When in 1836 Charles Dickens published his novel, The Pickwick Papers, he never imagined that one of the characters he created, Joe, would be the poster-boy for Pickwickian Syndrome. Charles Dickens was no medical doctor but he was a keen observer of human idiosyncrasies and an accurate portrayer of life-like characters.
Charles Dickens described Joe as a fat, red-faced boy who was always eating and always falling asleep no matter the time of day. Dickens did not know that he concisely painted a picture of a medical condition affecting obese people: Obesity Hypoventilation Syndrome. Its more common name is Pickwickian syndrome, a name coined after Charles Dickens’ novel.
Are you suffering from Pickwickian syndrome? Well, if you’re fat (obese) and red-faced (plethoric); if you don’t breathe deeply enough, (hypoventilating); and, you are always drowsy or excessively sleepy even in the daytime (somnolent) you probably have Pickwickian syndrome. The detailed causes of Obesity Hypoventilation Syndrome are unknown. But it is always associated with those who are severely obese. It is called a syndrome because it triggers groups of related symptoms that occur together.
Consider that severely obese people carry around the excessive weight of fat cells against their chest wall. The weight on their chest makes it difficult for the lungs to expand in order for them to breathe deeply and normally. Extremely obese people develop short thick necks, too, because of the extra padding of fat around the outside of the neck that constricts the airway. The fat around the inside of the throat and the soft palate also blocks the airway making deep breathing very difficult.
Persistent difficulty in breathing because of shallow or low breathing is called chronic hypoxia. This occurs because your body is starving for oxygen as the oxygen in your blood is too low; while at the same time, you are slowly drowning as carbon dioxide accumulates in your blood instead of being expelled as you exhale. To top this all off, when you have Pickwickian syndrome, you experience sleeplessness or poor sleep quality because you do not breathe fully or normally especially when sleeping at night. So if your nights are rough because you can’t breathe well enough to sleep soundly, your daytime life is even rougher because you also experience excessive daytime sleepiness.
It fits an unfortunate stereotype to imagine an extremely overweight person nodding off to sleep at any time and any place during the day, but the truth is, because obese people suffering from Pickwickian syndrome continuously have trouble sleeping at night they consistently fail to stay awake during the day, too.
Picwickian Syndrome Effects Your Mood
The persistent lack of sound and restful sleep makes you moody. You swing from feelings of annoyance, irritation and agitation to 
feelings of hopelessness, and depression. If you suffer more severely from complications of Pickwickian syndrome or obesity hypoventilation syndrome you will report headaches, lethargy, fainting, disorientation and loss of concentration. You may find that you have become uncharacteristically quarrelsome: you pick fights and start arguments or you become overly jealous or suspicious of others. These mood swings and abrupt changes in your behavior raises your risk of serious accidents at work or when driving on the road.
It is safe to say that if you are one of the 2.5 million people in the US who suffer from the nighttime sleeplessness and excessive daytime sleepiness due to Pickwickian syndrome, the quality of your life is poor. Excessive drowsiness decreases the quality of your performance at work and it decreases your enjoyment of your work. Excessive drowsiness interferes with your personal relationships. Imagine falling asleep in the middle of a romantic candlelit dinner with your spouse!
Is There a Cure for Picwickian Syndrome?
Since obesity is the most common factor in Pickwickian syndrome, weight loss is one of the first treatments. Your doctor will advise you to go on a sensible and well-balanced diet to keep you healthy and well-nourished. The most likely cause of obesity is eating more than one should or eating when one is not hungry. If you eat when you are already full and mostly consume high-carbohydrate, high-sugar foods, you should consider consulting with your doctor about a sensible diet and exercise program.
Going on a sensible diet to treat obesity will mean not only reducing the amount of food you eat, but also changing the types of food you eat. You will need to increase your intake of dietary fiber: this means eating more fruit and vegetables instead of eating fried, highly processed fast-food. You will have to stop eating out of habit, and eating just because you feel like it: you will have to eat only when you are really hungry and you will have to start eating to stay healthy.
The doctor will also recommend for you to engage in regular physical exercise such as walking, biking and lifting weights. Moving around and doing physical exercise may be difficult and tedious at first. It will take a lot of motivation and will-power on your part to consistently do what is necessary, but a lifestyle change is necessary in order to stay healthy.
Sometimes, behavior modification is not enough to ensure weight loss. When obesity is severe, doctors will often also prescribe anti-obesity drugs. In addition to diet and exercise, the anti-obesity drugs reduce your appetite or stop fat from being absorbed by the body.
When anti-obesity drugs accompanied by a diet and exercise program still do not work, surgery is the last resort. Your doctor may implant a balloon in your stomach so that you will not be able to eat as much at any one time. Or, your doctor may remove a small part of the stomach so that you will feel fuller with a smaller amount of food than you usually eat. Or, because it is when the food you eat is in the small intestines that nutrients are absorbed by your body, your doctor may trim off a portion of your intestines so that you will not absorb as much nutrients from the food you eat.
And to help smoothen your nighttime sleep, and thus reduce your daytime sleepiness, your doctor may also recommend that when sleeping at night, you use a special machine called a CPAP, that continuously pumps air into your nose and mouth to prevent your muscles from blocking your airway.
Obesity hypoventilation syndrome or Pickwickian syndrome due to obesity is not funny or fictional at all. It doesn’t only happen in novels or TV shows. It is now considered a global pandemic. Health authorities have noted with alarm that obesity is increasing among infants, school children, teenagers and adults all around the world.
Obesity causes more than just a fashion problem for you when you can’t find anything in the store that fits you. It causes more than just a social problem for you when you can’t find a date. Obesity hurts your well-being and it ruins your life. The health problems associated with obesity sucks the joy out of life. The complications of obesity such as Pickwickian syndrome are not fictional. It is important that you make the changes in your lifestyle today so that you can have live a happy healthy life tomorrow.