In the treatment of overweight or obesity, the first method of choice is a diet supplemented 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 offered to people 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 nutrition have contraindications and can even worsen the condition. Therefore, you should not rush with every new recipe that promises a slim figure.
Features of choosing a diet for obesity
When treating obesity, you must immediately abandon diets with a predetermined daily calorie intake. The diet must be individual, based on the stage of obesity, eating disorders, accompanying diseases and other important aspects. It is especially important to consider the presence of diabetes, gastrointestinal pathologies, blood formation problems and vitamin-mineral balance.
For example, diabetics are strictly forbidden to fast or, on the contrary, eat 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 can disrupt the growth and development of the musculoskeletal system.
The nutrition plan is compiled by clearly dividing the meals (3-5) and compiling the menu. Keeping a self-monitoring diary helps to monitor and modify the menu, where the patient must write down the food consumed daily in grams.
Important considerations when choosing a diet:
- Severe calorie restriction and nutritional deficiencies should be avoided. Suddenly reducing the energy content of the diet significantly, for example by half of the current value, produces impressive results, but not 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 increases obesity. Monotonous food is a common reason for diet failure. The patient feels hungry, burdened by restrictions, his "soul" demands relief. After eating forbidden sweet or fatty food and enjoying it, it is difficult to stop. The brain immediately reminds him how bad it was without "sweetness".
- The patient should drink a lot of water. You need to give up lemonade, sweet tea and alcohol.
An important element that limits appetite is vegetable fiber, which is involved in expanding the amount of food in the stomach and delaying its emptying. These substances also reduce the absorption of nutrients from the digestive system and speed up bowel movements. Therefore, almost all effective diets contain fruits and vegetables or additives that indicate satiety.
In difficult cases, if you cannot cope with your appetite, the endocrinologist prescribes a drug that affects the satiety center. When taking such tablets, the patient does not feel hungry. But it is important to understand that taking such drugs is limited by unpleasant side effects and many contraindications.
Low-calorie diets - classic diet
Calorie restriction diets 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 in 6 months, and by 10% after 18 weeks, however, after a year, every third patient returns to their previous weight, and after 3 years, almost all of them.
The essence of the classic diet
The classic diet is a high-carbohydrate diet whose calories correspond to the degree of overweight. 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 the current fat intake by 1/3. About 60% of the energy in this diet comes from carbohydrates, about 25% from fat, and 15% from protein.
Disadvantages, side effects and 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 its stimulation of insulin secretion, causing carbohydrates to accumulate as easily as fat. Furthermore, restrictive diets reduce thermogenesis and increase the body's energy efficiency, and are therefore ineffective. The side effects of restrictive diets are largely psychological.
A low-carbohydrate, high-protein diet
Low-carbohydrate protein diets are an alternative to high-carbohydrate 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-carbohydrate diet is immediate and so impressive that it provides additional motivation for the patient.
The essence of the protein diet
The diet is based on ketosis - the result of endogenous fat burning, 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, glycemia decreases, and in some cases lipid concentration also decreases.
Protein in the diet stimulates the release of glucagon, promoting a balance between insulinemia and glucagonemia. The feeling of fullness increases after eating, and this is due to the increased ratio of protein and energy obtained with food. It is important to understand that a high protein diet does not always mean a low calorie intake.
Disadvantages, side effects and long-term effects of the 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: grains, fruits, vegetables. On the contrary, the menu contains 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, folate, magnesium, iron, and potassium. The secondary increased secretion of calcium, vitamin D deficiency and TSH disturbs the calcium homeostasis of the cells, increases the level of cytosolic calcium, 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, as well as the lack of an increase in HDL, carries the risk of developing atherosclerosis, even despite the beneficial effect on triglyceride concentration. 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) and a carbohydrate-containing diet (12% protein, 58% carbohydrates), the advantage of the former is obvious. Studies have shown that fat mass is reduced to 8 kg compared to 4.
Protein-saving modified diet
This high protein, very low calorie, A diet with a caloric value of <800 kcal/day, with minimal lipid and carbohydrate content, is very popular in many European clinics.
The menu contains 1. 2 g/kg body weight for women and 1. 4 g/kg body weight for men. The diet therapy is carried out for one month under strict medical supervision. In addition, patients are prescribed vitamins. This diet will theoretically allow you to lose 90g of fat per day and lower your basal metabolic rate by 10-20%.
The protein-saving modified diet affects certain elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- increases lipid oxidation and insulin sensitivity of peripheral tissues;
- reduces hepatic insulin clearance and hepatic glucose release.
The essence of a protein-saving modified diet
This diet provides an adequate amount of protein (about 50 g/day), which protects the metabolic nitrogen balance and endogenous proteins from proteolysis. Low carbohydrate content limits insulin secretion and promotes fat breakdown. The energy difference between energy consumption and calorie intake (at least 650 kcal/day) is covered by the burning of endogenous lipids.
One of the popular meal replacements of the protein-saving modified diet is the protein shake. In addition to their high protein content, such products also contain other nutrients needed during the diet. When losing weight, you need to reduce the number of calories you eat. The protein shake is low in calories, allowing you to control your calorie intake and create a calorie deficit to reach your target weight. 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 can replace a meal and keep you full for 3-4 hours.
Decreased insulinemia and increased fat oxidation in the liver lead to the production of ketone bodies, which are energy materials for muscles and the brain, limit gluconeogenesis from protein substrates and reduce appetite.
A low-carb, high-fat diet
Such diets have been very successful in recent years, although they are by no means new. The Atkins diet, developed 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 dietary guidelines.
The essence of the Atkins diet
It's a low-carb, high-protein, high-fat diet. During the first two weeks, the carbohydrate content is limited to 20 g per day, and then to 30 g. After reaching the desired body weight, the carbohydrate content gradually increases.
There is serious debate among scientists about this diet because of 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 dietary components that have priority over lipids.
Alcohol is burned first, as 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 provide functional functions, as well as with 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 (primarily 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 less atherogenic effect than previously thought. They also noted that the decrease in insulin hypersecretion was accompanied by an increase in insulin sensitivity. Thus, this diet makes it possible to achieve the effect resulting from the nature of the etiopathogenetic therapeutic intervention of type 2 diabetes mellitus.
Scientifically proven probable weight loss with a diet of 10% after 6 months. No serious consequences have yet been identified.
Other diets
- A varied diet.This consists of eating certain types of food on certain days or abstaining from food altogether. 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 a single product such as boiled rice without salt, sugar and oil.
- Low fat diet.The composition of the diet includes the removal 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.
- Starvation. A diet involves complete abstinence from food for a certain period of time. This is not a recommended way to lose weight, no matter how long it takes. Fasting is especially dangerous for diabetics, people prone to depression, vitamin and micronutrient deficiencies, and those taking strong medications.
Fad diets have always been and will always be popular, usually based on the alleged unusual weight-loss properties of certain foods, most often fruits. For example, the apple diet prescribes only apples, the grape diet - grapes, the banana diet - bananas. Such diets are either ineffective or dangerous. For example, grape and banana diets are guaranteed to spike blood sugar levels, making diabetes worse.
Which diet is best?
You cannot choose your diet alone. The best solution is to consult an endocrinologist, who will select the appropriate diet based on the test results.
Physical activity is overrated due to overweight and obesity
The importance of physical activity in the process of losing weight is greatly overestimated. Judge for yourself: losing 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, you need to understand that physical education as a treatment method alone will not bring the result you want to achieve.
But that doesn't mean you have to stop being physically active. Exercise is important to slow weight gain and prevent weight gain from returning. It is also important to strengthen the muscle frame when losing extra kilos, then the skin will not become 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 the catabolism of muscle proteins;
- Reduces insulin resistance, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
Active sports and even a simple walk improve your mood, improve blood circulation and air exchange in the tissues. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.