The method of first choice in the treatment of overweight or obesity is diet supplemented with physical activity. Then, if weight loss does not occur, other treatment options will be used, including medical and surgical options.
Today, hundreds of diets are offered to people to lose weight, but only some of them are officially recognized. It has been proven that there is no universal and ideal diet. Many nutritional supplements have contraindications and can even worsen the condition. Therefore, you should not rush to follow every new formula that promises to get a slim figure.
Features of choosing a diet for obese people
When treating obesity, you should immediately abandon the diet with a predetermined daily calorie intake. The diet should be individual, based on the stage of obesity, eating disorders, comorbidities and other important points. It is especially important to take into account the presence of diabetes, gastrointestinal pathologies, problems with hematopoiesis and vitamin-mineral balance.
For example, patients with diabetes are strictly forbidden to fast or, conversely, eat a high-carbohydrate diet. People with anemia should not abstain from meat and organs. Children need dairy products; Removing them from the menu risks disrupting the growth and development of the musculoskeletal system.
The nutrition plan is built with a clear distribution of meals (3-5) and menu composition. A self-monitoring diary will help you monitor and modify the menu, where the patient must record all foods eaten daily in grams.
Important points when choosing a diet:
- Severe calorie restriction and nutritional deficiencies should be avoided. A sudden reduction in the energy content of the diet, for example to half the current value, will yield impressive results, but will not bring 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 foods are a common cause of diet failure. The patient feels hungry, weighed down by restrictions, and "the soul demands" relief. Having eaten forbidden sweet or fatty foods and having had great pleasure, it is difficult to stop. The brain is immediately reminded how bad it would be without "sweets".
- Patients should drink plenty of water. You will have to give up lemonade, sweet tea and alcohol.
An important factor that limits appetite is vegetable fiber, which participates in the mechanism of increasing the volume of food in the stomach and delaying food emptying. These substances also reduce the absorption of nutrients from the digestive tract and speed up their transit through the intestines. Therefore, almost every effective diet contains fruits and vegetables or additives that signal satiety.
In difficult cases, if you cannot cope with your appetite, the endocrinologist will prescribe a drug that affects the satiety center. Taking such pills, the patient does not feel hungry. But it is important to understand that the use of these drugs is limited by unpleasant side effects and some contraindications.
Calorie-restricted diet - classic diet
Calorie-restricted diets are often 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 associations, which is why it got its name.
According to statistics, such a diet can reduce body weight by 10 kg in 6 months or 10% in 18 weeks, however, after a year, every third patient returns to the previous body weight. and after 3 years, almost all.
The essence of the classic diet
The classic diet is a high-carbohydrate diet with a calorie intake corresponding to the degree of overweight. The energy value is usually 1200-1500 kcal/day. For women it is 1500-1800 kcal/day. for men. Regarding your current diet, assume a calorie deficit of 500 kcal/day, while limiting your current fat intake by 1/3. On 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 high-carbohydrate diets are empirically associated with weight gain in the mechanism of post-meal hyperglycemia and stimulation of insulin secretion, which then accumulates carbohydrates as easily as fat. Additionally, restrictive diets reduce heat production and increase the body's energy efficiency, so they are ineffective. The side effects of restrictive diets are largely psychological.
Low carb, high protein diet
Low-carbohydrate protein diets are an alternative to carbohydrate diets. Such diets are high in protein and fat and low in carbohydrates (and therefore low in calories). This leads to weight loss, which initially depends on the release of glycogen-bound water from the body.
The initial effects of a low-carb diet are so immediate and dramatic that it becomes an additional motivator for patients.
The essence of a protein diet
The diet is based on 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, blood sugar and sometimes lipid levels also decrease.
Dietary protein stimulates glucagon release, facilitating balance between blood insulin and blood glucagon. The feeling of fullness increases after eating, this is due to the increased ratio of protein and energy obtained from food. However, it is important to understand that a high-protein diet does not always mean low calories.
Disadvantages, side effects, long-term effects of protein diets
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 ingredients rich in fat (55-60%) and animal protein (25-30%).
Additionally, high-protein diets are often associated with calcium loss and reduced intake of vitamins E, A, B. 1, B6, folic acid, magnesium, iron and potassium. Calcium and vitamin D deficiencies and secondary TSH hypersecretion disrupt cellular calcium homeostasis, increasing intracellular calcium levels and this may 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. An increase in uric acid and LDL concentrations is observed and the absence of an increase in HDL confers a risk of developing atherosclerosis, even if there is a beneficial effect on triglyceride concentrations. In addition, reducing the proportion of fiber in the diet also 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 advantages of the former diet are obvious. Studies have shown a reduction in fat mass of up to 8 kg compared to 4.
Protein-sparing modified diet
This high-protein, very low-calorie diet has its caloric value<800 kcal/day, with minimal lipid and carbohydrate intake, is very popular in many European clinics.
The menu contains protein at an 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 one month under strict medical supervision. The patient is prescribed vitamin supplements. Theoretically, this diet allows you to lose 90 g of fat per day and reduce basal metabolism by 10-20%.
A protein-sparing modified diet affects each factor in the pathogenesis of type 2 diabetes:
- hypoglycemia 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-sparing modified diet
This dietary choice provides adequate protein intake (approximately 50 g/day), which helps protect the metabolic nitrogen balance and endogenous proteins from proteolysis. Low carbohydrate content restricts insulin secretion and promotes lipolysis. The energy difference between energy expenditure and calorie intake (at least 650 kcal/day) is compensated by the burning of endogenous lipids.
One of the popular meal replacements on protein-sparing modified diets is protein shakes. In addition to high protein content, these products also contain other nutrients needed in the diet. When losing weight, you need to reduce your total calorie intake. Protein shakes are low in calories, allowing you to control your calorie intake and create a calorie deficit to reach your goal weight. One packet contains 39 kcal. This cocktail also contains fiber, guarana extract, chia seeds, proteins, 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.
Reduced blood insulin and increased fat oxidation lead to the production of ketone bodies in the liver - energy materials for muscles and brain, limiting gluconeogenesis from protein substrates and reducing appetite.
Low carbohydrate, high fat diet
Such diets have become popular in recent years, although they are by no means new. The Atkins diet, introduced by a cardiologist in 1973, is especially popular. R. Atkins' book about healthy eating has sold more than 10 million copies. In European countries, it is read four times more often than all other dietary guidelines.
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, then 30 g/day. After achieving the desired body weight, the carbohydrate content gradually increases.
Serious controversy among scientists about this diet arose due to its high fat content. However, the amount of oxidized or stored fat depends on the difference between total energy requirements and the oxidation of other dietary components that take precedence over lipids.
Alcohol is burned first because the body cannot store it, so converting it into fat requires a lot of energy. The same situation occurs with amino acids and proteins that perform functional functions as well as carbohydrates, their storage in the form of glycogen is limited. Converting carbohydrates into fat also requires a lot of energy. Therefore, it can be assumed that their oxidation practically corresponds to the level of consumption.
On the other hand, the ability to accumulate fat (mainly in adipose tissue) is practically unlimited and the efficiency of this process is enormous.
The Atkins diet reduces plasma concentrations of insulin, C-peptide, and especially proinsulin under alkaline conditions and after glucagon stimulation, which may result in less proatherosclerotic effects compared withthought before. It has also been noted that a decrease in insulin secretion is accompanied by an increase in insulin sensitivity. Therefore, this diet may be effective in the nature of etiological intervention for type 2 diabetes.
Science has proven that the ability to lose weight when maintaining a diet is 10% after 6 months. Currently, no serious consequences have been identified.
Other diets
- Alternative diet.It involves eating a food or abstaining from it altogether on selected days. The effectiveness of this type of nutrition is low, mainly because you quit it quickly. It is difficult for the patient not to be able to fast, but eating just one dish such as boiled rice without salt, sugar, or oil is even more difficult.
- 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 will lead to anemia, weakening of the musculoskeletal system, and poor health.
- Hungry. The diet involves completely abstaining from food for a certain period of time. This is not a recommended weight loss method, regardless of how long it lasts. Fasting is especially dangerous for diabetics, people prone to depression, patients lacking vitamins and trace elements and taking strong medications.
At all times, quack diets have been and will be popular, often based on the supposedly unusual weight loss properties of certain foods, usually 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 spikes in blood sugar, making diabetes worse.
Which diet is best?
You cannot choose your own diet. The best option is to contact an endocrinologist, who will choose the right nutrition based on the results of the examination.
Physical activity is overrated for overweight and obesity
The importance of physical activity in the process of losing weight is overestimated. Judge for yourself: to lose 1 kg of weight requires a lot of effort, such as walking 250 km. And for many patients, such a load is simply prohibited due to accompanying pathologies. In other words, when planning to lose weight, you should understand that exercise alone as a treatment method will not bring you the results you desire.
But this does not mean that you need to give up physical activity. Physical activity is important to slow weight gain and prevent weight gain from returning. In addition, when losing extra weight, it is important to strengthen the muscle frame so that the skin will not become loose or saggy.
Physical activity has a beneficial effect on the entire body - this applies to both overweight and thin people.
Exercise:
- Maintains muscle mass during weight loss by preventing muscle protein catabolism;
- 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 tissues improve. Therefore, physical education with measured loads will always be an indispensable part of the complex treatment of overweight and obesity.