The first choice in the treatment of overweight or obesity is a diet rich in physical activity. Then, if weight loss does not occur, other treatment options are used, including medical and surgical methods.
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 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 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, nutritional disorder, concomitant diseases and other important factors. It is especially important to consider the existence of problems related to diabetes, gastrointestinal pathologies, hematopoiesis and vitamin-mineral balance.
For example, people with diabetes should not fast or, conversely, eat a diet rich in carbohydrates. Patients with anemia should not refuse meat and offal. Children need dairy products, removing them from the menu threatens to disrupt the growth and development of the musculoskeletal system;
The nutrition plan is drawn up with the exact distribution of meals (3-5) and the composition of the menu. Keeping a self-monitoring diary will help you monitor and change the menu, where the patient must write down all the food eaten in grams every day.
Important points when choosing a diet:
- Severe calorie restriction and malnutrition should be avoided. A sudden significant reduction in the energy content of the diet, for example, half of the current value, will produce impressive results, but will not ensure long-term success. The weight will return within a year, if not faster.
- The menu should not be monotonous, it should take into account the taste of the patient. Otherwise, stress will increase obesity. Monotonous foods are a common cause of dietary deficiency. The patient feels hungry, is burdened with restrictions and requires "soul" comfort. After eating a forbidden sweet or fatty food and enjoying it, it's hard to stop. The brain immediately reminds how bad it 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 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 every effective diet contains fruits and vegetables or supplements that signal satiety.
In difficult cases, if you cannot cope with your appetite, the endocrinologist will prescribe a drug that affects the satiety center. The patient does not feel hungry while taking such pills. However, it should be understood that the use of such drugs is limited by unpleasant side effects and a number of contraindications.
Calorie-restricted diets - classic diet
Calorie-restricted diets are usually low-fat. The most popular such diet is classic. 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 10% after 18 weeks, but after a year, every third patient returns to the previous body weight, and after 3 years, almost all of them return.
The essence of the classic diet
The classic diet is a high-calorie, high-carbohydrate diet. 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 per day is assumed by limiting the current fat intake to 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 effects of the classic diet
The problem is that a high-carbohydrate diet is empirically linked to weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, which then easily stores carbohydrates 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 psychological.
Low-carbohydrate, high-protein diets
Low-carb 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 first leads to weight loss depending on the release of glycogen-bound water from the body.
The initial effect of a low-carbohydrate diet is immediate and so effective that it becomes an additional motivation for the patient.
The essence of the 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, facilitating the balance between insulinemia and glucagonemia. The feeling of satiety increases after a meal, and this is due to an increase in the ratio of protein to energy from food. It should be understood that a high-protein diet does not always mean a low-calorie intake.
Cons, side effects, long term effect of protein diet
Unfortunately, there is not enough research to support the efficacy and safety of a high-protein diet. And it does not contain healthy foods: grains, fruits, vegetables. On the contrary, the menu contains a large amount of fat (55-60%) and animal proteins (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 increase in TSH secretion disrupt cellular calcium homeostasis, increase cytosolic calcium levels, and this can stimulate a number of adverse metabolic pathways, including lipid synthesis in adipose tissue.
The long-term effect of such a diet on the body is also unknown. Although the observed increase in uric acid and LDL levels and the lack of increase in HDL have a beneficial effect on triglyceride concentration, they pose risks for the development of atherosclerosis. Also, reducing the amount of fiber in the diet leads to constipation.
At the same time, when comparing the effectiveness of a protein diet (containing 25% protein, 45% carbohydrates) and a carbohydrate diet (12% protein, 58% carbohydrates), the advantage of the former is obvious. Studies have shown a loss of up to 8 kg of fat mass versus 4 kg.
A modified protein-retaining diet
Calorie valueThis high-protein, very low-calorie diet with <800 kcal/day, with minimal lipids and carbohydrates, 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. Diet therapy is carried out for a month under strict medical supervision. Patients are additionally prescribed vitamins. This diet theoretically allows you to lose 90 g of fat per day and reduce your basal metabolic rate by 10-20%.
A modified diet containing protein 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-retaining modified 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 the burning of endogenous lipids.
One of the popular meal replacements during a protein-retaining modified diet is a protein shake. In addition to high protein, such products also contain other nutrients needed during the diet. When losing weight, you need to reduce the total number of calories consumed. The protein shake offers a low calorie content, which allows you to control your calorie intake and create a calorie deficit to reach your target weight. One package contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and a complex of all vitamins. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
A decrease in insulinemia and an increase in fat oxidation lead to the production of ketone bodies in the liver - energy material for muscles and the brain, it limits gluconeogenesis from protein substrates and reduces appetite.
Low-carb, high-fat diets
Although such diets are far from new, they have become a hit in recent years. 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. It is read four times more than all other dietary guidelines in European countries.
The essence of the Atkins diet
It's a low-carb, high-protein, high-fat diet. During the first two weeks, the amount of carbohydrates is limited to 20 g/day, and then to 30 g/day. After reaching the desired body weight, the amount of carbohydrates is gradually increased.
There is serious debate among scientists about this diet due to 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 dominate lipids.
Alcohol is primarily burned because the body cannot store it and it takes a lot of energy to convert it into fat. The situation is similar with amino acids and proteins, which perform functional functions, and carbohydrates, which are limited in their storage in the form of glycogen. Converting carbohydrates to fat also requires a lot of energy. Thus, it can be assumed that their oxidation is practically suitable for 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 lead to 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 allows to achieve the effect of the nature of etiopathogenetic therapeutic intervention for type 2 diabetes mellitus.
It has been scientifically proven that you can lose 10% of your weight after 6 months of dieting. No serious complications have been identified yet.
Other diets
- Alternative diet.It consists of eating one type of food or completely abstaining from food on selected days. The effectiveness of this type of feeding is low, mostly it is quickly abandoned. 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 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 musculoskeletal system and deterioration of health.
- Hunger. A diet involves completely giving up 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 diabetics, people prone to depression, patients with vitamin and micronutrient deficiencies, and those taking strong medications.
Throughout history, fad diets have been and will continue to be popular, usually based on the supposed extraordinary weight-loss properties of certain foods, most often fruits. For example, you should eat only apples on an apple diet, grapes on a grape diet, and bananas on a banana diet. Such diets are either ineffective or dangerous. For example, grape and banana diets are guaranteed to increase blood sugar and aggravate diabetes.
Which diet is better?
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 examination results.
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 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 need to understand that physical education alone 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 from coming back. Also, when losing extra pounds, it is important to strengthen the muscle frame, then the skin will not sag and sag.
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.
Active sports and even a simple walk improve your mood, improve blood circulation and air exchange in the tissues. Therefore, physical training with measured loads will always be a component of the complex treatment of overweight and obesity.