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 options are used, including medical and surgical options.
Currently, hundreds of diets are offered to those who are losing weight, but only a few 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 with every new recipe that promises a slim body shape.
Features of choosing a diet for obesity
When dealing with obesity, you should immediately abandon a diet with a predetermined daily calorie intake. The diet should be individualized, based on the phase of obesity, eating disorders, comorbidities and other important points. It is very important to take into account the presence of diabetes, gastrointestinal pathology, problems of hematopoiesis and vitamin-mineral balance.
For example, diabetes sufferers are strictly prohibited from fasting or otherwise consuming foods high in carbohydrates. Anemia sufferers should not give up meat and offal. Children need dairy products; eliminating them from the menu can disrupt the growth and development of the musculoskeletal framework.
A nutritional plan is drawn up with a clear division of foods (3-5) and menu composition. Keeping a self-monitoring diary will help you monitor and modify the menu, where the patient should write down all the foods eaten every day 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 food, for example by half the current value, will give impressive results, but will not provide long-term success. The weight will return within a year, or even faster.
- The menu should not be monotonous; must take into account the patient's taste. Otherwise, stress will increase obesity. Monotonous foods are a common cause of diet failure. The patient feels hungry, burdened by restrictions and "his soul demands" relief. After eating prohibited sweet or fatty foods and getting incredible pleasure, it is already difficult to stop. The brain immediately reminds how bad it would be without "sweets".
- The patient should drink plenty of water. You should stop drinking lemonade, sweet tea and alcohol.
An important element that limits appetite is plant fiber, which plays a role in the mechanism of expanding the volume of food in the stomach and delays its emptying. They 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 additional ingredients that signal satiety.
In difficult cases, if you cannot overcome your appetite, the endocrinologist will prescribe drugs that affect the satiety center. By taking these pills, 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 a number of contraindications.
Calorie restricted diet - classic diet
Diets that restrict calories are usually 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, which is why it got its name.
According to statistics, such a diet can reduce weight by 10 kg in 6 months or 10% after 18 weeks, however, after a year, every 3rd patient returns to his previous weight, and after 3 years, almost all of them lose weight.
The essence of the classic diet
The classic diet is a high-carbohydrate diet with a number of calories appropriate to the degree of overweight. The energy value is usually 1200-1500 kcal/day. for women and 1500-1800 kcal/day. for men. In relation to current dietary patterns, a caloric deficit of 500 kcal/day is assumed, 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 high-carbohydrate diets are empirically combined with weight gain in the mechanism of postprandial hyperglycemia and stimulation of insulin secretion, followed by the accumulation of carbohydrates as easily as fat. In addition, restrictive diets reduce thermogenesis and increase the body's energy efficiency, making them ineffective. The side effects of crash diets are mostly mental.
Low carbohydrate and protein rich diet
A low carbohydrate protein diet is an alternative to a carbohydrate diet. Such a diet is high in protein and fat and low in carbohydrates (and therefore calories). This leads to weight loss, which initially relies on the release of glycogen-bound water from the body.
The initial effects of a low-carbohydrate diet are immediately visible and so impressive that they provide additional motivation for patients.
The essence of a protein diet
This diet is based on ketosis - the result of endogenous fat burning, which leads to a decrease in appetite. The second factor is a monotonous menu. As a result, the body's need for insulin decreases, glycemia, and sometimes lipid concentrations decrease.
Protein in food stimulates the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of fullness increases after eating, this is due to an increase in the ratio of protein to energy obtained from food. It is important to understand that a high protein diet does not necessarily 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 high-protein diets. And it does not contain healthy foods: grains, fruits, vegetables. On the other hand, the menu contains many ingredients high in fat (55-60%) and animal protein (25-30%).
In addition, 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. Deficiency of calcium, vitamin D and increased secondary TSH secretion disrupts cellular calcium homeostasis, increases cytosolic calcium levels, and this can stimulate several unfavorable 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 the absence of an increase in HDL pose a risk of developing atherosclerosis, despite a beneficial effect on triglyceride concentrations. In addition, a reduction in 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 a protein diet are clearly visible. Research shows a loss of fat mass of up to 8 kg versus 4.
Protein-saving modified diet
High protein diet, very low in calories by calorific value<800 kcal/day, with minimal lipids and carbohydrates, is very popular in many European clinics.
The menu contains protein 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 basal metabolism by 10-20%.
A protein-sparing modified diet affects individual elements of the pathogenesis of type 2 diabetes:
- reduces endogenous hyperglycemia and hyperinsulinemia;
- increases lipid oxidation and peripheral tissue sensitivity to insulin;
- reduces hepatic insulin clearance and hepatic glucose release.
The essence of the protein-sparing modified diet
This dietary option provides adequate amounts of protein (approximately 50 g/day), which protects metabolic nitrogen balance and endogenous protein from proteolysis. Low carbohydrate content limits insulin secretion and increases lipolysis. The energy difference between energy expenditure and caloric intake (at least 650 kcal/day) is covered by endogenous lipid burning.
One popular food replacement during a modified protein-saving diet is a protein shake. Apart from being high in protein, this product also contains other nutrients needed during a diet. When losing weight, you need to reduce the total number of calories consumed. Protein shakes offer low calorie content, allowing you to control your calorie intake and create a calorie deficit to reach your target weight. One sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and a vitamin complex. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
Reducing insulinemia and increasing fat oxidation lead to the production of ketone bodies in the liver - energy material for muscles and brain, limiting gluconeogenesis from protein substrates and reducing appetite.
Low carbohydrate and high fat diet
This type of eating pattern has become a trend in recent years, although it is nothing new. The Atkins diet, created by a cardiologist in 1973, is very popular. R. Atkins' books on healthy eating have sold more than 10 million copies. In European countries, it is read four times more often than other diet guides.
The essence of the Atkins diet
This is a low-carbohydrate, high-protein, high-fat diet. During the first two weeks, the carbohydrate content is limited to 20 g/day, and then to 30 g/day. After reaching the desired weight, the carbohydrate content gradually increases.
Serious controversy among scientists regarding this diet arises due to its high fat content. However, the amount of fat oxidized or stored depends on the difference between total energy requirements and the oxidation of other food components that take precedence over lipids.
Alcohol is burned first because the body cannot store it, and converting it to fat requires a lot of energy. A similar situation occurs with amino acids and proteins that perform functional functions, and carbohydrates, the storage of which in the form of glycogen is limited. Converting carbohydrates to fat also requires a lot of energy. Thus, it can be assumed that its oxidation is practically related 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 very 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 less atherogenic effects than previously thought. It is also known that a decrease in insulin hypersecretion is accompanied by an increase in insulin sensitivity. Thus, this diet makes it possible to achieve the effect of therapeutic interventions of an etiopathogenetic nature in type 2 diabetes mellitus.
The scientifically proven chance of losing weight by maintaining a healthy diet is 10% after 6 months. No serious consequences have been identified.
Other diets
- Alternate eating patterns.It consists of eating one type of food or not eating at all on certain 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, 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 implies 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 frame, and poor health.
- Hunger. Dieting involves abstaining from food completely for a certain period of time. This is not a recommended method for losing weight, no matter how long it takes. Fasting is especially dangerous for diabetics, people prone to depression, patients lacking vitamins and microelements, and those taking potent medications.
During this time, quack diets have been and will be popular, usually based on the unusual weight loss properties of certain foods, most often fruits. For example, the apple diet requires eating only apples, the grape diet - grapes, the banana diet - bananas. Such diets are ineffective or dangerous. For example, a diet of grapes and bananas is guaranteed to cause blood sugar spikes, thereby worsening diabetes.
Which diet is best?
You can't choose your own diet. The best option is to contact an endocrinologist, who will select the right type of nutrition based on the examination results.
Physical activity is overestimated for overweight and obesity
The importance of physical activity in the weight loss process is overstated. Judge for yourself: losing 1 kg of weight requires a lot of effort, for example, walking 250 km. And for many patients, such loads are prohibited due to the accompanying pathology. In other words, when planning to lose weight, you must understand that physical education alone as a method of treatment will not give you the results you want.
But that doesn't mean you have to stop doing physical activity. Physical activity is important for slowing weight gain and preventing weight gain again. In addition, when losing extra pounds, it is important to strengthen the muscle frame, so that the skin does not become flabby and saggy.
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 muscle protein catabolism;
- Reduces insulin resistance, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports and even simple walking, your mood improves, blood circulation and air exchange in tissues improve. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.