The first method of choice in the treatment of overweight or obesity is a diet supplemented by 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 people who are losing weight, but only a few of them are officially recognized. It is proven that there is no universal and ideal diet. Many types of nutrition have contraindications and can even aggravate the situation. 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, diabetic patients are strictly prohibited from fasting or, conversely, following a diet rich in carbohydrates. Patients suffering from 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 nutritional plan is established with a clear distribution of meals (3-5) and the composition of the menus. Keeping a self-monitoring diary will help you monitor and change the menu, where the patient should write down all foods consumed daily in grams.
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, or even sooner.
- The menu should not be monotonous; he must take into account the patient's tastes. Otherwise, stress will add to obesity. Monotonous eating is a common cause of eating failure. The patient is hungry, he is 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 recalls how bad it was without the "candies".
- 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 participates in the mechanism of increasing 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 all effective diets contain fruits and vegetables or additives that signal satiety.
In difficult cases, if you cannot control your appetite, the endocrinologist will prescribe a drug that affects the satiety center. While 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 diet. It has been used for over 40 years and is recommended by most scientific societies, hence the 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 its 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. Compared to the current diet, we assume a calorie deficit of 500 kcal/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 associated with weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, with the subsequent accumulation of carbohydrates as easily as fats. Additionally, restrictive diets reduce thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets are largely linked to the psyche.
Low-Carb, High-Protein Diets
Low-carb protein diets are an alternative to carbohydrate diets. These diets are high in protein and fat and low in carbohydrates (and therefore calories). This leads to weight loss, initially dependent on the body's release of glycogen-bound water.
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 a protein diet
The diet is based on ketosis, the result of burning endogenous fats, 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, blood sugar levels and sometimes lipid concentrations decrease.
Proteins present in the diet stimulate the release of glucagon, thus facilitating the balance between insulinemia and glucagonemia. The feeling of fullness increases after eating, due to the increased protein-to-energy ratio obtained from food. It is important to understand that a diet high in protein does not always mean low calorie intake.
Disadvantages, side effects, long-term effects of a protein diet
Unfortunately, there isn't 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 fats (55-60%) and animal proteins (25-30%).
Additionally, a high-protein diet is generally associated with 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 increased secondary secretion of TSH disrupt cellular calcium homeostasis, increase cytosolic calcium level, which can stimulate several adverse 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 lack of increase in HDL create risks for the development of atherosclerosis, even despite the beneficial effect on triglyceride concentrations. Additionally, 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 first is obvious. Studies have shown a loss of fat mass of up to 8 kg compared to 4.
Modified Protein-Sparing Diet
This high protein and very low calorie diet, with a caloric value<800 kcal/day, with minimal fat and carbohydrates, is very popular in many European clinics.
The menu contains protein at the rate of 1. 2 g/kg of body weight for women and 1. 4 g/kg of body weight for men. The diet is carried out for one 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 to 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 peripheral tissue sensitivity to insulin;
- reduces hepatic insulin clearance and hepatic glucose release.
The Essence of a Modified Protein-Sparing Diet
This dietary option provides a sufficient quantity of protein (around 50 g/day), which protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. Low carbohydrate restricts insulin secretion and promotes lipolysis. The energy difference between energy expenditure and caloric intake (at least 650 kcal/day) is covered by the combustion of endogenous lipids.
One of the most popular meal replacements when following a modified protein-sparing diet is a protein shake. In addition to being rich in protein, these products also contain other nutrients necessary for the diet. When you lose weight, you need to reduce the total number of calories consumed. A protein shake offers low calories, allowing you to control your calorie intake and create a calorie deficit to reach your goal weight. One sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and a whole vitamin complex. A serving of this cocktail can replace a meal and keep you full for 3 to 4 hours.
A decrease in insulinemia and an increase in 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-carb, high-fat diets
Such diets have enjoyed great success in recent years, although they are far from new. The Atkins diet, 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. During the first two weeks, the carbohydrate content is limited to 20 g/day, 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 fats oxidized or stored depends on the difference between the total energy requirement and the oxidation of other food components which take precedence over lipids.
Alcohol is burned first, because the body cannot store it, and turning it into fat requires a lot of energy. The situation is similar for amino acids and proteins that perform functional functions, as well as carbohydrates whose storage as glycogen is limited. Converting carbohydrates to fats also requires a lot of energy. Thus, we can assume that their oxidation practically corresponds to their consumption.
On the other hand, the possibilities for fat accumulation (mainly in adipose tissue) are practically unlimited and the effectiveness 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 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.
The probable, scientifically proven weight loss when maintaining a diet is 10% after 6 months. No serious consequences have yet been identified.
Other diets
- Alternate feeding.This involves eating one type of food or completely abstaining from eating on certain 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 just 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 fat-containing products. Long-term adherence to such a diet leads to anemia, weakening of the musculoskeletal system and poor health.
- Famine. A diet involves completely abstaining from eating for a certain period of time. This is not a recommended method for losing weight, no matter how long this method lasts. Fasting is especially dangerous for diabetics, people prone to depression, patients suffering from a lack of vitamins and microelements and taking potent medications.
Throughout history, quack diets have been and will be popular, usually based on the allegedly 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 either ineffective or dangerous. For example, grape and banana diets will definitely cause blood sugar spikes, making diabetes worse.
Which diet is best?
You cannot choose your own diet. 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 in cases of overweight and obesity
The importance of physical activity in the weight loss process is largely 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 need to understand that physical education alone as a method of treatment will not give the result that you would like to achieve.
But that doesn't mean you have to give up physical activity. Physical activity is important to slow down weight gain and prevent its return. In addition, when losing extra pounds, it is important to strengthen the muscle structure, so that the skin does not become 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 muscle protein catabolism;
- Reduces insulin resistance, improving carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports and even just 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.