Treatment Options for Overweight and Obesity - Diet: Effectiveness and Disadvantages

The first choice for treating overweight or obesity is diet combined with physical activity. Then, if weight isn't lost, other treatment options are used, including medications and surgical options.Today, hundreds of diets are offered to those trying to lose weight, but only a few of them are officially recognized. It turns out that there are no universal and ideal eating habits. Many types of nutrition have contraindications and can even worsen the condition. Therefore, you shouldn't rush to accept every new recipe that promises a slimmer figure.

Characteristics of Diet Choices in Obesity

When treating obesity, you should immediately abandon the diet of predetermined daily calorie intake. Diet should be individualized based on the stage of obesity, eating disorders, co-morbidities and other points. It is especially important to consider the presence of diabetes, gastrointestinal pathology, hematopoiesis and vitamin-mineral balance problems.For example, diabetics are strictly prohibited from fasting or, conversely, eating a high-carbohydrate diet. Anemic patients should not give up meat and offal. Children need dairy products; removing them from the menu may disrupt musculoskeletal growth and development.Develop a nutritional plan with clear meal portions (3-5) and menu composition. Keeping a self-monitoring diary will help you monitor and modify the menu. The patient must write down all the foods eaten every day (in grams).Key points when choosing a diet:

• Severe caloric restriction and nutritional deficiencies should be avoided. A sudden, large reduction in the energy content of the diet, for example by half its current value, will produce impressive results but will not lead to long-term success. The weight will return within a year, if not sooner.
• The menu should not be monotonous and the patient's taste should be taken into consideration. Otherwise, stress can exacerbate obesity. Food monotony is a common reason for diet failure. The patient is hungry, he is burdened by restrictions, and his "soul needs" relief. Once you've eaten forbidden sweets or greasy foods and gotten immense pleasure, it's already hard to stop. The brain immediately reminds you how bad it would be without the "candy. "
• The patient should drink plenty of water. You have to give up lemon water, sweet tea and alcohol.

An important element in limiting appetite is vegetable 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 speed up intestinal transit. Therefore, almost every effective diet contains fruits and vegetables or additives that indicate satiety.In difficult cases, if you are unable to cope with your appetite, an endocrinologist may prescribe a drug that affects the satiety center. Taking this medicine, patients will not feel hungry. But it is important to understand that taking such drugs is limited by unpleasant side effects and many contraindications.

Calorie Restricted Diet - Classic Diet

Calorie-restricted diets are usually lower in fat. The most popular such diet is the classic diet. It has been used for over 40 years and is recommended by most scientific societies, which is why it gets its name.According to statistics, such a diet can reduce weight by 10 kilograms in 6 months, or lose 10% of body weight after 18 weeks. However, after one year, one out of every three patients returns to their previous weight, and after 3 yearsAlmost all returned to his previous weight.

The essence of a 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, 1500-1800 calories per day. For men. For the current diet, assume a caloric deficit of 500 kcal/day while limiting current fat intake to 1/3. On this diet, approximately 60% of energy comes from carbohydrates, approximately 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 postprandial hyperglycemia and its mechanism of stimulating insulin secretion, with subsequent accumulation of carbohydrates as easily as fat. Additionally, restrictive diets reduce thermogenesis and increase the body's energy efficiency and are therefore ineffective. The side effects of restrictive diets are largely psychological.

Low-carb, protein-rich diet

A low-carbohydrate protein diet is an alternative to a carbohydrate-based diet. This diet is high in protein and fat and low in carbohydrates (and therefore calories). This results in weight loss, which initially depends on the release of glycogen-bound water in the body.The initial results of the low-carbohydrate diet were immediate and impressive, so much so that they served as additional motivation for the patient.

The Essence of a Protein Diet

This diet is based on ketosis, which is the result of burning endogenous fat and 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 protein stimulates glucagon release, promoting a balance between insulinemia and glucagonemia. The feeling of fullness increases after eating due to the increased ratio of protein to energy obtained from food. However, it's important to understand that a high-protein diet doesn't always mean low-calorie intake.

Disadvantages, Side Effects, and Long-Term Effects of a Protein Diet

Unfortunately, there is not enough research to support the effectiveness and safety of high-protein diets. And it doesn’t contain healthy foods: grains, fruits, vegetables. Instead, the menu contains many ingredients high in fat (55-60%) and animal protein (25-30%).Additionally, high-protein diets often result in calcium depletion and reduced levels of vitamins E, A, B. 1, B6, folate, magnesium, iron, and potassium. Calcium, vitamin D deficiency, and secondary increased TSH secretion disrupt cellular calcium homeostasis and increase cytoplasmic calcium levels, which stimulate multiple adverse metabolic pathways, including lipid synthesis in adipose tissue.The long-term effects of this diet on the body are also unknown. The observed increases in uric acid and low-density lipoprotein levels and no increase in high-density lipoprotein levels confer atherosclerotic risk despite beneficial effects on triglyceride concentrations. Additionally, reducing the proportion of fiber in your diet can lead to constipation.At the same time, comparing the effectiveness of a protein diet (containing 25% protein, 45% carbohydrates) and a carbohydrate diet (12% protein, 58% carbohydrates), the advantages of the former are obvious. Studies have shown a reduction in fat mass of up to 8 kg compared to 4 kg.

Protein-sparing modified diet

This high-protein, extremely low-calorie diet has a caloric value of<800 kcal/day, extremely low in lipids and carbohydrates, very popular in many European clinics. The protein content in the menu is 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 also takes additional vitamins. This diet can theoretically allow you to lose 90 grams of fat every day and reduce your basal metabolism by 10-20%.A modified protein-sparing diet affects various factors in the pathogenesis of type 2 diabetes:

• Reduce hyperglycemia and endogenous hyperinsulinemia;
• Enhance lipid oxidation and peripheral tissue sensitivity to insulin;
• Decreased hepatic insulin clearance and hepatic glucose release.

The nature of a protein-sparing modified diet

This dietary choice provides sufficient amounts of protein (approximately 50 g/day) to protect metabolic nitrogen balance and endogenous proteins from proteolysis. Low carbohydrate content limits insulin secretion and promotes lipolysis. The energy gap between energy expenditure and caloric intake (at least 650 kcal/day) is compensated by burning endogenous lipids.One of the popular meal replacement options in a protein-sparing modified diet is a protein shake. In addition to being high in protein, such products also contain other nutrients needed during the diet. When losing weight, you need to reduce the total number of calories you consume. Protein shakes are lower in calories, 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, protein, baobab fruit extract and a full complement of vitamins. One serving of this cocktail can replace a meal and keep you full for 3-4 hours.Decreased insulinemia 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-carb, high-fat diet

Such diets have become popular in recent years, although they are far from new. The Atkins diet, created by cardiologists in 1973, is especially popular. R. Atkins' books on healthy eating have sold more than 10 million copies. In European countries, the guideline is read four times more than all other dietary guidelines.

The essence of the Atkins diet

This is a low carb, high protein, high fat diet. Carbohydrate content is limited to 20 g/day for the first two weeks, then to 30 g/day. After reaching your ideal weight, gradually increase the carbohydrate content.This diet is heavily controversial among scientists due to its high fat content. However, the amount of fat that is oxidized or stored 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, and converting it into fat requires a lot of energy. The situation is similar for amino acids and proteins that perform functions and for carbohydrates stored in the form of glycogen. Converting carbohydrates into fat also requires a lot of energy. Therefore, it can be assumed that their oxidation actually corresponds to consumption.On the other hand, the possibilities for fat accumulation (mainly in adipose tissue) are virtually 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 following glucagon stimulation, which may result in less atherosclerotic effects than previously thought. A decrease in insulin hypersecretion was also noted to be accompanied by an increase in insulin sensitivity. This diet therefore makes it possible to achieve an essential effect of therapeutic intervention in the etiology and pathology of type 2 diabetes. It is scientifically proven that if you stick to your diet, you may lose 10% of your weight after 6 months. No serious consequences have been found.

Other diet

• Alternate diets.It involves eating one type of food or not eating at all on selected days. The effectiveness of these nutritional supplements is low, mainly due to their rapid disposal. It is difficult for patients not to eat anything, and even more difficult to eat only one product, such as rice without salt, sugar, or oil.
• Low-fat diet.The composition of the diet means the elimination of all meat and dairy products, vegetable oils, fish and, in general, all products containing fat. Long-term adherence to this diet can lead to anemia, musculoskeletal weakness and poor health.
• hunger. Dieting involves complete fasting for a period of time. This is not a recommended way to lose weight, no matter how long it lasts. Fasting is particularly dangerous for people with diabetes, people prone to depression, patients with vitamin and trace element deficiencies, and those taking strong medications.

Quack diets have long been and continue to be popular, often based on the purported unusual weight-loss properties of certain foods, most commonly fruits. For example, the apple diet requires eating only apples, the grape diet requires eating only grapes, and the banana diet requires eating only bananas. Such diets are either ineffective or dangerous. For example, a diet of grapes and bananas can definitely cause blood sugar to rise, thus exacerbating diabetes.

Which diet is best?

You don’t get to choose what you eat. Your best option is to contact an endocrinologist, who will choose the right type of nutrition based on the results.

Impact of physical activity on overweight and obesity overestimated

The importance of physical activity in the weight loss process is grossly overrated. Judge for yourself: losing 1 kilogram requires a huge effort, such as walking 250 kilometers. For many patients, such loading is prohibited due to concomitant pathological reasons. In other words, when you plan to lose weight, you should understand that using physical education as a treatment alone will not achieve the results you want.But that doesn’t mean you need to give up physical activity. Physical activity is important to slow weight gain and prevent recurrence of weight gain. Also, when losing excess weight, it is important to strengthen your muscle frame so that your skin does not sag and sag.Physical activity has benefits for the entire body—and this applies to both overweight and thin people.gymnastics:

• Preserve muscle mass during weight loss by preventing muscle protein catabolism;
• Reduce insulin resistance and improve carbohydrate and lipid metabolism;
• Normalize blood pressure.

By being active, or even simply walking, your mood will improve, as will blood circulation and air exchange in your tissues. Therefore, physical education with measured loads is always an integral part of the comprehensive treatment of overweight and obesity.