The first method of choice in the treatment of overweight or obesity is a diet integrated 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 proposed for weight loss, but only a few are officially recognized. It has been proven that there is no universal, 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, it is necessary to immediately abandon diets with a predetermined daily calorie intake. The diet should be individual, based on the stage of obesity, eating disorders, concomitant diseases and other important points. It is particularly 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, following a high-carbohydrate diet. Patients with anemia should not give up meat and offal. Children need dairy products; removing them from the menu risks compromising the growth and development of the musculoskeletal system.
The nutritional plan is drawn up with a clear distribution of meals (3-5) and composition of the menu. Keeping a self-monitoring diary will help monitor and modify the menu, where the patient will have to write down in grams all the foods consumed daily.
Important points when choosing a diet:
- Severe calorie restrictions and nutritional deficiencies should be avoided. A sudden and significant reduction in the energy content of the diet, for example by half the current value, will produce impressive results, but will not guarantee long-term success. The weight will return within a year, if not sooner.
- The menu doesn't have to be monotonous; must take into account the patient's tastes. Otherwise, stress will add to obesity. Monotonous food is a common cause of diet failure. The patient is hungry, burdened by restrictions, and his "soul demands" relief. After eating a forbidden sweet or fatty food and receiving great pleasure, it is already difficult to stop. The brain immediately remembers how bad it was without the "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 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 by 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 appetite, the endocrinologist will prescribe a drug that affects the satiety center. By 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.
Low-calorie diets - classic diet
Diets that restrict calories are generally low in fat. The most popular diet is the classic one. It has been used for more than 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 third patient returns to the previous body weight, and after 3 years almost all.
The essence of the classic diet
The classic diet is a carbohydrate-rich 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, limiting the current fat intake by 1/3. In this diet about 60% of 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 diet rich in carbohydrates is empirically combined with weight gain in the mechanism of postprandial hyperglycemia and with its stimulation of insulin secretion, resulting in the accumulation of carbohydrates as easily as fats accumulate. Furthermore, restrictive diets reduce thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets largely concern the psyche.
Low-carb, high-protein diets
Low-carbohydrate protein diets are an alternative to carbohydrate-based diets. Such diets are rich in proteins and fats 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 carbohydrate 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 and sometimes lipid concentrations decrease.
Proteins in the diet stimulate the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of satiety increases after eating and this is due to the increase in the ratio between proteins and 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: cereals, fruits, vegetables. On the contrary, the menu contains many ingredients rich in fat (55-60%) and animal proteins (25-30%).
Additionally, a high-protein diet is usually associated with a loss of calcium and decreased levels of vitamins E, A, B. 1, B6, folic acid, magnesium, iron and potassium. Deficiency of calcium, vitamin D and secondary increase in TSH secretion disrupt cellular calcium homeostasis, increase the cytosolic calcium level 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 increase in HDL create risks for the development of atherosclerosis, despite the beneficial effect on triglyceride concentrations. Furthermore, reducing the percentage 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 high carbohydrate diet (12% protein, 58% carbohydrates), the advantage of the former is evident. Studies have shown a loss of fat mass of up to 8 kg versus 4.
Modified protein-sparing diet
This high-protein and low-calorie diet with a caloric value<800 kcal/day, with a minimum of lipids and carbohydrates, it is highly appreciated in many European clinics.
The menu contains proteins in quantities equal to 1. 2 g/kg of body weight for women and 1. 4 g/kg of body weight for men. Diet therapy is carried out for a month under strict medical supervision. 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 modified protein-sparing diet affects individual 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 clearance of insulin and hepatic glucose release.
The essence of a modified protein-sparing 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. The 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 modified protein-sparing diet is a protein shake. In addition to being rich in proteins, these products also contain other nutrients necessary during the diet. When losing 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 achieve your desired weight. One sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, proteins, 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 insulin levels 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 successful in recent years, although they are far from new. Particularly popular is the Atkins diet, created by a cardiologist in 1973. 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. During the first two weeks, carbohydrate content is limited to 20 g/day, then 30 g/day. After reaching the desired body weight, the carbohydrate content gradually increases.
A serious controversy among scientists about this diet arises because of its high fat content. However, the amount of fat oxidized or stored depends on the difference between total energy needs 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 with carbohydrates, the storage of which in the form of glycogen is limited. Converting carbohydrates to fat also requires a lot of energy. Therefore, it can be assumed that their oxidation practically corresponds to consumption.
On the other hand, the possibilities for fat accumulation (especially in adipose tissue) are practically unlimited and the efficiency of this process is high.
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 smaller atherogenic effect than previously thought. It was also noted that a decrease in insulin hypersecretion was accompanied by an increase in insulin sensitivity. Therefore, this diet allows you to achieve the effect of the nature of the etiopathogenetic therapeutic intervention for type 2 diabetes mellitus.
The probable scientifically proven weight loss when maintaining a diet is 10% after 6 months. No serious consequences have yet been identified.
Other diets
- Alternating diet.It involves eating one type of food or completely abstaining from eating on set days. The effectiveness of this type of nutrition 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 involves the elimination 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.
- Hunger. A diet involves total abstention from food for a certain period of time. This is not a recommended method for losing weight, no matter how long it lasts. Fasting is especially dangerous for diabetics, people prone to depression, patients with vitamin and microelement deficiency and taking strong medications.
At all times, quack diets have been and will be popular, usually based on the seemingly unusual slimming 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 ineffective or dangerous. For example, diets based on grapes and bananas are guaranteed to lead to blood sugar spikes, exacerbating diabetes.
Which diet is best?
You can't choose your diet alone. The best option would be to contact an endocrinologist, who will select the right type of nutrition 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 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 treatment method will not give the result you would like to achieve.
But this doesn't mean you have to give up physical activity. Physical activity is important to slow weight gain and prevent its return. In addition, when losing extra pounds, it is important to strengthen the muscle structure, so the skin will not be flabby 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 catabolism;
- Reduces insulin resistance, improving carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sport and even simple walking, mood improves, blood circulation and air exchange in the tissues improve. Therefore, physical education with measured loads will always be an integral part of the complex treatment of excess weight and obesity.