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, there are hundreds of diets 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 diet have contraindications and can even worsen the condition. Therefore, you should not rush with every new recipe that promises a slim figure.
Features of diet selection in obesity
When treating obesity, diets with a predetermined daily calorie intake should be abandoned immediately. The diet should be individual, taking into account the phase of obesity, eating disorders, accompanying diseases and other important points. It is especially important to take into account the presence of diabetes, pathologies of the gastrointestinal tract, problems with hematopoiesis and vitamin-mineral balance.
For example, it is strictly forbidden for patients with diabetes to fast or, on the contrary, to eat a high-carbohydrate diet. Patients with anemia should not give up meat and offal. Children need dairy products; removing them from the menu threatens to interfere with the growth and development of the musculoskeletal system.
The diet plan is drawn up with a clear distribution of meals (3-5) and the composition of the menu. Keeping a self-monitoring diary will help to monitor and modify the menu, in which the patient must write down in grams all the foods eaten on a daily basis.
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 taste. Otherwise, stress will increase obesity. Monotonous food is a common cause of diet failure. The patient feels hungry, burdened by restrictions and his "soul demands" relief. After eating a forbidden sweet or fatty food and having received great pleasure, it is already difficult to stop. The brain immediately reminds you how bad it was without "sweets".
- 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 is involved in the mechanism of increasing the volume of food in the stomach and delays its emptying. These substances also reduce the absorption of nutrients from the digestive tract and accelerate intestinal transit. That's why 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 drugs that affect the satiety center. When using such tablets, the patient does not feel hungry. But it is important to understand that the use of such drugs is limited by unpleasant side effects and several contraindications.
Diets with a limited amount of calories - the 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 within 6 months or by 10% after 18 weeks, however, after a year, every third patient returns 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. The current diet assumes a caloric deficit of 500 kcal per day 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 combined with weight gain in the mechanism of postprandial hyperglycemia and stimulates insulin secretion, and then carbohydrates accumulate as easily as fat. Similarly, 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, high-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, which initially depends 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 basis of the diet is 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 lipid concentrations decrease.
Protein in the diet stimulates the release of glucagon, contributing to 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 dietary energy. It is important to understand that a high protein diet does not necessarily mean a low calorie diet.
Disadvantages of the protein diet, side effects, long-term effects
Unfortunately, there is not enough research to support the effectiveness and safety of a high protein diet. And it does not contain healthy food: grains, fruits, vegetables. On the contrary, 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 cytosolic 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 observed increase in uric acid and LDL levels and non-increase in HDL poses a risk for the development of atherosclerosis, even despite the beneficial effect on triglyceride concentrations. Also, reducing the proportion of fiber in the diet causes 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 advantages of the first are obvious. Studies show a reduction in fat mass of up to 8 kg compared to 4 kg.
Protein-saving modified diet
This high protein, very low calorie diet with calorie value<800 kcal/day, with minimal lipid and carbohydrate content, is very popular in many European clinics.
The menu contains proteins 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 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-saving modified diet affects certain elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- improves 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 dietary option provides sufficient protein (approx. 50 g/day), which protects metabolic nitrogen balance 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 burning endogenous lipids.
One of the most popular meal replacements during a protein-sparing modified diet is a protein shake. In addition to the amount of protein, such products also contain other nutrients that are necessary during the diet. When losing weight, you need to reduce the total number of calories you consume. The 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 packet contains 39 kcal. Also, the cocktail contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and a whole vitamin complex. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
Reduced insulinemia and increased fat oxidation cause the formation of ketone bodies in the liver - energy materials for muscles and brain, limit gluconeogenesis from protein substrates and reduce appetite.
Low-carb, high-fat diets
Such diets have been popular in recent years, although they are by no means new. The Atkins diet, which was 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 diet guides.
The essence of the Atkins diet
This is a low-carb, high-protein, high-fat diet. Carbohydrates are limited to 20 g per day for the first two weeks and then to 30 g per day. After reaching the desired body weight, the carbohydrate content gradually increases.
Serious controversy among scientists about this diet stands out because of its high fat content. However, the amount of fat oxidized or stored depends on the difference between the total energy demand and the oxidation of other dietary components that take priority over lipids.
Alcohol is burned first because the body cannot store it and it takes a lot of energy to turn it into fat. A similar situation is 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 of fat accumulation (mainly in adipose tissue) are practically unlimited, and the efficiency of this process is excellent.
The Atkins diet reduces plasma concentrations of insulin, C-peptide, and especially proinsulin under alkaline conditions and after glucagon stimulation, which may lead to less atherogenic effects than previously thought. It was also noted that a decrease in insulin hypersecretion was associated with an increase in insulin sensitivity. Thus, this diet makes it possible to achieve the effect of type 2 diabetes etiopathogenetic therapeutic intervention.
Scientifically proven possible weight loss by following the diet is 10% after 6 months. No serious consequences have yet been identified.
Other diets
- A variable diet.It consists of eating one type of food or completely abstaining from food on certain days. The effectiveness of this type of diet is low, mainly because it is quickly abandoned. 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 means the removal of all meat and dairy products, vegetable oils, fish and, in general, all fat-containing products. Prolonged adherence to such a diet leads to anemia, weakening of the musculoskeletal system and poor health.
- Hunger. A diet involves completely giving up 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 trace elements, and the use of strong medications.
Fad diets have always been and will be popular, usually based on the supposed extraordinary weight-loss properties of certain foods, most often fruits. For example, the apple diet involves eating only apples, the grape diet - grapes, the banana diet - bananas. Such diets are either ineffective or dangerous. For example, diets of grapes and bananas can cause blood sugar levels to rise, exacerbating diabetes.
Which diet is best?
You cannot choose a diet on your own. The best option would be to contact an endocrinologist who, based on the results of the examinations, will choose the right type of diet.
Physical activity is overrated for overweight and obesity
The importance of physical activities in the slimming process is greatly overestimated. Judge for yourself: to lose 1 kg of weight 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 planning to lose weight, one must understand that physical education alone as a treatment method will not give the desired result.
But that doesn't mean you have to 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 muscle frame, then the skin will not be flabby and flabby.
Physical activity has a beneficial effect on the whole body - this applies to both overweight and thin people.
Exercise:
- Maintains muscle mass during weight loss by preventing catabolism of muscle proteins;
- Reduces insulin resistance by improving carbohydrate and lipid metabolism;
- Normalizes blood pressure.
Active sports and even just walking improve mood, improve blood circulation and air exchange in tissues. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.