The first method of choice for treating overweight or obesity is 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 want to lose weight, but only some 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 to every new recipe that promises a slim figure.
Aspects of diet selection for obesity
When treating obesity, you should immediately abandon diets with a predetermined daily calorie intake. The diet should be individual, based on the degree 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, patients with diabetes are strictly forbidden to fast or, conversely, eat a diet high in carbohydrates. Patients with anemia should not give up meat and offal. Babies need dairy products;
The nutrition plan is drawn up with a clear distribution of meals (3-5) and menu composition. A self-monitoring diary will help you monitor and modify the menu, where the patient must write down all the foods he eats daily in grams.
Important points when choosing a diet:
- Severe calorie restriction 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 give great results, but will not provide long-term success. The weight will return within a year, if not sooner.
- The menu should not be monotonous; the patient's taste should be taken into account. Otherwise, stress will contribute to obesity. Monotonous food is a common cause of diet failure. The patient feels hungry, he is burdened with restrictions and his soul demands relief. After eating forbidden sweet or fatty food and getting great pleasure, it is already difficult to stop. The brain immediately remembers how bad it was without the "sweets. "
- The patient should drink a lot of water. You will need to bring lemonade, sweet tea and alcohol.
An important element that limits appetite is plant fiber, which is involved in the mechanism of expanding the amount 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, there are fruits and vegetables or additives in almost all effective diets that show 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 some contraindications.
Calorie restricted diets - classic diet
Diets that restrict calories are usually low in fat. The most common such diet is the classic one. It has been used for more than 40 years and has been recommended by most scientific societies, which is why it got its name.
According to statistics, such a diet can reduce body weight by 10 kg in 6 months or 10% after 18 weeks, however, after a year, every 3rd patient returns to their previous body weight, and after 3year, almost every.
The essence of the classic diet
The classic diet is a high-carbohydrate diet with calories corresponding to the amount of excess weight. The energy value is usually 1200-1500 kcal per day. for women and 1500-1800 kcal / day. for the men. Regarding the current diet, it is assumed that there is a caloric deficit of 500 kcal per day, and to limit the current fat intake by 1/3. In this diet, about 60% of the energy comes from carbohydrates, about 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 empirically associated with weight gain in the postprandial hyperglycemia mechanism and its stimulation of insulin secretion, with the accumulation of carbohydrates as easily as fat. Also, restrictive diets reduce thermogenesis and increase the body's energy efficiency, and are therefore ineffective. The side effects of restrictive diets are mostly related to the psyche.
Low-carb, protein-rich diets
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 results in 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 an additional motivation for the patient.
The essence of 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 is reduced, glycemia is reduced, and sometimes lipid concentration is reduced.
Protein in the diet stimulates the release of glucagon, which facilitates 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. It is important to understand, however, that a high protein diet does not always mean a 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 there are no healthy foods: grains, fruits, vegetables. On the contrary, the menu contains many ingredients that are high 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. Calcium deficiency, vitamin D and secondary increased secretion of TSH disrupt cellular calcium homeostasis, increase cytosolic calcium level, 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 and lack of increased HDL pose risks for the development of atherosclerosis, even despite the beneficial effect on triglyceride concentration. Also, a reduction in the content of fiber in the diet leads to constipation.
At the same time, comparing the effectiveness of a protein diet (containing protein 25%, carbohydrates 45%) with a carbohydrate diet (protein 12%, carbohydrates 58%), the benefit of the first one is obvious. Studies have shown a loss of up to 8 kg per 4 fat mass.
Protein-sparing modified diet
This high-protein, very low-calorie, low-calorie diet is very popular. <800 kcal per day, with minimal lipids and carbohydrates, in many European clinics.
The menu contains protein 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 also prescribed 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-enriched diet affects individual aspects of the pathogenesis of type 2 diabetes:
- reduces endogenous hyperglycemia and hyperinsulinemia;
- improves lipid oxidation and peripheral tissue sensitivity to insulin;
- decreases hepatic insulin clearance and hepatic glucose release.
The essence of a modified diet that saves protein
This dietary choice provides a sufficient amount of protein (about 50 g / day), which protects the nitrogen balance of the metabolism and the endogenous proteins from proteins. Low carbohydrate content restricts insulin secretion and promotes lipolysis. The energy difference between energy expenditure and calorie intake (at least 650 kcal per day) is covered by endogenous lipid burning.
One of the common meal replacements during a protein-enriched modified diet is a protein shake. In addition to high protein, such products also contain other nutrients required during the diet. When losing weight, you must 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 sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and a complete vitamin complex. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
Reduced insulinemia and increased fat oxidation are the result of the production of ketone bodies in the liver - energy material for muscles and brain, limiting gluconeogenesis from protein substrates and appetite decreases.
low-carbohydrate, high-fat diets
Such diets have been popular 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 dietary guidelines.
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 will gradually increase.
This diet causes serious controversy among scientists because of its high fat content. However, the amount of fat that is oxidized or stored depends on the difference between the total energy requirement and the oxidation of other dietary components that prioritize lipids.
Alcohol is burned first, since the body cannot store it, and it takes a lot of energy to turn it into fat. 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. Therefore, 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 almost limitless, and the effectiveness of this process is amazing.
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 noted that an increase in insulin sensitivity was accompanied by a decrease in insulin hypersecretion. Therefore, this diet can achieve the effect of the nature of etiopathogenetic therapeutic intervention for diabetes mellitus type 2.
scientifically proven probable weight loss when maintaining a 10% diet after 6 months. No serious consequences have yet been identified.
other diets
- Alternative diet.It consists of eating one type of food or completely abstaining from eating it on selected days. The effectiveness of this type of diet 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 elimination of all meat and dairy products, vegetable oils, fish and, in general, all products containing any fats. Long-term adherence to such a diet results in anemia, weakening of the musculoskeletal frame, and poor health.
- Hunger. A diet involves completely abstaining from food for a certain period of time. This is not a recommended method of losing weight, no matter how long it lasts. Fasting is especially dangerous for diabetics, people prone to depression, patients with a lack of vitamins and microelements, and taking strong medications.
Always, there have been and will be popular fad diets, usually based on the unusual weight loss properties of certain foods, most often results. 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, grape and banana diets are guaranteed to cause spikes in blood sugar, which contributes to diabetes.
Which diet is best?
You cannot choose your diet by yourself. The best option is 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 is significantly overestimated. Judge for yourself: losing 1 kg of weight requires a huge effort, for example, 250 km of walking. And for many patients, such loads are simply prohibited due to concomitant pathologies. In other words, when you are planning to lose weight, you should understand that physical education alone as a treatment method will not give you the result you want to get.
But this does not mean that you need to give up physical activity. Physical activity is important to slow weight gain and prevent weight gain. Also, when losing extra pounds, it is important to strengthen the muscle frame, then the skin will not be 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 inhibiting the catabolism of muscle proteins;
- It reduces insulin resistance, improving carbohydrate and lipid metabolism;
- Normalizes blood pressure.
Active sports and even simple walking improve your mood, improve blood circulation and air exchange in tissues. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.