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 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 diet 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, you should immediately leave the child with a predetermined daily calorie intake. Nutrition should be individual, based on the stage of obesity, eating disorders, accompanying diseases and other important points. It is especially important to take care of the presence of diabetes, gastrointestinal pathologies, problems with hematopoiesis and vitamin-mineral balance.
For example, patients with diabetes are strictly forbidden to fast or, on the contrary, eat a diet rich in carbohydrates. Anemic patients should not give up meat and offal. Children need dairy products, their removal from the menu threatens to disrupt the growth and development of the musculoskeletal skeleton.
The diet 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 monitor and modify the menu, where the patient must write down in grams all the food he eats daily.
Important points when choosing a diet:
- Severe calorie restriction and nutritional deficiencies should be avoided. Suddenly significantly reducing the energy content of the diet, for example by half the current value, will give impressive results, but will not ensure 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 taste of the patient. 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 is looking for" relief. After you have eaten forbidden sweet or fatty food and received great pleasure, it is already difficult to stop. The brain immediately reminds 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 are plant fibers, which are involved in the mechanism of expanding the amount 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 additives that signal satiety.
In severe cases, if you cannot cope with your appetite, the endocrinologist will prescribe a drug that affects the satiety center. Taking such tablets, 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.
Diet with limited calorie intake - classic diet
A calorie-restricted diet is usually low in fat. The most popular such diet is the classic one. 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 by 10% after 18 weeks, however, after a year every third patient returns to the previous body weight, and after 3 years almost all of them.
The essence of a classic diet
The classic diet is a diet rich in carbohydrates 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, with a limitation of 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 empirically combines with weight gain in the mechanism of postprandial hyperglycemia and its stimulation of insulin secretion, with the subsequent accumulation of carbohydrates as readily 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.
A low-carb, high-protein diet
A low-carb diet is an alternative to high-carb diets. Such diets contain a lot of protein and fat, and little carbohydrates (and therefore calories). This leads to weight loss, initially dependent 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 a protein diet
The diet is based on ketosis - the result of endogenous fat burning, which causes a decrease in appetite. Another factor is the monotony of the menu. As a result, the body's need for insulin, glycemia, and sometimes lipid concentration are reduced.
Dietary protein 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 and energy obtained from food. It is important to realize 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 efficacy and safety of a high-protein diet. And it does not contain healthy food: grains, fruits, vegetables. On the contrary, the menu contains many ingredients rich 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 increased secretion of TSH disrupts cellular calcium homeostasis, increases the level of cytosolic calcium, and this can stimulate several unfavorable metabolic pathways, including lipid synthesis in adipose tissue.
The long-term effect of such a diet on the body is also unknown. The observed increase in the level of uric acid and LDL and the absence of an increase in HDL create risks for the development of atherosclerosis, even despite the beneficial effect on the concentration of triglycerides. Also, reducing the amount 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 former is obvious. Research has shown a loss of fat mass of up to 8 kg compared to 4.
A modified protein-sparing diet
This high protein, very low calorie diet with calorie value<800 kcal/day, with minimal intake 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 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 protein-sparing diet affects individual 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 modified protein-saving diet
This dietary option provides a sufficient amount of protein (approx. 50 g/day), which protects the nitrogen balance in metabolism and endogenous proteins from proteolysis. Low carbohydrate content restricts insulin secretion and promotes lipolysis. The energy difference between energy consumption and calorie intake (at least 650 kcal/day) is covered by the burning of endogenous lipids.
One of the popular meal replacements during a modified protein-saving diet is a protein shake. In addition to being rich in protein, such products also contain other nutrients needed during a diet. When losing weight, it is necessary to reduce the total number of calories consumed. The protein shake offers a low calorie content, allowing you to control your calorie intake and create a calorie deficit to reach your goal weight. One bag contains 39 kcal. The cocktail also contains fiber, guarana extract, chia seeds, proteins, baobab fruit extract and the entire vitamin complex. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.
Reduced insulinemia and increased fat oxidation lead to the production of ketone bodies in the liver - energy material for muscles and brain, limit gluconeogenesis from protein substrates and reduce appetite.
A low-carb, high-fat diet
These diets have been a hit in recent years, although they are far from new. The Atkins diet, which was designed 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 all other nutrition 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 is gradually increased.
Serious controversy among scientists about this diet arises because of the 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 precedence over lipids.
Alcohol is burned first, because the body cannot store it, and it takes a lot of energy to turn it into fat. The situation is similar with amino acids and proteins that perform functional functions, and carbohydrates whose storage 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 possibilities of fat accumulation (primarily in adipose tissue) are practically unlimited, and the efficiency of this process is high.
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 has also been observed that a decrease in insulin hypersecretion is accompanied by an increase in insulin sensitivity. Thus, this diet allows achieving the effect of the nature of etiopathogenetic therapeutic intervention for type 2 diabetes mellitus.
Scientifically proven probable weight loss when maintaining a diet is 10% after 6 months. No serious consequences have yet been identified.
Other children
- Alternating diet.It consists of eating one type of food or completely abstaining from eating on selected days. The effectiveness of this type of diet is low, mainly due to the rapid abandonment of it. 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 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, weakening of the musculoskeletal system and poor health.
- Starvation. A diet implies 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 vitamin and microelement deficiencies, and those taking strong medications.
At any given time, fad diets have been and will continue to be popular, usually based on the allegedly unusual weight-loss properties of certain foods, most 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 will certainly lead to spikes in blood sugar, which will worsen diabetes.
Which diet is best?
You cannot choose your own diet. The best option would be to consult an endocrinologist, who will choose the right diet based on the results of the examination.
Physical activity is overrated due to 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 huge effort, for example, 250 km of walking. And for many patients, such loads are simply prohibited due to accompanying pathologies. In other words, when you plan to lose weight, you should understand that only physical education as a treatment method will not give the result you would like to get.
But that doesn't mean you have to give up physical activity. Physical activity is important for slowing weight gain and preventing weight gain. Also, when losing extra pounds, it is important to strengthen the muscle frame, then the skin will not be limp and relaxed.
Physical activity has a beneficial effect on the whole body - this applies to both obese 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 simple walking, improve mood, improve blood circulation and air exchange in tissues. Therefore, physical education with measured loads will always be an integral part of the complex treatment of excess weight and obesity.