabolism and hormones. In particular, it affects blood levels of leptin, which is released by fat cells and signals satiety, and ghrelin, which is produced by the stomach and signals hunger. After two nights of sleep deprivation, blood levels of leptin fell on average by 18 per cent and those of ghrelin rose by 28 per cent in experimental subjects. Orexin, produced in the hypothalamus, is concerned with controlling appetite and promoted wakefulness. Antifatigue drugs may contribute to obesity in some situations but there remains the problem of why some people manage on four hours’ sleep while others require nine.

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Motivation: the gentle art of boosting an ego

There are two main ways of boosting an individual's ego (that is, his sense of self-importance in this world). First, there is the lamentable and socially destructive attitude of arrogance in which selfish interests alone are heeded and deaf ears are turned to others and to wider considerations. Secondly, there is the self-examination, which assesses one’s worth in terms of qualifications, training and interactions with neighbours and colleagues through sympathy and empathy. In the first instance blind self-interest rules, in the second, a balance is struck between rights and obligations.

A comment by a psychologist at the University of Virginia in Science for 1 September describes the ability of brief psychological interventions focusing on a person’s perception of self to improve academic performance in students. College students in the US were studied to find out how they explained poor academic performance, their views on how their own intelligence might be altered and their sense of their interactions with the rest of society. Those who took part achieved higher grades than controls who did not. The increases were modest but impressive.

Students given treatment spent 15 minutes writing to explain why certain values, such as relationships with others, were considered important to them. Those acting as controls explained why certain values were important to other people. It is concluded that it is as important to change common notions of the social world and the individual’s place in it as it is to try to alter the objective environment. How people perceive their environment has an influence on projected steps to bring about lasting change. Motivation produces important changes in performance, and the fact that large-scale societal factors need to be changed should not prevent us from seeking proximate solutions that can be achieved with greater ease.

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Recreational drug abuse extends its limits

In the 30 September issue of New Scientist there is a rather worrying article regarding the proliferation of “recreational drugs” that are perfectly legal to deal in but which nevertheless pose a looming problem when it comes to their control.

Hallucinogens such as Salvia divinorum and others are proving popular among people aged 20 to 30 in their search for materials that will raise the level of consciousness without bringing unpleasant or alarming side effects. Pierazine derivatives with an amphetamine-like effect — notably benzylpiperazine and trifluorophenylmethylpiperazine — are also finding a ready sale. They activate the serotonin receptor in the brain, releasing dopamine.

Although these drugs produce heightened awareness that is found pleasant, they also induce a feeling of paranoia, insomnia and a hangover. Moreover, they may pave the way for an individual to try illegal substances. Nausea, vomiting, anxiety and palpitations are commonplace, and the supposed safety margin of the drugs tempts users to increase the dose they indulge in.

The main objection taken to psychoactive substances, hallucinogens in particular, is that they may render an individual psychotic. Meanwhile, there exist many herbal products which people can be persuaded are harmless and pleasure giving, but which, in fact, are doubtful in many aspects.

The main task of reformers is to convince gullible people, who find normal living dull and uninspiring, that resorting to the use of drugs, whether natural or synthetic, does not offer a true solution to their problems. Instead, they should try looking within themselves for an answer that will ease their perplexities.

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Actions and attitudes: the sense of responsibility is paramount

“Our notion of responsibility centres on our understanding of people's purposes. And responsibility is not just a legal matter. It covers a far wider area of life than mere blame and punishment. It covers the whole ownership of actions, the notions that we form of people’s characters, the grounds of our entire social attitude to them. In considering these things, we constantly concentrate on what we believe them to be thinking.”
—Mary Midgley: ‘The myths we live by’ (2003).

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