The first choice method 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 do not need to rush for every new recipe that promises a slim figure.
Features of choosing a diet for obesity
When treating obesity, you should immediately leave the diet with the prescribed daily calorie intake. Nutrition should be individual, based on the phase of obesity, eating disorders, concomitant diseases and other important factors. It is very important to take into account the presence of diabetes, gastrointestinal pathology, problems with hematopoiesis and vitamin-mineral balance.
For example, diabetic patients are absolutely forbidden to fast or, conversely, eat foods high in carbohydrates. Patients with anemia should not give up meat and offal. Children need dairy products; removing it from the menu threatens to disrupt the growth and development of the musculoskeletal system.
A nutrition plan is prepared with a distribution of meals (3-5) and a clear composition of the menu. Keeping a self-monitoring diary will help you monitor and modify the menu, where the patient must write down 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 of the current value, will produce impressive results, but will not provide long-term success. The weight will return within a year, if not sooner.
- The menu should not be boring; 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 burdened by restrictions and "his soul demands" relief. After eating forbidden sweet or fatty foods and having had great pleasure, it is difficult to stop. The brain immediately reminds how bad things are without "sweets".
- The patient should drink a lot of water. You need to leave lemonade, sweet tea and alcohol.
An important element that limits appetite is plant fiber, which is involved in the mechanism of expanding the volume of food in the stomach and delaying its emptying. These ingredients also reduce nutrient absorption 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 control your appetite, the endocrinologist will prescribe drugs that affect 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 diet - 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 more than 40 years and is 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 by 10% after 18 weeks, however, after a year, every 3 patients return to their 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. 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 the 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 stimulation of insulin secretion, with the subsequent accumulation of carbohydrates as easily as fat. Also, strict diets reduce thermogenesis and increase the body's energy efficiency, so they are ineffective. The side effects of strict diets are largely psychological.
A low-carb, high-protein diet
A low-carb protein diet is an alternative to a carbohydrate 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 patients.
The essence of a 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 monotonous menu. As a result, the body's need for insulin decreases, glycemia, 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 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 effects 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 food: grains, fruits, vegetables. On the other hand, 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. Lack of calcium, vitamin D and secondary TSH secretion disrupt cellular calcium homeostasis, increase cytosolic calcium levels, and this can stimulate several unfavorable 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 the level of uric acid and LDL and the absence of an increase in HDL creates a risk for the development of atherosclerosis, although there is a favorable effect on the concentration of triglycerides. Also, reducing the portion 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 first is clear. Studies have shown a loss of fat mass of up to 8 kg compared to 4.
A protein-sparing modified diet
A high protein, very low calorie diet<800 kcal/day, with minimal lipids and carbohydrates, is very popular in many European clinics.
This 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 also given 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:
- reduce endogenous hyperglycemia and hyperinsulinemia;
- increase lipid oxidation and peripheral tissue sensitivity to insulin;
- reduce hepatic insulin release and hepatic glucose release.
The essence of a protein-sparing modified diet
This dietary choice provides a sufficient amount of protein (approximately 50 g/day), which protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. Low carbohydrate content suppresses 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 protein-saving modified diet is a protein shake. In addition to being high in protein, the product also contains other nutrients that are needed during a diet. When losing weight, you need to reduce the number of calories consumed. Protein shakes offer a low calorie content, allowing you to control your calorie intake and create a calorie deficit to reach your goal weight. One sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, protein, baobab fruit extract and a whole vitamin complex. 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 substances for muscles and the brain, limiting gluconeogenesis from protein substrates and reducing appetite.
Low carb, high fat diet
This type of diet has gained popularity in recent years, although it is far from new. The Atkins diet, created by a cardiologist in 1973, is very 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, 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.
Serious controversy among scientists about this diet arose 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 are favored over lipids.
Alcohol is burned first, because the body cannot store it, and turning it into fat requires a lot of energy. This situation is similar to amino acids and proteins that perform functional functions, and carbohydrates, the storage of which 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 possibility of fat accumulation (especially in adipose tissue) is practically unlimited, and the efficiency of this process is great.
The Atkins diet reduces plasma concentrations of insulin, C-peptide, and especially proinsulin in alkaline conditions and after glucagon stimulation, which may result in less atherogenic effects than previously thought. It was also observed that a decrease in insulin hypersecretion was accompanied by an increase in insulin sensitivity. Therefore, this diet makes it possible to achieve the effect of etiopathogenetic therapeutic intervention properties for type 2 diabetes mellitus.
The scientifically proven chance of weight loss when maintaining the diet is 10% after 6 months. No serious consequences have been identified.
Other diets
- Alternating feeding.It consists of eating one type of food or completely abstaining from food on certain days. The effectiveness of this type of diet is low, mainly due to rapid neglect. It is difficult for the patient 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 implies the elimination 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, musculoskeletal weakness, and poor health.
- Famine. A diet involves completely abstaining from food for a certain period of time. This is not a recommended method for losing weight, no matter how long it lasts. Fasting is especially dangerous for diabetics, people prone to depression, patients who lack vitamins and microelements, and take strong drugs.
At all times, quack diets have been and will be popular, usually based on the supposedly extraordinary weight loss properties of certain foods, often fruits. For example, the apple diet requires eating only apples, the grape diet - grapes, the banana diet - bananas. Such diets are either ineffective or dangerous. For example, a diet of grapes and bananas is guaranteed to lead to a spike in blood sugar, worsening diabetes.
Which diet is best?
You cannot choose your own diet. The best option is to contact an endocrinologist, who will choose the right type of nutrition based on the results of the examination.
Excessive physical activity for overweight and obesity
The importance of physical activity in the process of losing weight is overestimated. Judge for yourself: losing 1 kg of weight requires a lot of effort, for example, 250 km on foot. And for most patients, such a load is simply prohibited due to concomitant pathology. In other words, when planning to lose weight, you should understand that physical education alone as a treatment method will not give you the results you want to get.
But this does not mean that you have to stop doing physical activity. Physical activity is important to delay weight gain and prevent weight gain from returning. 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 overweight and thin people.
Gymnastics:
- Maintains muscle mass during weight loss by inhibiting muscle protein catabolism;
- Reduces insulin resistance, improves carbohydrate and lipid metabolism;
- Normalizes blood pressure.
With active sports and even a simple walk, your mood improves, blood circulation and air exchange in the tissues improves. Therefore, physical education with measured loads will always be an important part of the complex treatment of overweight and obesity.