The first method of choice in the treatment of overweight or obesity is diet supplemented with physical activity. Then, if weight loss does not occur, other treatment options are used, including medical and surgical options.
Today, hundreds of diets are offered for those who are losing weight, but only a few of them are officially recognized. It has been proven that there is no universal and ideal diet. Many types of food have contraindications and can even worsen the condition. Therefore, you should not rush to 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. Food should be individual, based on the stage of obesity, eating disorders, concomitant diseases and other important points. It is especially important to take into account the presence of diabetes, gastrointestinal pathologies, problems with hematopoiesis and vitamin-mineral balance.
For example, patients with diabetes are strictly prohibited from fasting or, on the contrary, following a diet rich in carbohydrates. Patients with anemia should not give up meat and offal. Children need dairy products; Removing them from the menu threatens to hinder the growth and development of the musculoskeletal skeleton.
The nutritional 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 modify the menu, where the patient must write down all the foods consumed daily in grams.
Important points when choosing a diet:
- Severe calorie restrictions and nutritional deficiencies should be avoided. A sudden and significant reduction in the energy content of the diet, for example to half the current value, will produce impressive results, but will not provide long-term success. The weight will return within a year, if not sooner.
- The menu should not be monotonous; must take into account the patient's taste. Otherwise, stress will increase obesity. Monotonous eating is a common cause of diet failure. The patient feels hungry, is overwhelmed with restrictions, and his "soul demands" relief. After eating a forbidden sweet or fatty food and having received a lot of pleasure, it is already difficult to stop. The brain immediately remembers how bad it was without the "sweets".
- The patient should drink lots of water. You will have to give up lemonade, sweet tea and alcohol.
An important element that limits appetite is vegetable fiber, which is involved in the mechanism of 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 speed up intestinal transit. Therefore, almost every effective diet contains fruits and vegetables or additives that signal satiety.
In difficult cases, if you cannot control your appetite, the endocrinologist will prescribe a medication that affects the satiety center. When taking these pills, the patient does not feel hungry. But it is important to understand that the use of such medicines is limited by unpleasant side effects and a number of contraindications.
Calorie restricted diets – classic diet
Diets that restrict calories are generally low in fat. The most popular diet is the classic one. It has been used for over 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, however, after a year, every third patient returns to their previous body weight, and after 3 years, almost all.
The essence of the classic diet
The classic diet is a diet rich in carbohydrates with calories corresponding to the degree of excess weight. The energy value is usually 1200-1500 kcal/day. for women and 1500-1800 kcal/day. for men. In relation to the current diet, a caloric deficit of 500 kcal/day is assumed, limiting the current fat intake 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 effects of the classic diet
The problem is that a high-carbohydrate diet is empirically coupled with weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, with the subsequent accumulation of carbohydrates as easily as fat. Furthermore, restrictive diets reduce thermogenesis and increase the body's energy efficiency, which is why they are ineffective. The side effects of restrictive diets are largely related to the psyche.
Low-carb, high-protein diets
Low-carb, low-protein diets are an alternative to high-carb diets. These diets are high in protein and fat and low in carbohydrates (and therefore calories). This leads to weight loss, initially dependent on the body releasing glycogen-bound water.
The initial 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 endogenous fat burning, which causes a decrease in appetite. The second factor is the monotony of the menu. As a result, the body's need for insulin decreases, blood glucose levels and sometimes lipid concentrations decrease.
Dietary protein stimulates the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of satiety increases after eating, and this is due to the increased proportion of protein in relation to the energy obtained from food. It is important to understand that a high-protein diet, however, does not always mean a low calorie intake.
Disadvantages, side effects, long-term effects 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 rich in fat (55-60%) and animal protein (25-30%).
Additionally, a high-protein diet is often associated with calcium loss and decreased levels of vitamins E, A, B. 1, B6, folic acid, magnesium, iron and potassium. Deficiency of calcium, vitamin D and secondary increase in TSH secretion disturb cellular calcium homeostasis, increase the level of cytosolic calcium, and this can stimulate several unfavorable metabolic pathways, including lipid synthesis in adipose tissue.
The long-term effect of this diet on the body is also unknown. The observed increase in uric acid and LDL levels and the absence of an increase in HDL create risks for the development of atherosclerosis, even despite the beneficial effect on triglyceride concentrations. Furthermore, reducing the proportion of fiber in the diet leads to constipation.
At the same time, comparing the effectiveness of a protein diet (containing 25% proteins, 45% carbohydrates) with a carbohydrate diet (12% proteins, 58% carbohydrates), the advantage of the first is obvious. Studies have shown a loss of fat mass of up to 8 kg versus 4.
Modified protein-sparing diet
This high-protein, very low-calorie diet with a caloric value<800 kcal/day, with a minimum of lipids and carbohydrates, is very popular in many European clinics.
The menu contains proteins in the amount of 1. 2 g/kg of body weight for women and 1. 4 g/kg of body weight for men. Diet therapy is carried out for a month under strict medical supervision. Patients also receive vitamins. This diet theoretically allows you to lose 90 g of fat per day and reduce basal metabolism by 10-20%.
A modified protein-sparing diet affects individual elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- increases lipid oxidation and the sensitivity of peripheral tissues to insulin;
- reduces hepatic insulin clearance and hepatic glucose release.
The essence of a modified protein-sparing diet
This diet option provides a sufficient amount of protein (approx. 50 g/day), which protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. Low carbohydrate content restricts insulin secretion and promotes lipolysis. The energy difference between energy expenditure and caloric intake (at least 650 kcal/day) is covered by the burning of endogenous lipids.
One of the popular meal replacements during a modified protein-sparing diet is a protein shake. In addition to being rich in protein, these products also contain other nutrients necessary during the diet. When losing weight, you need to reduce the total number of calories consumed. A protein shake offers low calories, allowing you to control your calorie intake and create a calorie deficit to achieve your ideal weight. One sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, proteins, baobab extract and a whole complex of vitamins. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
Decreased 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 Diets
These diets have been a success in recent years, although they are far from new. The Atkins diet, created by a cardiologist in 1973, is especially popular. R. Atkins' book on healthy eating has sold more than 10 million copies. In European countries, it is read four times more than all other dietary guides.
The essence of the Atkins diet
This is a low-carb, high-protein, high-fat diet. During the first two weeks, carbohydrate content is limited to 20 g/day and then to 30 g/day. After reaching the desired body weight, the carbohydrate content gradually increases.
Serious controversy among scientists about this diet arises due to its high fat content. However, the amount of fat oxidized or stored depends on the difference between the total energy requirement and the oxidation of other dietary components that take precedence over lipids.
Alcohol is burned first as the body cannot store it and turning it into fat requires a lot of energy. The situation is similar with amino acids and proteins that perform functional roles, and carbohydrates, the storage of which in the form of glycogen is limited. Converting carbohydrates to fat also requires a lot of energy. Therefore, it can be assumed that its oxidation practically corresponds to consumption.
On the other hand, the possibilities for fat accumulation (mainly 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 observed 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 the nature of etiopathogenetic therapeutic intervention for type 2 diabetes mellitus.
The probable scientifically proven weight loss when maintaining a diet is 10% after 6 months. No serious consequences have yet been identified.
Other diets
- Alternate diet.It consists of eating a type of food or completely abstaining from eating on selected days. The effectiveness of this type of food is low, mainly due to the rapid abandonment of it. It is difficult for the patient not to eat anything, and it is even more difficult to eat only one product, for example, rice cooked without salt, sugar and oil.
- Low-fat diet.The composition of the diet implies the removal of all meat and dairy products, vegetable oils, fish and, in general, all products containing fats. Prolonged adherence to this diet leads to anemia, weakening of the musculoskeletal structure and health problems.
- 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 lack of vitamins and microelements and taking strong medications.
At all times, charlatan diets have been and will be popular, usually based on the supposedly unusual weight loss properties of certain foods, most often fruits. For example, the apple diet requires eating only apples, the grape diet - grapes, the banana diet - bananas. These diets are either ineffective or dangerous. For example, grape and banana diets certainly lead to blood sugar spikes, worsening diabetes.
Which diet is best?
You can't choose your diet alone. The best option would be to contact an endocrinologist, who will select the appropriate type of nutrition based on the test results.
Physical activity is overrated for overweight and obesity
The importance of physical activity in the weight loss process is significantly overestimated. Judge for yourself: losing 1 kg of weight requires enormous effort, for example, 250 km of walking. And for many patients, such loads are simply prohibited due to concomitant pathologies. That is, when planning to lose weight, you must understand that physical education alone as a method of treatment will not give the results you would like.
But that doesn't mean you need to give up physical activity. Physical activity is important to slow weight gain and prevent weight gain from returning. In addition, when losing extra pounds, it is important to strengthen the muscular structure so that the skin does not become saggy and saggy.
Physical activity has a beneficial effect on the entire body - this applies to both overweight and thin people.
Gymnastics:
- Maintains muscle mass during weight loss, preventing the catabolism of muscle proteins;
- Reduces insulin resistance, improving carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports and even simple walks, your mood improves, blood circulation and air exchange in tissues improve. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.