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 to those who want to lose 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 nutrition have contraindications and can even worsen the condition. Therefore, you should not rush with 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, 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 forbidden to starve or, on the contrary, eat a high-carbohydrate diet. Anemic patients should not give up meat and offal. Children need dairy products, removing them from the menu threatens to disrupt the growth and development of the musculoskeletal system.
The food plan is drawn up with a clear distribution of meals (3-5) and composition of the menu. Keeping a self-monitoring diary will help you monitor and change the menu, where the patient must write down all the foods that are consumed daily in grams.
Important points when choosing a diet:
- Severe calorie restriction and nutritional deficiencies should be avoided. Suddenly significantly reducing the energy content of the diet, for example by half of the current value, will produce impressive results, but will not ensure 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 tastes. Otherwise, stress will contribute to obesity. Monotonous food is a common cause of diet failure. The patient is hungry, he is burdened by restrictions and his "soul wants" relief. After you have eaten forbidden sweet or fatty food and received great pleasure, it is already difficult to stop. The brain immediately reminds how bad it was without "sweet".
- The patient should drink plenty of water. You will have to give up lemonade, sweet tea and alcohol.
An important element that limits appetite is vegetable fiber, which participates in the mechanism of expanding the volume of food in the stomach and slowing down 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 supplements that signal satiety.
In difficult cases, if you cannot cope with your appetite, the endocrinologist will prescribe a drug that affects the satiety center. Taking such pills, the patient does not feel hungry. But it is important to understand that taking such drugs is limited by unpleasant side effects and a number of contraindications.
Calorie restricted diets - classic diet
Diets that restrict calories are usually low in fat. The most popular such diet is the classic one. It has been used for more than 40 years and is recommended by most scientific societies, hence 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 3 patients return to their previous body weight, and after 3 years almost all of them.
The essence of the classic diet
The classic diet is a high-carbohydrate diet with 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. In relation to the current diet, a caloric deficit of 500 kcal/day is assumed, limiting current fat intake by 1/3. On this diet, about 60% of energy comes from carbohydrates, about 25% from fat, and 15% from protein.
Disadvantages, side effects, long-term effects of the classic diet
The problem is that a high-carbohydrate diet is empirically associated with weight gain through the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, with subsequent accumulation of carbohydrates as easily as fat. Also, restrictive diets reduce thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets are largely psychological.
Low-carb, high-protein diets
Low-carb protein diets are an alternative to high-carb diets. Such diets are high in protein and fat and low in carbohydrates (and therefore calories). This leads to weight loss, initially dependent on the release of glycogen-bound water from the body.
The initial effect of the low-carbohydrate diet is immediate and so impressive that it becomes an additional motivation for the patient.
The essence of the protein diet
The diet is based on ketosis - the result of endogenous fat burning, which leads to a decrease in appetite. The second factor is the monotony of the menu. As a result, the body's need for insulin decreases, glycemia, and sometimes the concentration of lipids decreases.
Protein in the diet stimulates the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of satiety increases after a meal and this is due to the increased ratio of protein to energy obtained from the food. It is important to understand that a high protein diet does not always mean a low calorie intake, however.
Disadvantages, side effects, long term effects of 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 a high fat content (55-60%) and animal protein (25-30%).
In addition, a high-protein diet is usually associated with calcium loss and decreased levels of vitamins E, A, B. 1, B6, folate, magnesium, iron, and potassium. Deficiency of calcium, vitamin D, and secondary increased secretion of TSH disrupts cellular calcium homeostasis, increases the level of cytosolic calcium, and this 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 increase in HDL pose risks for the development of atherosclerosis, despite the beneficial effect on triglyceride concentrations. In addition, 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 fat loss of up to 8 kg compared to 4 kg.
A protein-sparing modified diet
This high protein, very low calorie diet<800 kcal/day, with minimal lipids and carbohydrates, is very popular in many European clinics.
The menu contains proteins in the 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 one month under strict medical supervision. Patients are prescribed additional vitamins. This diet theoretically allows you to lose 90g of fat per day and lower your basal metabolic rate by 10-20%.
A protein-sparing modified diet affects individual elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- increases lipid oxidation and sensitivity of peripheral tissues to insulin;
- decreases hepatic insulin clearance and hepatic glucose release.
The essence of the protein-sparing modified diet
This type of diet provides a sufficient amount of protein (approximately 50 g/day) that protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. Low carbohydrate content limits insulin secretion and promotes lipolysis. The energy gap between energy expenditure and caloric intake (at least 650 kcal/day) is covered by burning endogenous lipids.
One of the popular meal replacements during a protein-sparing modified diet is a protein shake. Besides being high in protein, such products also contain other nutrients needed during the diet. When losing weight, you need to reduce the total number of calories consumed. The protein shake offers a low calorie content that allows 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.
Decreased insulinemia and increased fat oxidation lead to the production of ketone bodies in the liver - energy material for muscles and the brain, limit gluconeogenesis from protein substrates and reduce appetite.
Low-carb, high-fat diets
Such diets have been a hit in recent years, although they are far from new. Especially popular is the Atkins diet, created by a cardiologist in 1973. R. Atkins' book on healthy eating has sold more than 10 million copies. In European countries, it is read four times more often than all other dietary guidelines.
The essence of the Atkins diet
It's a low-carb, high-protein, high-fat diet. During the first two weeks, the carbohydrate content is limited to 20 g/day, and then to 30 g/day. After reaching the desired body weight, the carbohydrate content is gradually increased.
Serious controversy among scientists about this diet arises because of the 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 because the body cannot store it and turning it into fat requires a lot of energy. The situation is similar with amino acids and proteins, which perform functional functions, and carbohydrates, whose storage in the form of glycogen is limited. Converting carbohydrates to fat also requires a lot of energy. Thus, it can be assumed that their 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 noted that the reduction in insulin hypersecretion was accompanied by an increase in insulin sensitivity. Thus, this diet allows to achieve an effect of the nature of etiopathogenetic therapeutic intervention in type 2 diabetes mellitus.
Scientifically proven probable weight loss when maintaining a diet is 10% after 6 months. No serious consequences have yet been identified.
Other diets
- Alternating diet.It consists of eating one type of food or completely abstaining from food on selected days. The effectiveness of this type of feeding is low, mainly due to the rapid rejection of it. It is difficult for patients not to eat anything, and even more difficult to eat only one product, for example, boiled rice without salt, sugar and oil.
- A low-fat diet.The composition of the diet implies the elimination of all meat and dairy products, vegetable oils, fish and, in general, all products containing any fat. Long-term adherence to such a diet leads to anemia, weakening of the musculoskeletal system and poor health.
- Starvation. The diet involves complete abstinence from food for a certain period of time. This is not a recommended weight loss method, no matter how long it lasts. Starvation is especially dangerous for diabetics, people prone to depression, patients with vitamin and micronutrient deficiencies, and those taking strong medications.
At all times, fad diets have been and will continue to be popular, usually based on the alleged unusual weight-loss properties of certain foods, most commonly 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, grape and banana diets are guaranteed to cause blood sugar spikes, making diabetes worse.
Which diet is best?
You can't choose your diet yourself. The best option would be to contact an endocrinologist, who will choose the right type of nutrition based on the results of the study.
Physical activity is overrated for overweight and obesity
The importance of physical activity in the process of losing weight is greatly overestimated. Judge for yourself: losing 1 kg requires a huge effort, for example, walking 250 km. And for many patients, such loads are simply prohibited due to concomitant pathologies. In other words, when you plan to lose weight, you need to understand that physical education alone as a method of treatment will not give the result you would like to get.
But that doesn't mean you have to give up physical activity. Physical activity is important for slowing weight gain and preventing weight gain. Also, when losing extra pounds, it is important to strengthen the muscle frame, then the skin will not be loose and sagging.
Physical activity has a beneficial effect on the whole organism - this applies to both overweight and thin people.
gymnastics:
- Maintains muscle mass during weight loss by preventing the catabolism of muscle proteins;
- Reduces insulin resistance, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports and even simple walking, the mood improves, blood circulation and air exchange in the tissues improves. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.