The first method of choice for treating overweight or obesity is diet with added 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 a few of them are officially recognized. It has been proven that there is no universal and ideal diet. Many types of food have contraindications and can even worsen the condition. Therefore, you should not rush to every new recipe that promises a slim figure.
Peculiarities of choosing an obesity diet
When treating obesity, you should immediately abandon a diet with a predetermined daily calorie intake. The diet should be individual, taking into account the phase of obesity, eating disorders, concomitant diseases and other important points. It is especially important to consider diabetes, gastrointestinal pathologies, hematopoiesis and vitamin-mineral balance problems.
For example, people with diabetes are strictly prohibited from fasting or, conversely, a diet rich in carbohydrates. Patients with anemia should not leave meat and offal. Children need to remove them from the menu of dairy products due to the delay in the growth and development of the muscular skeleton.
The meal plan is made up of meals (3-5) and menu composition with a clear distribution. Keeping a self-monitoring diary will help to monitor and change the menu, where the patient should record all the food eaten daily 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 of the current value, will produce impressive results, but does not provide long-term success. The weight will come back within a year, if not sooner.
- The menu should not be monotonous, it should take into account the patient's taste. Otherwise, stress will add to obesity. Monotonous foods are a common cause of diet failure. The patient feels hunger, he is burdened by restrictions, and his "soul asks" for relief. When eating forbidden sweet or fatty food and having a great pleasure, it is already difficult to stop. The brain immediately remembers how bad it was without "sweets".
- The patient should drink a lot of water. You will have to give up lemonade, sweet tea and alcohol.
An important element that limits appetite is vegetable fiber, which participates 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 all effective diets contain fruits and vegetables or supplements that signal satiety.
In difficult cases, if you cannot handle your appetite, the endocrinologist will prescribe a drug that affects the satiety center. When 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 diet - classic diet
Diets that restrict calories are usually low in fat. The most popular such diet is classic. It has been used for over 40 years and is recommended by most of the scientific community, hence 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 third patient returns to his previous 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 overweight. The energy value is usually 1200-1500 kcal/day. for women and 1500-1800 kcal/day. for men. For the current diet, the caloric deficit is assumed to be 500 kcal/day, while limiting 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, long-term effect of classical diet
The problem is that a high-carbohydrate diet has been empirically linked to weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, further storing carbohydrates 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 largely psychological.
A low-carb, high-protein diet
A low-carb protein diet is an alternative to a high-carb diet. Such a diet is high in protein and fat and low in carbohydrates (and therefore calories). This leads to weight loss, initially depending 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 leads to 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 concentration decreases.
Dietary protein stimulates the release of glucagon, which contributes to the balance between insulinemia and glucagonemia. The feeling of fullness increases after a meal, and this is due to the increased ratio of protein to 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 effect of protein diet
Unfortunately, there is not enough research to support the effectiveness and safety of high protein diets. And it does not contain healthy foods: grains, fruits, vegetables. On the contrary, the menu contains many fatty ingredients (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, folate, magnesium, iron, and potassium. Calcium, vitamin D deficiency, and secondary increased secretion of TSH disrupt cellular calcium homeostasis, increase cytosolic calcium levels, and this can lead to several adverse metabolic pathways, including adipose tissue lipid synthesis.
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 absence of an increase in HDL pose a risk for the development of atherosclerosis, despite a beneficial effect on triglyceride concentrations. Also, reducing the proportion of fiber in the diet causes constipation.
At the same time, comparing the effectiveness of a high-protein diet (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 is a high protein, very low calorie dietWith a caloric value of <800 kcal/day, minimal lipids and carbohydrates, it is very popular in many European clinics.
The menu contains protein at 1. 2 g/kg of body weight for women and 1. 4 g/kg for men. Diet therapy is carried out for a month under strict medical supervision. Patients are additionally prescribed vitamins. This diet theoretically allows you to lose 90g of fat per day and lower your basal metabolic rate by 10-20%.
A modified protein-saving diet affects certain elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- enhances lipid oxidation and sensitivity of peripheral tissues to insulin;
- Reduces hepatic insulin clearance and hepatic glucose release.
The essence of a protein-saving modified diet
This diet 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 for protein-sparing modified diets is a protein shake. In addition to the protein content, such products contain other nutrients needed in the diet. When losing weight, you need to reduce the total number of calories consumed. The protein shake offers a low calorie content that allows you to control your calorie intake and create a calorie deficit to reach your goal weight. One package 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 happy for 3-4 hours.
A decrease in insulinemia and an increase in fat oxidation leads to the formation of ketone bodies in the liver - energy material for muscles and brain, limits gluconeogenesis from protein substrates and reduces appetite.
Low-carb, low-fat diets
Such diets have become very popular in recent years, but 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 any other diet guide.
The essence of the Atkins diet
This is a low carbohydrate, protein and 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 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 balance between total energy requirements and the oxidation of other dietary components that favor lipids.
Alcohol is burned first because the body cannot store it and it takes a lot of energy to turn it into fat. A similar situation is with amino acids and proteins, which 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 great.
The Atkins diet reduces plasma concentrations of insulin, C-peptide, and especially proinsulin under alkaline conditions and after glucagon stimulation, which may have a less atherogenic effect than previously thought. It was 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 of the nature of etiopathogenetic therapeutic intervention for type 2 diabetes.
Scientifically proven estimated weight loss on the diet is 10% after 6 months. Serious consequences have not 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 efficiency of this type of feeding is low, mainly due to its rapid abandonment. Patients find it difficult 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 involves 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 muscular system and deterioration of health.
- hunger. A diet involves complete abstinence from food for a certain period of time. This is not a recommended weight loss method, 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 those taking strong medications.
Quack diets have always been popular, usually based on the supposed unusual weight-loss properties of certain foods, most commonly fruits. For example, the apple diet requires eating only apples, the grape diet - grapes, the banana diet - bananas. Such a diet is either ineffective or dangerous. For example, a diet of grapes and bananas is guaranteed to increase blood sugar, aggravating diabetes.
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 excessive in case of overweight and obesity
The importance of physical activity in the process of weight loss is greatly exaggerated. Judge for yourself: losing 1 kg of weight requires a lot of effort, for example, walking 250 km. And for many patients, such loads are simply prohibited due to accompanying pathologies. In other words, when planning to lose weight, you should understand that only physical education as a treatment method will not give you the results 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. In addition, when losing extra pounds, it is important to strengthen the muscle frame, then the skin will not be dark 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 catabolism of muscle proteins;
- reduces insulin resistance, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports and even simple walking, your mood improves, blood circulation and air exchange in the tissues improves. Therefore, physical education with measured loads will always be an integral part of the complex treatment of overweight and obesity.