Your Sleep Apnea
Can Be an Obesity Problem

For many patients, obstructive sleep apnea is driven by excess tissue around the airway. When that's the case, treating the root cause — not just the symptom — can change the outcome. Physician-led care, covered by OHIP & MSP.

Take the 60-Second Screen Book Free Assessment

Metabolite · OSA Pathway

OHIP/MSP Covered

Weight Reduction

~20%

SURMOUNT-OSA, NEJM 2024

AHI Reduction

−29.3

events/hour at week 52

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OHIP & MSP Covered

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CPSO-Regulated Physicians

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100% Virtual · Ontario & BC

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PHIPA / PIPA Compliant

The Root Cause

Excess Weight Narrows the Airway — Literally

MRI research has shown that people with obesity carry more fat in the tongue, soft palate, and tissues around the pharynx. That extra tissue compresses the airway from within.6 When those muscles relax during sleep, the airway collapses — and the apnea begins.

Interactive · Drag to explore

Watch the airway narrow as BMI rises

Body-mass index is the strongest modifiable risk factor for OSA. As BMI climbs, parapharyngeal fat deposits increase — and OSA risk rises sharply.2 6

32kg/m²

Class I obesity

22NormalOverOb IIIIII

Airway · Cross-section

Pharyngeal view

Airway narrowing

~32%

Est. vs. normal-weight baseline

OSA likelihood

Moderate

Based on population epidemiology2

~70%

of people with OSA also have obesity — the primary modifiable driver

Young et al., AJRCCM 20022

+32%

AHI severity increase from just a 10% weight gain

Peppard et al., JAMA 20007

−26%

AHI reduction from just a 10% weight loss

Peppard et al., JAMA 20007

92.9%

of Canadians at high risk for OSA are undiagnosed

Rizzo et al., CJPH 20241

Am I at Risk?

60-Second Clinical Screen

The validated STOP-BANG questionnaire — notice how closely it weighs obesity markers: BMI, neck size, and age. Informational only; not a diagnosis.4

STOP-BANG Screening

Question 1 of 8

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Your STOP-BANG Score

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Screening source: Chung F, et al., Anesthesiology 20084

The Trial

SURMOUNT-OSA: Treating Obesity Resolved the Apnea

Published in NEJM (October 2024), SURMOUNT-OSA was a phase 3 randomized, double-blind, placebo-controlled trial evaluating tirzepatide in 469 adults with moderate-to-severe OSA and obesity over 52 weeks.8 Zepbound® was subsequently authorized by the FDA for this indication in December 2024.9

Mean AHI Reduction at Week 52

−29.3

events/hr · Trial 2

NEJM 2024

Tirzepatide

Placebo

📄Malhotra A, et al., NEJM 2024Mean AHI reductions: −25.3 events/hr in Trial 1 (95% CI −29.3 to −21.2) and −29.3 events/hr in Trial 2 (95% CI −33.2 to −25.4), both P<0.001 vs placebo.8

Disease Resolution at Week 52

51.5%

tirzepatide · Trial 2

NEJM 2024

TZP · Trial 2

51.5%

TZP · Trial 1

43.0%

Placebo

~14%

Resolution: AHI <5/hr, or AHI 5–14 with ESS ≤10.8

📄Key Secondary EndpointOver half of participants on tirzepatide met criteria for disease resolution — a threshold at which PAP therapy may no longer be recommended.8

Before & After

One Treatment, Two Problems Solved

By treating the obesity, SURMOUNT-OSA demonstrated simultaneous improvement across four interconnected systems. Composite values reflect published trial averages; individual outcomes vary.8

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Body Weight

SURMOUNT-OSA · baseline BMI ≈ 39

Class IIobesity · root cause

Mean BMI at enrollment was 39.1 (Trial 1) and 38.7 (Trial 2). Airway soft tissue and tongue fat contribute directly to collapse risk.6 8

NormalOverClass III+

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Apnea-Hypopnea Index

Mean baseline AHI ≈ 50

~50events/hr · severe

Participants averaged roughly 50 breathing events per hour — firmly severe. The primary driver: excess tissue narrowing the airway.8

NormalMildModSevere

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Hypoxic Burden

Cumulative oxygen debt

Highelevated CV risk

Sleep-apnea-specific hypoxic burden independently predicts cardiovascular mortality, beyond AHI alone.10

LowModHighSevere

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Systolic Blood Pressure

Linked to obesity & OSA

Elevatedcompounded risk

Untreated OSA is associated with 2–3× higher hypertension risk.7 SURMOUNT-OSA showed significant systolic BP reduction.8

NormalElevHTN-1HTN-2

Your Care Team

Obesity Medicine, Delivered Virtually

We are a physician-led obesity medicine clinic — not a sleep lab. We treat the underlying condition driving your apnea, and we do it entirely online, across Ontario and British Columbia.

Healix · Between-Visit Support

AI Coaching, Clinician Oversight

Healix is our patient-facing AI tool for reminders, educational content, and progress tracking between visits. It is non-diagnostic and does not replace clinical judgment. All medical decisions remain with your licensed physician.

Medication remindersWeekly check-insProgress tracking

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🍁 Covered by OHIP & MSP

HEALIX PROGRAM

12-Week Lifestyle Reversal Program

Every Metabolite patient is enrolled in our signature 12-week program — structured weekly modules covering nutrition, sleep, movement, stress, and habit-building, fully guided by Healix.

Program Progress 1 / 12 weeks

W1W2W3W4W5W6W7W8W9W10W11W12

✓ Weekly modules ✓ Habit tracking ✓ Progress scoring ✓ Built-in accountability

ISSUE 10

Nutrition

ISSUE 11

Exercise

ISSUE 12

Snacking

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