The first method of choice in the treatment of excess weight or obesity is a 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 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 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 abandon diets with a predetermined daily calorie intake. The diet should be individual, based on the phase 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, eating a diet high in carbohydrates. Patients with anemia 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 skeleton.
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 modify the menu, where the patient must write down all the foods eaten 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, he is burdened by restrictions 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 reminds how bad it was without the "sweets. "
- The patient should drink a lot of water. You will have to give up lemonade, sweet tea and alcohol.
An important element that limits appetite is plant 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 accelerate 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.
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, 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 3rd patient returns to their previous body weight, and after 3 years, almost all.
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. In relation 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 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 combined 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. Also, restrictive diets reduce thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets largely relate to the psyche.
Low-carb, protein-rich diets
Low-carbohydrate protein diets are an alternative to carbohydrate 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 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, glycemia, and sometimes lipid concentrations decrease.
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 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 high in fat (55-60%) and animal protein (25-30%).
Also, a high protein diet is usually associated with a loss of calcium and a decrease in the levels of vitamins E, A, B. 1, B6, folic acid, magnesium, iron, and potassium. Deficiency of calcium, vitamin D and secondary increased secretion of TSH disrupt 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 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 create risks for the development of atherosclerosis, even despite the beneficial effect on triglyceride concentrations. Also, reducing the proportion of 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 a loss of fat mass of up to 8 kg versus 4.
Protein-sparing modified diet
This high-protein, very low-calorie diet with a caloric 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 additionally 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 elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- enhances 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 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 calorie 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. In addition to 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. A protein shake offers a low calorie content, allowing you to control your calorie intake and create a calorie deficit to achieve 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 brain, limit gluconeogenesis from protein substrates and reduce appetite.
Low-carbohydrate, high-fat diets
Such diets have been a hit in recent years, although they are far from new. The Atkins diet, created by a cardiologist in 1973, is especially popular. R. Atkins's book on healthy eating has sold more than 10 million copies. In European countries, it is read four times more often than all other diet 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, since 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 functions, and carbohydrates, the storage of which in the form of glycogen is limited. Converting carbohydrates into 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 (primarily 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 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.
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 eating on selected days. The effectiveness of this type of nutrition is low, mainly due to the rapid abandonment of it. 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 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 frame, and poor health.
- Starvation. A diet involves completely abstaining from food for a certain period of time. This is not a recommended method of 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, quack 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 calls for 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 spikes in blood sugar, aggravating diabetes.
Which diet is best?
You cannot choose your diet on your own. The best option would be to contact an endocrinologist, who will select the right type of nutrition based on the examination results.
Physical activity is overrated for overweight and obesity
The importance of physical activity in the process of losing weight 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. In other words, when planning to lose weight, you should understand that physical education alone as a method of treatment will not give the result that you would like to get.
But this does not mean that you need to give up physical activity. Physical activity is important to slow down weight gain and prevent weight gain from returning. Also, when losing extra pounds, it is important to strengthen the muscle frame, then the skin will not be flabby and sagging.
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 by preventing the catabolism of muscle proteins;
- Reduces insulin resistance, improving carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports and even simple walking, your mood improves, blood circulation and air exchange in tissues improves. Therefore, physical education with measured loads will always be an integral part of the complex treatment of excess weight and obesity.