The first method of choice in the treatment of overweight or obesity is diet combined with physical activity. Then, if weight loss does not occur, other treatment options are used, including medical and surgical procedures.
Today, there are hundreds of diets available for those who want to lose weight, but only a few of them are officially approved. 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 to every new recipe that promises a slim figure.
Features of choosing a diet for obesity
When treating obesity, you should immediately stop dieting with a predetermined daily calorie intake. The diet should be individualized, based on obesity level, eating disorders, co-morbidities and other important factors. It is especially important to take into account the presence of diabetes, diseases of the digestive tract, problems with hematopoiesis and vitamin-mineral balance.
Patients with diabetes, for example, are strictly forbidden to fast or, on the contrary, eat a diet high in carbohydrates. Patients with anemia should not give up meat and offal. Babies need dairy products; if they are taken off the menu, there is a risk of disrupting the growth and development of the musculoskeletal system.
The nutrition plan is made 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, as the patient must write down all the food eaten daily in grams.
Important points when choosing a diet:
- Severe calorie restriction and nutritional deficiencies should be avoided. A sudden drastic 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 results. The weight comes back within a year, if not sooner.
- The menu should not be monotonous; he should take into account the taste of the patient. Otherwise, stress will increase obesity. Monotonous food is a common cause of diet failure. The patient feels hungry, he is weighed down by restraints and his "soul demands" relief. After eating forbidden sweet or fatty food and getting great pleasure, it is already difficult to stop. The brain immediately reminds how bad it was without the "sweets". .
- The patient should drink plenty of water. You must give up lemonade, sweet tea and alcohol.
An important factor that limits appetite is plant fiber, which is involved in increasing the amount of food in the stomach and delaying its emptying. These substances also reduce the absorption of nutrients from the digestive tract and speed up transit in the intestines. That's why almost every successful diet includes fruits and vegetables or supplements that signal satiety.
In severe cases, if you cannot control your appetite, the endocrinologist will prescribe a drug that affects the satiety center. By taking such tablets, 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 diet - 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 3rd patient returns to the previous body weight, and after 3 years, almost all.
The essence of the classic diet
A classic diet is a high-carbohydrate diet with calories corresponding to 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, while limiting the current fat intake by 1/3. In this diet, about 60% of the 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 combined with weight gain in the system of postprandial hyperglycemia and its 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 diets are largely psychological.
A low-carb, high-protein diet
A low-carb protein diet is an alternative to a high-carbohydrate diet. Such a diet is 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 a 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 need for insulin decreases, blood sugar drops, and sometimes the concentration of fat decreases.
Dietary protein stimulates the release of glucagon, which facilitates the balance between hyperinsulinemia and glucagonemia. The feeling of satiety increases after eating and it is caused by the increased ratio of protein and energy obtained from 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 include healthy foods: grains, fruits, vegetables. On the contrary, the menu contains many ingredients that contain a lot of fat (55-60%) and animal protein (25-30%).
Also, a high-protein diet is usually associated with calcium loss and a decrease in the concentration of E, A, B. 1, B6, folic acid, magnesium, iron and potassium. Deficiency of calcium, vitamin D, and increased secretion of TSH disrupts cellular calcium homeostasis, increases cellular calcium levels, and this can stimulate several adverse metabolic pathways, including lipid synthesis in adipose tissue.
The long-term effects of such a diet on the body are also unknown. The increase in uric acid and LDL levels and the lack of increase in HDL creates a risk of developing atherosclerosis, even despite the positive effect on triglyceride levels. Reducing the amount of fiber in the diet also leads to constipation.
At the same time, when the activity of a protein diet (containing 25% protein, 45% carbohydrates) is compared with a carbohydrate diet (12% protein, 58% carbohydrates), the advantage of the former is obvious. Studies have shown a loss of up to 8 kg of fat mass versus 4.
Protein-sparing modified diet
This high protein low calorie diet with calorie count<800 kcal/day, with minimal lipids and carbohydrates, is very popular in many clinics in Europe.
The menu contains protein 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 a month under the strict supervision of a doctor. Patients are also prescribed vitamins. This diet theoretically allows you to lose 90 g of fat per day and reduce your basal metabolism by 10-20%.
A protein-sparing modified diet affects individual factors in the pathogenesis of type 2 diabetes:
- reduces blood sugar and endogenous hyperinsulinemia;
- increases fat oxidation and sensitivity of peripheral tissues to insulin;
- reduces hepatic insulin clearance and hepatic glucose release.
The essence of a protein-saving modified diet
This dietary option provides a sufficient amount of protein (approximately 50 g/day), which protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. Low carbohydrate content limits insulin secretion and promotes lipolysis. Energy difference between energy expenditure and caloric intake (at least 650 kcal/day) is covered by burning endogenous lipids.
One of the most popular meal replacements during a low-protein modified diet is a protein shake. In addition to being rich in protein, such products also contain other nutrients that are needed in the diet. When you lose weight, you need to reduce the total number of calories consumed. Protein shakes offer a low calorie content, allowing you to control your calorie intake and create a calorie deficit to reach your goal weight. One bag 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 hyperinsulinemia and increased fat oxidation lead to the production of ketone bodies in the liver - energy for muscles and the brain, limit glycogen synthesis from protein substrates and reduce appetite.
Low carb, high fat diet
Such a diet has been popular in recent years, although it is 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 than all other dietary guidelines.
The essence of the Atkins diet
This is a low-carb, high-protein, high-fat diet. For 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 is gradually increased.
Serious controversy among scientists about this diet arises because of the 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 food components that take precedence over lipids.
Alcohol is first burned as the body cannot store it and it takes a lot of energy to turn it into fat. The situation is similar with amino acids and proteins that have functional functions and carbohydrates, but their 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 corresponds almost to consumption.
On the other hand, the possibilities of fat accumulation (mainly in adipose tissue) are almost unlimited and the efficiency of this process is high.
The Atkins diet reduces plasma levels of insulin, C-peptide, and especially proinsulin under alkaline conditions and after glucagon stimulation, which may lead to less angiogenic effects 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 the etiopathogenetic therapeutic intervention for type 2 diabetes.
Scientifically proven probable weight loss when following a diet is 10% after 6 months. No serious consequences have yet been revealed.
Another diet
- Alternating diet.It consists of eating one type of food or completely abstaining from eating on selected days. The effectiveness of this type of nutrition is low, mainly due to the rapid withdrawal. It is difficult for patients not to eat anything, and it is even more difficult to eat just one product, for example boiled rice without salt, sugar and oil.
- Low fat diet.The composition of the diet includes the removal of all meat and dairy products, vegetable oils, fish and, in general, all products containing fat. Long-term adherence to such a diet leads to anemia, weakening of the musculoskeletal system and poor health.
- Famine. A diet involves completely abstaining from food for a certain period of time. This is not a recommended method of weight loss, no matter how long it lasts. Fasting 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 continue to be popular, usually based on the supposed extraordinary weight loss properties of certain foods, most commonly fruit. For example, an apple craze calls for eating only apples, a grape diet - grapes, a banana diet - bananas. Such a diet is either ineffective or dangerous. For example, a diet with grapes and bananas is guaranteed to lead to an increase in blood sugar, which increases diabetes.
Which diet is best?
You cannot choose a 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 examination.
Physical activity is overrated for overweight and obesity
The importance of exercise in weight loss is greatly overrated. Judge for yourself: Losing 1 kg of weight requires a huge effort, for example a 250 km walk. And for many patients, such stress is simply prohibited due to concomitant pathology. In other words, when you plan to lose weight, you should understand that exercise alone as a treatment method will not give you the results you want.
But this does not mean that you have to stop physical activity. Physical activity is important to slow weight gain and prevent weight gain from coming back. Also, when you lose the extra kilos, it is important to strengthen the muscle frame, so that the skin does not become limp and sagging.
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 muscle protein breakdown;
- Reduces insulin resistance, improves the metabolism of carbohydrates and fats;
- Regulates blood pressure.
With active sports and even simple walks, the mood improves, blood circulation and air exchange in the tissues improves. Therefore, exercise with measured stress will always be an integral part of the complex treatment of overweight and obesity.