The first method preferred in the treatment of overweight or obesity is a diet supported by physical activity. If weight loss does not occur later, other treatment options, including medical and surgical options, are used.
Today, hundreds of diets are offered to those who 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 worsen the situation. Therefore, you should not rush into 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, depending on the stage 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, diabetics are strictly prohibited from fasting or, on the contrary, eating a diet rich in carbohydrates. Patients with anemia should not give up meat and offal. Children need dairy products; Their exclusion from the menu threatens the growth and development of the musculoskeletal system.
The nutrition plan is prepared with a clear distribution of meals (3-5) and menu composition. Keeping a self-tracking diary will help you monitor and change the menu, in which the patient should write down in grams all the foods he eats daily.
Important points when choosing a diet:
- Severe calorie restrictions and nutrient 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 ensure long-term success. The weight will return within a year, if not sooner.
- The menu should not be monotonous, the patient's tastes should be taken into account. 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. "Once you have eaten a forbidden sweet or fatty food and enjoyed it greatly, it is already difficult to stop. The brain immediately reminds how bad everything is 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 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 from the digestive system and accelerate intestinal transit. That's why almost every effective diet includes fruits and vegetables or additives that signal satiety.
If you cannot cope with your appetite in difficult situations, the endocrinologist will prescribe a drug that affects the satiety center. The patient taking such pills 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.
Calorie restricted diets - classic diet
Diets that restrict calories are generally low in fat. The most popular of these types of diets is the classic one. It has been used for over 40 years and is recommended by most scientific communities, hence its name.
According to statistics, such a diet can reduce body weight by 10 kg in 6 months or 10% after 18 weeks, but after a year 1 in 3 patients returns to the previous body weight, and after 3 years almost all return to the previous body weight.
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 generally 1200-1500 kcal/day. For women, 1500-1800 kcal/day. for men. Regarding the current diet, a calorie deficit of 500 kcal/day is assumed while limiting current fat intake by 1/3. In this diet, approximately 60% of energy comes from carbohydrates, approximately 25% from fats, and 15% from proteins.
Disadvantages, side effects, long-term effects of the classic diet
The problem is that a high-carbohydrate diet is combined with weight gain empirically in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, after which carbohydrates accumulate as easily as fat. Additionally, restrictive diets reduce thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets are largely psyche-related.
Low-carb, protein-rich diets
Low-carb protein diets are an alternative to carbohydrate diets. These types of diets are high in protein and fat and low in carbohydrates (and therefore calories). This initially leads to weight loss due to the release of glycogen-bound water from the body.
The first effect of the low-carb diet is immediate and so impressive that it becomes an additional motivation for the patient.
The essence of the protein diet
The diet is based on ketosis, which is the result of burning endogenous fats, 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 and sometimes lipid concentrations decrease.
Dietary protein stimulates glucagon release, facilitating the balance between insulinemia and glucagonemia. The feeling of fullness increases after eating, and this is due to the increased ratio of protein to energy obtained from food. However, it is important to understand that a high-protein diet does not always mean low calorie intake.
Disadvantages, side effects, long-term effects of 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 that are high in fat (55-60%) and animal protein (25-30%).
Additionally, a high-protein diet is often 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, increasing the cytosolic calcium level, which can stimulate many 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 pose a risk for the development of atherosclerosis, despite its beneficial effect on triglyceride concentrations. Additionally, reducing fiber in the diet also causes constipation.
At the same time, when the effectiveness of the protein diet (containing 25% protein, 45% carbohydrates) is compared with the carbohydrate diet (containing 12% protein, 58% carbohydrates), the advantage of the first is obvious. Studies have shown a loss in fat mass of up to 8 kg compared to 4.
Protein-sparing modified diet
Caloric value, containing minimal lipids and carbohydratesThis high protein, very low calorie diet, <800 kcal/day, is very popular in many European clinics.
The menu contains protein in the amount of 1. 2 g/kg body weight for women and 1. 4 g/kg body weight for men. Dietary therapy is carried out for a month under strict medical supervision. Patients are also given vitamin prescriptions. This diet theoretically allows you to lose 90g of fat per day and reduce your basal metabolism by 10-20%.
A protein-sparing modified diet affects individual elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- increases lipid oxidation and sensitivity of peripheral tissues to insulin;
- It reduces hepatic insulin clearance and hepatic glucose release.
The essence of the protein-sparing modified diet
This dietary option provides a sufficient amount of protein (approximately 50 g/day) that protects the nitrogen balance of the metabolism and endogenous proteins from proteolysis. Its low carbohydrate content restricts insulin secretion and promotes lipolysis. The energy difference between energy expenditure and calorie intake (at least 650 kcal/day) is met by burning endogenous lipids.
One popular meal replacement during a modified diet that preserves protein is a protein shake. In addition to being high in protein, such products also contain other nutrients needed during the diet. When losing weight, you need to reduce the total amount of calories consumed. Protein shakes offer a low-calorie content, 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 number 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 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-carb, high-fat diets
Although these types of diets are not new, they have become very popular in recent years. The Atkins diet, created by a cardiologist in 1973, is especially popular. R. Atkins' book on healthy eating has sold more than 10 million copies. It is read four times more frequently in European countries than any other dietary guide.
The essence of the Atkins diet
This is a low-carb, high-protein, high-fat diet. Carbohydrate content is limited to 20 g/day for the first two weeks, and 30 g/day thereafter. After reaching the desired body weight, the carbohydrate content gradually increases.
Serious controversy arises among scientists regarding this diet due to 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 other dietary components that take priority over lipids.
Since alcohol cannot be stored by the body, it is first burned and converting it into fat requires a lot of energy. The situation is similar for amino acids and proteins that perform functional functions and carbohydrates, which have limited storage in the form of glycogen. Converting carbohydrates into 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 of accumulating fat (primarily in adipose tissue) are almost 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; this may result in less atherogenic effects than previously thought. It was also noted that the decrease in excessive insulin secretion 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.
The scientifically proven possible weight loss while following the diet is 10% after 6 months. No serious consequences have been detected yet.
Other diets
- Alternative diet.It consists of eating one type of food on certain days or abstaining from it 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 even more difficult to eat a single product, for example, boiled rice without salt, sugar and oil.
- Low fat diet.The composition of the diet includes the elimination of all meat and dairy products, vegetable oils, fish and in general all products containing any fat. Long-term adherence to such a diet leads to anemia, weakening of the structure of the musculoskeletal system and deterioration of health.
- Hunger. The diet involves complete abstinence from food for a certain period of time. No matter how long it takes, this is not a recommended weight loss method. Fasting is especially dangerous for diabetics, people prone to depression, patients with vitamin and microelements deficiencies, and patients taking strong medications.
Quack diets have always been popular and will always be popular; It is often based on the supposedly unusual weight-loss properties of certain foods, most often fruits. For example, the apple diet requires eating only apples, the grape diet requires eating grapes, and the banana diet requires eating bananas. Such diets are either ineffective or dangerous. For example, grape and banana diets are guaranteed to aggravate diabetes by causing spikes in blood sugar.
Which diet is best?
You cannot choose your diet on your own. 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 exaggerated. 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. So, when planning to lose weight, you must understand that physical education alone as a treatment method will not give you the result you want.
But this does not mean that you should give up physical activity. Physical activity is important to slow weight gain and prevent weight gain from returning. It is also important to strengthen the muscle frame when losing excess weight, then the skin will not sag and sag.
Physical activity has a beneficial effect on the entire body - this applies to both overweight and underweight people.
Gymnastics:
- Preserves muscle mass during weight loss by preventing the catabolism of muscle proteins;
- Reduces insulin resistance, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports or even simple walking, your mood improves, blood circulation and air exchange in the tissues improve. Therefore, physical training with measured loads will always be an integral part of the complex treatment of overweight and obesity.