Can We Have A Fat Tongue?

 "Lose tongue fat with this one, weird old tip."

"Burn tongue fat with this workout."

"7 secrets to losing stubborn tongue fat."

Unfortunately, I could see headlines such as these in the future, due to recent interest in and research on tongue fat.

In this case, the concern for excessive tongue fat comes from its potential role in obstructive sleep apnea (OSA) – sleep disorder characterized by brief and repeated pauses in breathing during sleep.

OSA is a major public health burden that affects more than 15 million adult Americans.³ It is also associated with other health concerns, such as heart disease and diabetes, while being an independent risk factor for premature death.^2,4-6,8

Obesity and OSA

We do know that as body fat accumulates, so does the risk for OSA. Accordingly, obesity is the strongest risk factor for OSA. However, scientists do not fully understand how obesity contributes to OSA.

So, we see several alternative therapies attempting to "cure" OSA, such as mouth pieces, neck monitors that vibrate when you sleep on your back, negative and positive pressure machines, surgical procedures to stiffen the soft palate with woven inserts, and radio frequencies to reduce tongue and tonsil size.

A Fat Tongue?

As body fat accumulates, so can the fat deposits in the tongue. As seen below, the excessive fat can predispose one to OSA through physical narrowing of the upper airway and displacing the hyoid bone and epiglottis.

Godoy et al., 2016

Autopsy studies have found that the tongue can hold quite a bit of fat, especially at the base, averaging around 30% of the tongue's composition.⁷ Tongue fat also appears to be higher in men.¹

Similarly, apneics (those with OSA) can have an average of 5% more fat in their tongue than those without OSA (32.6% vs. 27.7%).³

As shown in the following MRI – despite a similar "obese" BMI classification (≥ 30 kg/m²), the apneic subject had a tongue with 42% fat, compared to only 24% in the normal subject (no OSA).

Kim et al., 2014

Conclusion

Confirmed: Yes, the tongue can have excessive fat deposits (i.e. "a fat tongue").

Fat in the tongue does parallel body fat accumulation and increased risk of cardiometabolic disease risk (e.g. heart disease, diabetes), and is associated with obstructive sleep apnea. Serious stuff.

More research is needed on the effects of whole body fat loss on tongue fat, but since excessive fat is the major risk factor for OSA (plus cardiometabolic disease and premature death), it seems reasonable to promote an active lifestyle and a healthy diet to treat the cause of both tongue fat and OSA.

And, let's cross our fingers that we will not see advertisements any time soon for contraptions, slimming garments, or spot-reducing exercises aimed at reducing tongue fat.

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References

1. Godoy IR, Martinez-Salazar EL, Eajazi A, Genta PR, Bredella MA, Torriani M. Fat accumulation in the tongue is associated with male gender, abnormal upper airway patency and whole-body adiposity. Metabolism. 2016;65(11):1657-63.
2. Foster GD, Borradaile KE, Sanders MH, et al. A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch Intern Med 2009;169:1619-26.
3. Kim AM, Keenan BT, Jackson N, Chan EL, Staley B, Poptani H, Torigian DA, Pack AI, Schwab RJ. Tongue fat and its relationship to obstructive sleep apnea. Sleep. 2014;37(10):1639-48.
4. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046-53.
5. Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 2008;31:1079-85.
6. Nagayoshi M, Punjabi NM, Selvin E, Pankow JS, Shahar E, Iso H, Folsom AR, Lutsey PL. Obstructive sleep apnea and incident type 2 diabetes. Sleep Medicine. 2016 Sep 30;25:156-61.
7. Nashi N, Kang S, Barkdull GC, Lucas J, Davidson TM. Lingual fat at autopsy. The Laryngoscope. 2007;117(8):1467-73.
8. Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation scienti c statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. Circulation 2008;118:1080-111.