The first method of choice in the treatment of overweight or obesity is a diet supplemented with physical activity. Then, if weight loss does not occur, other treatment methods are used, including medical and surgical methods.
Today, hundreds of diets are recommended for weight loss, but only a few of them are officially recognized. It has been proven that there is no universal and perfect diet. Many types of nutrition have contraindications and can even worsen the condition. Therefore, do not rush to every new recipe that promises a slim figure.
Features of choosing a diet for obesity
In the treatment of obesity, a predetermined daily caloric diet should be immediately abandoned. The diet should be individualized based on the stage of obesity, eating disorders, co-morbidities and other important points. It is especially important to take into account diabetes, gastrointestinal pathology, problems with hematopoiesis and vitamin-mineral balance.
For example, patients with diabetes are strictly prohibited from fasting or, on the contrary, using a diet rich in carbohydrates. Anemic patients should not give up meat and alcohol. Children need dairy products, removing them from the menu leads to a violation of the growth and development of the musculoskeletal system;
A meal plan is created with a clear distribution of food (3-5) and menu composition. Keeping a self-monitoring diary will help you monitor and change the menu, where the patient should write down all the food he eats in grams every day.
Important points when choosing a diet:
- Severe calorie restriction and malnutrition should be avoided. A sudden and significant reduction in dietary energy content, for example to half of the current value, produces impressive results, but does 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 taste of the patient. Otherwise, stress increases obesity. Monotonous food is a common cause of diet failure. The patient feels hunger, restrictions are imposed on him and the relief that "requires his soul". Once you enjoy eating a forbidden sweet or fatty food, it's hard to stop. The brain immediately remembers how bad it was without "sweets".
- The patient should drink a lot of water. Lemonade, sweet tea and alcohol should be avoided.
An important element that limits appetite is vegetable fiber, which is involved in the mechanism of expanding the amount of food in the stomach and delaying its release. 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 supplements that signal satiety.
In severe cases, if you cannot control 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 the reception of such drugs is limited by unpleasant side effects and a number of contraindications.
Calorie-restricted diets are classic diets
Calorie-restricted diets are usually low in fat. The most popular diet is the classic one. It has been in use 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 10% after 18 weeks, but after a year, every third patient returns to the previous body weight, and after 3 years, almost all.
The essence of the classic diet
A classic diet is a calorie-carbohydrate diet that corresponds to the degree of excess weight. Energy cost is usually 1200-1500 kcal/day. for women and 1500-1800 kcal/day. for men. A caloric deficit of 500 kcal/day is assumed for the current diet, while fat intake is limited to 1/3. In this diet, about 60% of energy comes from carbohydrates, 25% from fats, and 15% from proteins.
Disadvantages, side effects, and long-term effects of the classic diet
The problem is that high-carbohydrate diets are empirically associated with weight gain in the mechanism of postprandial hyperglycemia, combined with its stimulation of insulin secretion and subsequent easy storage of carbohydrates 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 mostly psychological.
Low carb, high protein diets
Low-carb protein diets are an alternative to high-carb diets. Such a diet is high in protein and fat and low in carbohydrates (and therefore calories). It initially depends on the release of glycogen-bound water from the body, leading to weight loss.
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 protein diet
The diet is based on ketosis - the result of endogenous fat burning, which suppresses 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.
Dietary protein stimulates glucagon release, maintaining a balance between insulinemia and glucagonemia. The feeling of fullness increases after a meal, and this is due to the increased protein-to-energy ratio of food. It is important to understand that a high protein diet, however, does not always mean low calorie intake.
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. But it does not contain useful nutrients: grains, fruits, vegetables. On the contrary, the menu contains ingredients with a lot of fat (55-60%) and animal protein (25-30%).
Also, a high-protein diet is usually associated with decreased calcium and decreased levels of vitamins E, A, B. 1, B6, folic acid, magnesium, iron, and potassium. Calcium, vitamin D deficiency, and secondary secretion of TSH disrupt cellular calcium homeostasis, increase cytosolic calcium levels, and this stimulates 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 marked increase in uric acid and LDL levels and the absence of an increase in HDL pose risks for the development of atherosclerosis despite beneficial effects 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) shows the superiority of the former. Studies have shown that the loss of fat mass is up to 8 kg versus 4 kg.
A modified protein-sparing diet
This is a high protein, very low calorie dietVery popular in many European clinics with <800 kcal/day, minimal lipids and carbohydrates.
The menu contains 1. 2 g/kg of protein for women and 1. 4 g/kg for men. Diet therapy is carried out for a month under strict medical supervision. Patients are prescribed additional vitamins. This diet theoretically allows you to lose 90g of fat per day and reduce your basal metabolic rate by 10-20%.
A modified protein-saving diet affects some elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- increases lipid oxidation and insulin sensitivity of peripheral tissues;
- Decreases hepatic insulin clearance and hepatic glucose output.
The essence of a modified protein-saving diet
This dietary option provides a sufficient amount of protein (approximately 50 g/day) to protect metabolic nitrogen balance and endogenous proteins from proteolysis. Low carb restricts 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 modified protein-sparing diet is a protein shake. Such foods are rich in protein and also contain other nutrients needed during the diet. When you need to lose weight, reduce the total number of calories consumed. Protein shakes offer a low calorie content, which allows you to control your calories and create a calorie deficit to reach your goal. 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 replaces a meal and keeps you full for 3-4 hours.
A decrease in insulinemia and an increase in fat oxidation lead to the formation of ketone bodies in the liver - an energy material for muscles and the brain, which limits gluconeogenesis from protein substrates and reduces appetite.
Low-carb, high-fat diets
Although such diets are far from new, they have become a hit in recent years. The Atkins diet, created by a cardiologist in 1973, is particularly popular. R. Atkins' nutrition book has sold more than 10 million copies. In European countries, it is read four times more than other dietary guidelines.
The essence of the Atkins diet
It is a low carb, protein and fat diet. During the first two weeks, the amount of carbohydrates is limited to 20 g per day, then 30 g per day. After reaching the desired body weight, the carbohydrate content is gradually increased.
A serious debate among scientists about this diet is 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 have priority over lipids.
Alcohol is first burned because the body cannot store it and it takes a lot of energy to convert it into fat. The situation is similar with amino acids and proteins, which perform functional functions, as well as with carbohydrates, which have limited storage in the form of glycogen. Converting carbohydrates to fat also requires a lot of energy. Thus, it can be assumed that their oxidation corresponds practically 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 hypersecretion of insulin was accompanied by an increase in insulin sensitivity. Thus, this diet allows to achieve the effect of the nature of etiopathogenetic therapeutic intervention for type 2 diabetes.
Scientifically proven estimated weight loss is 10% after 6 months of dieting. Serious consequences have not yet been determined.
Other diets
- Alternative diet.It consists of eating a certain type of food or avoiding food altogether on selected days. The effectiveness of this type of diet is low, mainly due to its rapid rejection. 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.
- A low-fat diet.The composition of the diet refers to the exclusion of all meat and dairy products, vegetable oil, fish and, in general, all foods containing any type of fat. Adhering to such a diet for a long time leads to anemia, weakening of the musculoskeletal system, and deterioration of health.
- Hunger. A diet involves abstaining from food for a certain period of time. This is not a recommended method for weight loss, no matter how long it lasts. Fasting is especially dangerous for people with diabetes, people prone to depression, vitamin and micronutrient deficiencies, and those taking strong medications.
Quack diets have always been and will continue to be popular, usually based on the unusual weight-loss properties of certain foods, usually fruits. For example, an apple diet means eating only apples, a grape diet means grapes, and a banana diet means bananas. Such diets are either ineffective or dangerous. For example, a diet of grapes and bananas can cause high blood sugar levels and aggravate diabetes.
Which diet is best?
You cannot choose a diet on your own. The best option is to contact an endocrinologist, who will choose the right diet based on the results of the examination.
Physical activity is overrated for overweight and obesity
In the process of significant physical exercise, weight loss will be significantly increased. See for yourself: losing 1 kg of weight requires a lot of effort, for example, walking 250 km. And for many patients, such downloads are simply prohibited by the accompanying pathology. In other words, when planning to lose weight, you need to understand that physical education alone, as a treatment method, will not give you the desired result.
But that doesn't mean you should give up physical activity. Physical activity is important for slowing weight gain and preventing weight gain. Also, it is important to lose extra pounds to strengthen the muscle frame, then the skin will not sag and relax.
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;
- reduces insulin resistance, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
Active sports, even simple walking, will improve your mood, improve blood circulation and air exchange in the tissues. Therefore, physical training with measured loads will always be an integral part of the comprehensive treatment of overweight and obesity.