The first method of choice in the treatment of excess weight 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 is 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 with every new recipe that promises a slim figure.
Features of choosing a diet for obesity
When treating obesity, it is advisable to immediately abandon diets with a predetermined daily calorie intake. The diet should be individual, based on the phase of obesity, eating disorders, concomitant diseases and other important points. It is especially important to take into account the presence of diabetes, gastrointestinal pathologies, hematopoiesis problems and vitamin-mineral balance.
For example, patients with diabetes are strictly prohibited from fasting or, conversely, following a diet rich in carbohydrates. Patients with anemia should not give up meat and offal. Children need dairy products; Removing them from the menu threatens to disrupt the growth and development of the musculoskeletal skeleton.
The nutrition plan is drawn up with a clear distribution of meals (3-5) and the composition of the menu. Keeping a self-monitoring diary will help you control 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 restrictions and nutritional deficiencies should be avoided. A sudden and significant reduction in the energy content of the diet, for example to half the current value, will produce impressive results, but will not guarantee long-term success. The weight will return within a year, if not sooner.
- The menu should not be monotonous; must take into account the patient's tastes. Otherwise, stress will aggravate obesity. Monotonous food is a common cause of dietary failure. The patient feels hungry, is overwhelmed by restrictions, and his "soul demands" relief. After having eaten a forbidden sweet or fatty food and having received great pleasure, it is difficult to stop doing it. The brain immediately remembers how bad it was without the "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 is involved 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 additives that indicate satiety.
In difficult cases, if you cannot control your appetite, the endocrinologist will prescribe a medication that affects the satiety center. By taking these pills, the patient does not feel hungry. But it is important to understand that the intake of such drugs is limited by unpleasant side effects and a number of contraindications.
Calorie restricted diets - classic diet
Diets that restrict calories are usually low in fat. The most popular diet is the classic one. It has been used for more than 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 by 10% after 18 weeks, however, after a year, one in three patients returns to their previous body weight, and after 3 years, almost all of them.
The essence of the classic diet
The classic diet is a carbohydrate-rich diet with calories corresponding to the degree of excess weight. The 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, limiting the current fat intake to 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 diet rich in carbohydrates is empirically combined with weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, with the consequent accumulation of carbohydrates as easily as fat. . Furthermore, restrictive diets reduce thermogenesis and increase the body's energy efficiency, making them ineffective. The side effects of restrictive diets are largely related to the psyche.
Low-carbohydrate, high-protein diets
Low-carbohydrate protein diets are an alternative to carbohydrate diets. These diets are rich in protein and fat and low in carbohydrates (and therefore calories). This leads to weight loss, which initially depends on the body's release of glycogen-bound water.
The initial effect of a low-carbohydrate diet is immediate and so impressive that it becomes an additional motivation for the patient.
The essence of a protein diet.
The diet is based on ketosis, the result of burning endogenous fat, which causes a decrease in appetite. The second factor is the monotony of the menu. As a result, the body's need for insulin decreases, blood glucose and sometimes lipid concentrations decrease.
Dietary proteins stimulate the release of glucagon, facilitating the balance between insulinemia and glucagonemia. The feeling of satiety increases after eating, and this is due to the increase in the proportion of protein and 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 a protein diet.
Unfortunately, there is not enough research to support the effectiveness and safety of a high-protein diet. And it does not contain healthy foods: cereals, fruits, vegetables. On the contrary, the menu contains many ingredients rich in fat (55-60%) and animal proteins (25-30%).
In addition, a high protein diet is usually associated with a loss of calcium and a decrease in the levels of vitamins E, A, B. 1, B6, folic acid, magnesium, iron and potassium. Deficiency of calcium, vitamin D and secondary increase in TSH secretion disturb 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 this diet on the body is also unknown. The observed increase in uric acid and LDL levels and the absence of an increase in HDL create risks for the development of atherosclerosis, even despite the beneficial effect on triglyceride concentrations. Additionally, reducing the proportion of fiber in the diet causes constipation.
At the same time, when comparing the effectiveness of a protein diet (containing 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 diet rich in protein and very low in calories with a caloric value of<800 kcal/day, with a minimum of lipids and carbohydrates, is very popular in many European clinics.
The menu contains proteins in the amount of 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 strict medical supervision. Patients are also prescribed vitamins. In theory, this diet allows you to lose 90 g of fat per day and reduce your basal metabolism by 10 to 20%.
A modified protein-sparing diet affects individual elements of the pathogenesis of type 2 diabetes:
- reduces hyperglycemia and endogenous hyperinsulinemia;
- improves lipid oxidation and the sensitivity of peripheral tissues to insulin;
- Reduces hepatic insulin clearance and hepatic glucose release.
The essence of a modified protein-saving diet
This diet option provides a sufficient amount of protein (approx. 50 g/day), which protects the nitrogen balance of metabolism and endogenous proteins from proteolysis. Low carbohydrate content restricts 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 most popular meal replacements during a modified protein-sparing diet is a protein shake. In addition to being rich in protein, these products also contain other nutrients necessary during the diet. When losing weight, it is necessary to reduce the total amount 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 ideal weight. One sachet contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, proteins, baobab fruit extract and a whole complex of vitamins. One serving of this cocktail can replace a meal and keep you full for 3 to 4 hours.
The decrease in insulinemia and the increase in fat oxidation lead to the production of ketone bodies in the liver, energy material for muscles and the brain, limit gluconeogenesis from protein substrates and reduce appetite.
Low-carbohydrate, high-fat diets
These types of diets have been a success in recent years, although they are nothing new. The Atkins diet, created by a cardiologist in 1973, is especially popular. R. Atkins' book on healthy eating has sold more than 10 million copies. In European countries it is read four times more than other dietary guides.
The essence of the Atkins diet.
This is a low carb, high protein and high fat diet. For 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 is gradually increased.
A great controversy arises among scientists about this diet due to its high fat content. However, the amount of fat oxidized or stored depends on the difference between the total energy requirement and the oxidation of other dietary components that take priority over lipids.
Alcohol is burned first as the body cannot store it and converting it into fat requires a lot of energy. The situation is similar with amino acids and proteins that perform functional functions, and with 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 its oxidation practically corresponds to consumption.
On the other hand, the possibilities of fat accumulation (mainly in adipose tissue) are practically unlimited, and the effectiveness 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 result in a less atherogenic effect than previously thought. It was also observed that a 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 the etiopathogenetic therapeutic intervention in type 2 diabetes mellitus.
The scientifically proven probable weight loss by maintaining a diet is 10% after 6 months. No serious consequences have yet been identified.
Other diets
- Alternate diet.It consists of eating a type of food or completely abstaining from eating 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 a single product, for example, boiled rice without salt, sugar and oil.
- Low fat diet.The composition of the diet involves the elimination of all meat and dairy products, vegetable oils, fish and, in general, all products containing fats. Prolonged adherence to such a diet causes anemia, weakening of the musculoskeletal structure and poor health.
- Hunger. A diet involves completely abstaining from food for a set 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 with a lack of vitamins and microelements and taking strong medications.
At all times, quack diets have been and will be popular, usually based on the supposedly unusual properties of certain foods for weight loss, usually fruits. For example, the apple diet calls for eating only apples, the grape diet calls for grapes, and the banana diet calls for eating only bananas. These types of diets are ineffective or dangerous. For example, diets with grapes and bananas are guaranteed to cause blood sugar spikes, which will aggravate diabetes.
What diet is best?
You can't choose your diet on your own. The best option would be to contact an endocrinologist, who will select the correct 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 weight loss process is significantly overestimated. Judge for yourself: losing 1 kg of weight requires enormous effort, for example, 250 km of walking. And for many patients, such loads are simply prohibited due to concomitant pathologies. In other words, when planning to lose weight, you need to understand that physical education alone as a method of treatment will not give the result that you would like to obtain.
But this does not mean that you should give up physical activity. Physical activity is important to slow weight gain and prevent weight gain again. In addition, when losing extra kilos, it is important to strengthen the muscle structure, so that the skin does not become sagging or sagging.
Physical activity has a beneficial effect on the entire body; This applies to both overweight and thin people.
Gym:
- Maintains muscle mass during weight loss by preventing the catabolism of muscle proteins;
- Reduces insulin resistance, improving 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 improve. Therefore, physical education with measured loads will always be an integral part of the complex treatment of excess weight and obesity.