The first method of choice in the treatment of overweight or obesity is a diet supplemented with physical activity. Then, if no weight loss occurs, other treatment options are used, including medical and surgical options.
Today, hundreds of diets are offered to those who lose weight, but only some of them are officially recognized. It has been proven that there is no universal and ideal diet. Many food items 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. The diet should be individual, based on the stage of obesity, eating disorders, accompanying diseases and other important points. It is especially important to take into account the presence of diabetes, gastrointestinal pathologies, hematopoiesis problems and vitamin-mineral balance.
For example, patients with diabetes are strictly prohibited from fasting or, conversely, a diet rich in carbohydrates. 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 diet 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 record all the food consumed daily in grams.
Important points when choosing a diet:
- Severe calorie restriction and nutritional deficiencies should be avoided. A sudden significant reduction in the energy content of the diet, for example by half of 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, it should take into account the patient's tastes. Otherwise, stress will add to obesity. Monotonous food is a common cause of diet failure. The patient feels hungry, burdened by limitations and "his soul demands" relief. Having eaten a forbidden sweet or fatty food and having received great pleasure, it is already difficult to stop. The brain immediately remembers how bad it was without the "sweets".
- The patient should drink a lot of water. You should give up lemonade, sweet tea and alcohol.
An important element that limits appetite is plant fiber, which participates 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 system 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 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.
Restricted calorie 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 over 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, however, after a year, every 3 patients return to their previous body weight, and after 3 yearsalmost everyone.
The essence of the classic diet
The classic diet is a high-carbohydrate diet 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. Relative to the current diet, a caloric deficit of 500 kcal/day is assumed, while limiting current fat intake by 1/3. In 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 in the mechanism of postprandial hyperglycemia and stimulation of insulin secretion, with the 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 dieting are largely related to the psyche.
Low-carb, high-protein diets
Low-carb 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 a low-carb 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 burning endogenous fat, which causes a decrease in appetite. The second factor is the monotony of the menu. As a result, the body's needs for insulin are reduced, glycemia and sometimes lipid concentrations are reduced.
Protein in the diet stimulates the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of fullness increases after eating, 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, 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. Instead, the menu contains many ingredients with a high fat content (55-60%) and animal protein (25-30%).
Also, a high-protein diet is usually associated with calcium loss and decreased levels of vitamins E, A, B. 1, B6, folic acid, magnesium, iron and potassium. Calcium, vitamin D deficiency, and secondary increased TSH secretion disrupt cellular calcium homeostasis, increase 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 absence of an increase in HDL pose risks for the development of atherosclerosis, even despite the beneficial effect on triglyceride concentrations. Also, reducing the proportion of vegetable fiber in the diet leads to constipation.
At the same time, comparing the effectiveness of a protein diet (containing 25% protein, 45% carbohydrates) with a carbohydrate diet (12% protein, 58% carbohydrates), the advantage of the former is obvious. Studies have shown fat loss of up to 8 kg versus 4.
Modified protein-sparing diet
This high protein, very low calorie diet with caloric value<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 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 metabolism by 10-20%.
A modified protein-sparing diet affects individual components of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia.
- enhances 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 (about 50 g/day), which protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. Low carbohydrate content limits 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 the high protein content, such products also contain other nutrients that are needed during the diet. When you lose weight, you need to reduce the total number of calories you consume. 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 diets
Such diets have become popular in recent years, although they are far from new. The Atkins diet, created 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 all other nutrition guides.
The essence of the Atkins diet
This is 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 its high fat content. However, the amount of fat that is oxidized or stored depends on the difference between the total energy requirement and the oxidation of other dietary components that dominate lipids.
Alcohol is burned first, since the body cannot store it and turning it into fat requires a lot of energy. The situation is similar to amino acids and proteins that perform functional functions and carbohydrates, the storage of which 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 of fat accumulation (mainly in adipose tissue) are practically unlimited and the effectiveness 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 makes it possible to achieve the result of the nature of the etiopathogenic therapeutic intervention for type 2 diabetes mellitus.
Scientifically proven potential weight loss while 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 diet is low, mainly due to its rapid abandonment. It is difficult for patients not to eat anything, 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 implies the removal of all meat and dairy products, vegetable oils, fish and, in general, all products containing any fats. Long-term adherence to such a diet leads to anemia, weakening of the musculoskeletal framework and poor health.
- Hunger. 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. Fasting is especially dangerous for diabetics, people prone to depression, patients with a lack of vitamins and microelements and taking strong drugs.
Fad diets have always been and will be popular, usually based on the supposed unusual weight-loss properties of certain foods, most often fruit. 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 lead to blood sugar spikes, worsening diabetes.
Which diet is best?
You cannot choose your diet for yourself. The best option would be to contact an endocrinologist, who will choose the right type of diet based on the results of the examination.
Physical activity is overrated for overweight and obesity
The importance of physical activity in the weight loss process is greatly overestimated. Judge for yourself: losing 1 kg requires a huge effort, for example, 250 km of walking. And for many patients, such loads are simply prohibited due to accompanying pathologies. In other words, when you plan to lose weight, you should understand that physical therapy alone as a method of treatment will not give the result that you would like to have.
But this does not mean that you should give up physical activity. Physical activity is important to slow weight gain and prevent weight gain. Also, when losing extra pounds, it is important to strengthen the muscular frame, then the skin will not be flabby and loose.
Physical activity has a beneficial effect on the whole body - this applies to both overweight and thin people.
Gymnastics:
- Maintains muscle mass during weight loss by preventing catabolism of muscle proteins.
- It reduces insulin resistance, improving the metabolism of carbohydrates and lipids.
- Normalizes blood pressure.
With active sports and even simple walking, your mood improves, blood circulation and air exchange in the tissues improves. Therefore, physical therapy with measured loads will always be an integral part of the complex treatment of overweight and obesity.