The first method chosen 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.
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 even worsen the condition. Therefore, you should not rush for 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 stage of obesity, eating disorders, concomitant diseases and other important points. It is especially important to consider the presence of diabetes, gastrointestinal pathologies, problems with hematopoiesis and vitamin-mineral balance.
For example, patients with diabetes are strictly forbidden to fast or, on the contrary, eat a diet rich in carbohydrates. Anemic patients 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 muscular skeleton.
The nutrition plan is designed with a clear distribution of meals (3-5) and menu composition. Keeping a self-monitoring diary will help you monitor and modify the menu, where the patient must record all the food 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 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, it should take into account the patient's tastes. Otherwise, stress will add to obesity. Monotonous eating is a common cause of diet failure. The patient feels hungry, he is burdened by restrictions and his "soul seeks" relief. Eating a forbidden sweet or fatty food and having great pleasure, it is already difficult to stop. The brain immediately remembers how bad it was 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 vegetable 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 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 your appetite, the endocrinologist will prescribe a drug that affects the satiety center. 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.
Calorie restricted diets - classic diet
Diets that restrict calories 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 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 of them.
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. In relation to the current diet, a caloric deficit of 500 kcal/day is assumed, 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 combined with weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, with the subsequent accumulation of carbohydrates as easily as fat. Also, restrictive diets decrease thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets are mainly related to the psyche.
Low-carb, high-protein diet
Low-carb protein diets are an alternative to high-carb diets. Such diets are high in protein and fat 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-carb diet is immediate and so impressive that it becomes 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 glucose and sometimes lipid concentrations decrease.
Protein in the diet stimulates 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 of proteins to the 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 protein (25-30%).
Also, 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 the secondary increase in TSH secretion disrupt cellular calcium homeostasis, increase 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 the levels of uric acid and LDL and the lack of increase in HDL creates risks for the development of atherosclerosis, despite the beneficial effect on the concentration of triglycerides. Also, 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 carbohydrate diet (12% protein, 58% carbohydrates), the advantage of the former is obvious. Studies have shown a loss of fat mass of up to 8 kg versus 4.
Modified protein-sparing diet
This high-protein, very low-calorie, calorie-dense diet<800 kcal/day, with minimal lipids and carbohydrates, is very popular in many European clinics.
The menu contains proteins in an amount 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 strict medical supervision. Patients are prescribed additional 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-saving diet affects individual elements of the pathogenesis of type 2 diabetes:
- reduces endogenous hyperglycemia and hyperinsulinemia;
- increases lipid oxidation and sensitivity of peripheral tissues to insulin;
- reduces hepatic clearance of insulin and hepatic release of glucose.
The essence of a modified protein-sparing diet
This dietary option provides a sufficient amount of protein (about 50 g/day), which protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. 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 endogenous lipid burning.
One of the popular meal replacements during a modified protein-sparing diet is a protein shake. Besides being rich in protein, such products also contain other nutrients needed during the diet. When you lose weight, you need to reduce the total number of calories consumed. A protein shake offers a low calorie content, 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 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 diet
Such diets have been a hit in recent years, although they are by no means 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 and then to 30 g/day. After reaching the desired body weight, the carbohydrate content is gradually increased.
Serious debates among scientists about this diet arise because of the 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 have priority over lipids.
Alcohol is burned first, as the body cannot store it, and turning it into fat takes a lot of energy. The situation is similar with amino acids and proteins that perform functional functions and 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 (mainly in adipose tissue) are practically unlimited, and the efficiency 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 a less atherogenic effect than previously thought. It was also observed 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 scientifically proven potential weight loss when following a diet is 10% after 6 months. No serious consequences have yet been identified.
Other diets
- Alternative diet.It consists of eating one type of food or complete abstinence from eating on selected 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 means the removal 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 musculoskeletal system and poor health.
- starvation. A diet involves complete abstinence from food for a certain period of time. This is not a recommended method of losing weight, no matter how long it takes. Fasting is especially dangerous for diabetics, people prone to depression, patients with a lack of vitamins and trace elements and those taking strong medications.
At all times, fad diets have been and will be popular, usually based on the supposed unusual weight loss properties of certain foods, most often fruits. For example, the apple diet calls for eating only apples, the grape diet - grapes, the banana diet - bananas. Such diets are either ineffective or dangerous. For example, diets with grapes and bananas are guaranteed to lead to increased blood sugar, worsening diabetes.
Which diet is best?
You cannot choose your own diet. The best option would be to contact an endocrinologist, who will choose 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 process of losing weight has been significantly overestimated. Judge for yourself: losing 1 kg of weight requires great efforts, for example, 250 km of walking. And for many patients, such loads are simply prohibited due to accompanying pathologies. In other words, when you plan to lose weight, you should understand that only physical education as a treatment method will not give the result you want to get.
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 coming back. Also, when losing extra pounds, it is important to strengthen the muscle frame, then the skin will not be smooth 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 sports and even simple walking, your mood improves, blood circulation and air exchange in tissues improves. Therefore, physical education with moderate loads will always be an integral part of the complex treatment of overweight and obesity.