The first method of choice in treating overweight or obesity is a diet supplemented with physical activity. If weight loss does not occur, other treatment options are used, including medical and surgical options.
There are hundreds of weight loss diets available today, but only a few are officially recognized. It has been proven that there is no universal and ideal diet. Many diets have contraindications and can even worsen the condition. That's why you shouldn't rush into every new recipe that promises a slim figure.
Features of choosing a diet for obesity
When treating obesity, you should immediately abandon diets with a predetermined daily calorie intake. The diet should be individual and based on the phase of overweight, eating disorders, concomitant illnesses and other important points. It is especially important to take into account the presence of diabetes, gastrointestinal diseases, problems with hematopoiesis and vitamin-mineral balance.
For example, patients with diabetes are strictly forbidden to fast or, on the contrary, eat a diet rich in carbohydrates. Patients with anemia should not avoid meat and offal. Children need dairy products; If they are eliminated from the diet, there is a risk that they will disrupt the growth and development of the musculoskeletal system.
The nutrition plan is drawn up with a clear distribution of meals (3-5) and menu composition. Keeping a self-monitoring diary will help you monitor and change the menu, requiring the patient to write down all the foods eaten daily in grams.
Important points when choosing a diet:
- Severe calorie restrictions and nutritional deficiencies should be avoided. A sudden significant reduction in the energy content of food, for example by half of the current value, will produce impressive results, but will not bring long-term success. The weight will return within a year, if not sooner.
- The menu should not be monotonous; it should take into account the patient's taste. Otherwise, stress leads to obesity. Monotonous eating is a common cause of diet failure. The patient feels hungry, he is burdened by restrictions and his "soul demands" relief. If you have eaten a forbidden sweet or fatty food and get great pleasure from it, it is difficult to stop. The brain immediately remembers thathow bad it was without the "sweets".
- The patient should drink plenty of water. You must avoid lemonade, sweet tea and alcohol.
An important element that limits appetite is plant fiber, which is involved in expanding the volume of food in the stomach and delaying its emptying. These substances also reduce the absorption of nutrients from the digestive tract and accelerate intestinal transit. Therefore, almost every effective diet contains fruits and vegetables or additives that signal satiety.
In difficult cases, when you cannot manage your appetite, the endocrinologist will prescribe a drug that affects the satiety center. When taking such pills, the patient does not feel a feeling of hunger. However, it is important to understand that the use of such drugs is limited by unpleasant side effects and a number of contraindications.
Calorie-reduced diets – classic diet
Diets that restrict calories are usually low in fat. The most popular of these diets is the classic one. It has been used for more than 40 years and is recommended by most scientific societies, which is why it got its name.
According to statistics, such a diet can reduce body weight by 10 kg in 6 months or by 10% after 18 weeks, but after a year every 3rd patient returns to their previous body weight, and after 3 years almost all of them.
The essence of the classic diet
The classic diet is a carbohydrate-rich diet with an amount of calories corresponding to the degree of overweight. The energy value is usually 1200-1500 kcal/day. for women and 1500-1800 kcal/day. for men. Based on the current diet, a calorie deficit of 500 kcal/day is assumed, while the current fat intake is limited to 1/3. In this diet, about 60% of the energy comes from carbohydrates, about 25% from fats and 15% from proteins.
Disadvantages, side effects, long-term consequences of the classic diet
The problem is that a high-carbohydrate diet is empirically linked to weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, with the subsequent accumulation of carbohydrates as easily as fat. Additionally, restrictive diets reduce thermogenesis and increase the body's energy efficiency, making them ineffective. The side effects of restrictive diets are largely psychological.
Low-carb and high-protein diet
An alternative to the carbohydrate diet are low-carbohydrate protein diets. Such diets are high in protein and fat and low in carbohydrates (and therefore low in calories). This leads to weight loss, which is initially due to the release of glycogen-bound water from the body.
The first effect of a low-carb diet is immediate and so impressive that it becomes an additional motivation for the patient.
The essence of a protein diet
The diet is based on ketosis - the result of burning the body's own fat, which leads to a reduction in appetite. The second factor is the monotony of the menu. As a result, the body's need for insulin decreases, blood sugar levels and sometimes lipid concentrations decrease.
Protein in the diet stimulates the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of satiety increases after eating, which is due to the increased ratio of protein to energy from food. It is important to understand that a high protein diet does not always mean low calorie intake, however.
Disadvantages, side effects, long-term consequences of a protein diet
Unfortunately, there is not enough research to support the effectiveness and safety of a high-protein diet. And it does not contain healthy foods: grains, fruits, vegetables. On the contrary, the menu contains many ingredients with high fat content (55-60%) and animal protein (25-30%).
In addition, a high-protein diet is usually accompanied by a loss of calcium and a decrease in vitamins E, A, B. 1, B6, folic acid, magnesium, iron and potassium. Deficiency of calcium, vitamin D, and secondarily increased TSH secretion disrupt cellular calcium homeostasis, increase cytosolic calcium levels, and can stimulate several adverse metabolic pathways, including lipid synthesis in adipose tissue.
The long-term effect of such a diet on the body is also unknown. The observed increase in uric acid and LDL levels and the lack of an increase in HDL, despite the positive effect on triglyceride concentration, pose risks for the development of atherosclerosis. Reducing the amount of fiber in the diet also leads to constipation.
At the same time, if we compare the effectiveness of a protein diet (with 25% protein, 45% carbohydrates) with a carbohydrate diet (12% protein, 58% carbohydrates), the advantage of the former is obvious. Studies have shown a loss in fat mass of up to 8 kg compared to 4 kg.
Protein-sparing, modified diet
This high protein, very low calorie diet with a calorie value of<800 kcal/day, with minimal lipids and carbohydrates, is very popular in many European clinics.
The menu contains protein in an amount of 1. 2 g/kg body weight for women and 1. 4 g/kg body weight for men. Diet therapy is carried out for a month under strict medical supervision. Patients are also prescribed vitamins. With this diet you can theoretically lose 90g of fat per day and reduce your basal metabolic rate by 10-20%.
A protein-sparing change in diet influences individual elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- increases lipid oxidation and sensitivity of peripheral tissues to insulin;
- reduces hepatic insulin clearance and hepatic glucose release.
The essence of a protein-sparing modified diet
This diet variant provides a sufficient amount of protein (approx. 50 g/day), which protects the nitrogen balance of the metabolism and the body's own proteins from proteolysis. Low carbohydrate content limits insulin secretion and promotes lipolysis. The energy difference between energy expenditure and calorie intake (at least 650 kcal/day) is covered by the combustion of the body's own lipids.
One of the most popular meal replacements during a protein-sparing diet is a protein shake. In addition to high protein content, such products also contain other nutrients that are needed during the diet. When losing weight, you need to reduce the total number of calories consumed. A protein shake offers a low calorie content, allowing you to control your calorie intake and create a calorie deficit to reach your goal weight. One sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and a whole complex of vitamins. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
Reduced insulinemia and increased fat oxidation lead to the production of ketone bodies in the liver - energy material for muscles and brain, limit gluconeogenesis from protein substrates and reduce appetite.
Low-carb, high-fat diet
Such diets have been a hit in recent years, although they are far from new. The Atkins diet, which was developed by a cardiologist in 1973, is particularly popular. R. Atkins' book on healthy eating has sold more than 10 million copies. In European countries it is read four times more often than any other nutritional guide.
The essence of the Atkins diet
This is a low-carb, high-protein, high-fat diet. In the first two weeks, the carbohydrate content is limited to 20 g/day, then to 30 g/day. After reaching the desired body weight, the carbohydrate content gradually increases.
There is serious controversy about this diet among scientists due to its high fat content. However, the amount of oxidized or stored fat depends on the difference between total energy requirements and the oxidation of other dietary components that take precedence over lipids.
Alcohol is first burned because the body cannot store it and converting it into fat requires a lot of energy. The situation is similar with amino acids and proteins that perform functional functions, as well as with carbohydrates, the storage of which in the form of glycogen is limited. Converting carbohydrates into fat also requires a lot of energy. It can therefore be assumed that their oxidation practically corresponds to consumption.
On the other hand, the possibilities of fat accumulation (especially in adipose tissue) are practically unlimited and the efficiency of this process is great.
The Atkins diet reduces plasma concentrations of insulin, C-peptide and especially proinsulin under alkaline conditions and after glucagon stimulation, which may result in a less atherogenic effect than previously thought. It was also found that a decrease in insulin hypersecretion was accompanied by an increase in insulin sensitivity. Thus, this diet makes it possible to achieve the effect of etiopathogenetic therapeutic intervention in type 2 diabetes mellitus.
Scientifically proven that the likely weight loss after 6 months of dieting is 10%. No serious consequences have yet been identified.
Other diets
- Varied diet.It consists of eating a specific type of food or completely abstaining from eating on selected days. The effectiveness of this form of nutrition is low, which is mainly due to the rapid abandonment of it. It is difficult for patients not to eat, and it is even more difficult to eat only one product, for example, boiled rice without salt, sugar and oil.
- Low-fat diet.The composition of the diet includes the exclusion of all meat and dairy products, vegetable oils, fish and in general all products containing fats. Long-term adherence to such a diet leads to anemia, weakening of the musculoskeletal system and poor health.
- hunger. A diet involves completely abstaining from food for a certain period of time. This is not a recommended method for losing weight, no matter how long it lasts. Fasting is especially dangerous for diabetics, people prone to depression, patients with a deficiency of vitamins and microelements, as well as those taking strong medications.
Quack diets have always been popular and are usually based on the supposedly unusual weight-reducing properties of certain foods, usually fruits. For example, the apple diet requires eating only apples, the grape diet - grapes, the banana diet - bananas. Such diets are either ineffective or dangerous. For example, a diet full of grapes and bananas is guaranteed to cause blood sugar spikes that worsen diabetes.
Which diet is the best?
You cannot decide your diet yourself. It is best to contact an endocrinologist who, based on the results of the examination, will select the right type of diet.
Physical activity is overrated when it comes to overweight and obesity
The importance of physical activity in losing weight is significantly overestimated. Judge for yourself: losing 1 kg of weight requires enormous efforts, for example walking 250 km. And for many patients, such stress is simply forbidden due to comorbidities. In other words, if you plan to lose weight, you should understand that physical education alone as a method of treatment will not give the desired result.
However, this does not mean that you have to give up physical activity. Physical activity is important to slow weight gain and prevent weight gain again. Even when losing extra pounds, it is important to strengthen the muscle frame so that the skin does not become sagging and sagging.
Physical activity has a positive effect on the entire body - this applies to both overweight and thin people.
Gymnastics:
- Maintains muscle mass during weight loss by preventing the breakdown of muscle proteins;
- Reduces insulin resistance and improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
Through active sports and even just walking, your mood improves, blood circulation and air exchange in the tissues improve. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.