The first method of choice for treating overweight or obesity is diet supplemented with physical activity. Then, if the weight doesn't come off, other treatment options are pursued, including medical and surgical options.
Today, hundreds of diets are offered for slimming, 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 to every new recipe that promises a slim figure.
Features of choosing an obesity diet
When treating obesity, you should immediately abandon diets with a predetermined amount of daily calories. Nutrition should be individualized, taking into account the stage of obesity, eating disorders, co-morbidities and other important factors. It is especially important to consider diabetes, pathologies of the digestive tract, hematopoiesis and vitamin-mineral balance problems.
For example, it is strictly forbidden for patients with diabetes to starve or, on the contrary, to eat foods containing a lot of carbohydrates. Anemic patients 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 made by clearly dividing the dishes (3-5) and the composition of the menu. Keeping a self-monitoring diary will help to monitor and change the menu, where the patient must write down all the food items eaten daily in grams.
Important points when choosing a diet:
- Severe calorie restriction and nutritional deficiencies should be avoided. A sudden, significant reduction in dietary energy, such as halving the current value, will produce 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 will increase obesity. Monotonous food is a common cause of diet failure. The patient feels hungry, he is oppressed by restrictions, his "soul demands" relief. After eating forbidden sweet or fatty food and getting great pleasure, it is already difficult to stop. The brain immediately reminds how bad it was without "candy".
- The patient should drink plenty of water. You will have to give up lemonade, sweet tea and alcohol.
An important appetite-limiting element is vegetable 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 speed up bowel movement. Therefore, almost every effective diet contains fruits and vegetables or supplements that signal satiety.
In severe cases, if you cannot cope with your appetite, the endocrinologist will prescribe a drug that affects the satiety center. When taking such pills, the patient does not feel hungry. However, it is important to understand that the use of such drugs is limited by unpleasant side effects and many contraindications.
Restricted calorie diets are a 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 many scientific societies, 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 every 3 patients return to their previous body weight, and after 3 years - almost all of them.
The essence of the classic diet
A classic diet is a high-carbohydrate diet with a caloric content corresponding to the degree of overweight. The energy value is usually 1200-1500 kcal per day. for women and 1500-1800 kcal/d. for men. Regarding the current diet, a caloric deficit of 500 kcal per day is assumed, and the current fat intake is limited to 1/3. During this diet, about 60% of energy comes from carbohydrates, about 25% from fat and 15% from protein.
Disadvantages of the classic diet, side effects, long-term effects
The problem is that a high-carbohydrate diet is empirically associated with weight gain through postprandial hyperglycemia and its stimulation of insulin secretion, and then carbohydrates accumulate as easily as fat. Also, restrictive diets reduce thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets are mostly mental.
Low-carb, high-protein diets
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 fast and so impressive that it becomes an additional motivation for the patient.
The essence of the protein diet
The basis of the diet is ketosis, the result of endogenous fat burning, which reduces appetite. The second factor is the monotony of the menu. As a result, the body's need for insulin decreases, glycemia decreases, and sometimes lipid concentration decreases.
Dietary protein stimulates the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of satiety increases after a meal, which is due to the increased ratio of protein to dietary energy. However, it is important to understand that a high-protein diet does not always mean a low-calorie diet.
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 there is no healthy food in it: grains, fruits, vegetables. In contrast, the menu contains many ingredients that are high in fat (55-60%) and animal protein (25-30%).
In addition, a high-protein diet is commonly associated with calcium loss and decreased levels of vitamins E, A, B. 1, B6, folate, magnesium, iron, and potassium. Calcium, vitamin D deficiency, and secondary increased TSH secretion disrupt cellular calcium homeostasis, increase cytosolic calcium, which may induce several adverse metabolic pathways, including lipid synthesis in adipose tissue.
The long-term effects of such a diet on the body are also unknown. The observed increase in uric acid and LDL concentrations and the absence of an increase in HDL risk the development of atherosclerosis, even despite the positive effect on triglyceride concentrations. In addition, reducing the amount of fiber in the diet leads to constipation.
At the same time, comparing the effectiveness of a protein diet (which contains 25% protein, 45% carbohydrates) with a carbohydrate diet (12% protein, 58% carbohydrates), the advantage of the first is obvious. Studies have shown that fat mass has decreased to 8 kg compared to 4.
Protein-saving modified diet
This high-protein, very low-calorie diet with<800 kcal/day, with minimal lipids and carbohydrates, is very popular in many European clinics.
Protein in the menu is 1. 2 g/kg of body weight for women and 1. 4 g/kg of body weight for men. Diet therapy is carried out for a month under the strict supervision of a doctor. Patients are additionally given vitamins. This diet theoretically allows you to lose 90 g of fat per day and reduce your basal metabolic rate by 10-20%.
A protein-saving modified diet affects individual 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-sparing modified diet
This diet option provides a sufficient amount of protein (about 50 g/day), which protects the metabolic nitrogen balance and endogenous proteins from proteolysis. Low carbohydrate intake limits insulin secretion and promotes lipolysis. The energy difference between energy expenditure and caloric intake (at least 650 kcal per day) is covered by burning endogenous lipids.
One of the most popular meal replacements during a protein-saving modified diet is a protein shake. Such products contain not only a lot of protein, but also other nutrients needed during the diet. Losing weight requires reducing the total number of calories consumed. A protein shake is low in calories, so you can control your calorie intake and create a calorie deficit to reach your goal. One packet contains 39 kcal. The shake also contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and vitamins of the whole complex. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
Decreased insulinemia and increased fat oxidation leads to the production of ketone bodies in the liver - an energy substance for muscles and brain, limits gluconeogenesis from protein substrates and reduces appetite.
A low-carb, high-fat diet
Such diets have been popular in recent years, although they are far from new. The Atkins diet, which was 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 than all other diet guides.
The essence of the Atkins diet
It's a low-carb, high-protein, high-fat diet. Carbohydrates are limited to 20 g per day for the first two weeks, and then to 30 g per day. After reaching the desired body weight, the amount of carbohydrates is gradually increased.
Serious controversy among scientists regarding this diet is due to the 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 food components that prevail over lipids.
First, alcohol is burned because the body cannot store it, and turning it into fat requires a lot of energy. A similar situation exists 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 (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, so the atherogenic effect may be less than previously thought. Decreased insulin hypersecretion was also observed to increase insulin sensitivity. Thus, this diet makes it possible to achieve the nature of etiopathogenetic therapeutic intervention in type 2 diabetes.
The scientifically proven expected weight loss on the diet after 6 months is 10%. So far, no serious consequences have been identified.
Other diets
- Changing diet.It consists of eating one type of food or completely abstaining from food 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 eliminating all meat and dairy products, vegetable oils, fish and, in general, all products containing any fat. Long-term adherence to such a diet causes anemia, weakens the framework of the musculoskeletal system, and worsens 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 lasts. Fasting is especially dangerous for people with diabetes, depression, patients who lack vitamins and microelements, and take strong drugs.
Quack diets have always been and will be popular, usually based on the supposedly unusual weight-loss properties of certain foods, mostly fruits. 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 raise blood sugar levels, making diabetes worse.
What diet is best?
You cannot choose the diet yourself. 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 due to overweight and obesity
The importance of physical activity in the process of losing weight is greatly overestimated. Judge for yourself: to lose 1 kg of weight requires a huge effort, for example, to walk 250 km. And for many patients, such loads are simply prohibited due to concomitant pathologies. In other words, when planning to lose weight, you should 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. Also, when getting rid of extra pounds, it is important to strengthen the muscle frame, then the skin will not be loose and flabby.
Physical activity has a positive 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, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
Active sports and even simple walking improve mood, improve blood circulation and air circulation in tissues. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.