Losing weight is a goal that many people set for themselves, although some do not need it. In cases where there is overweight or obesity, one should not start a weight loss process in any way.
Our weight depends on the calories we consume and the calories we expend. The fundamental cause of overweight and obesity is an energy imbalance that occurs if we consume too many calories and do not expend enough.
The World Health Organization (WHO) notes that there has been a worldwide “ increase in the intake of high-calorie foods and a decrease in physical activity due to the increasingly sedentary nature of many forms of work, new modes of transport, and increasing urbanization.”
However, some people who set themselves the goal of losing weight don’t need to lose weight.
“It is important to know whether it is necessary or indicated to lose weight. Often, having a slight weight gain or localized fat accumulation is not a reason to start a weight loss process,” says Ana de Hollanda, a specialist in Endocrinology and Nutrition at the Hospital Clínic de Barcelona and coordinator of the Obesity Area of the Spanish Society of Endocrinology and Nutrition (SEEN).
“However, when we are faced with a situation of overweight associated with other health problems such as alterations in blood sugar, cholesterol, high blood pressure, fatty liver or joint problems, among others, or in a range of obesity, losing weight, actually losing fat, will help improve these health problems and also prevent them from appearing,” highlights the endocrinologist.
What to do to lose weight?
“Once the health problem is diagnosed and weight loss is a required treatment, we must put ourselves in the hands of a professional, such as a family doctor, a dietician-nutritionist, or our reference nurse. They will guide the process, through a personalized assessment, to improve health. In general, this is achieved through changes in diet, prescription of personalized physical exercise, stress reduction, and reinforcing motivation to achieve goals,” she says.
Similarly, specialists from the National Institute of Diabetes, Digestive and Kidney Diseases in the United States point out that the safest way to lose weight and keep it off is to “follow a healthy diet with fewer calories than you used to consume and exercise every day.” In this regard, they advise choosing healthy foods, eating smaller portions, and incorporating exercise into your daily routine. “Together, these eating and exercise habits can be a healthy way to lose weight and keep it off. They also decrease the likelihood of developing heart disease, high blood pressure, and type 2 diabetes,” they emphasize.
As for the amount of weight to lose, Dr. De Hollanda explains that there is no set amount of weight to lose in a month. “Weight loss is usually very variable between people and depends on the magnitude of the changes made to achieve it,” she points out.
However, the endocrinologist warns that when a large amount of weight is lost suddenly, the body activates a series of mechanisms that make it increasingly difficult to continue losing weight and even regain the weight lost. “The feeling of hunger increases and metabolic expenditure decreases. In other words, the body burns fewer calories. It is a mechanism designed to protect the body itself since it detects a loss of cell mass,” she explains.
She says that, on the one hand, the rebound effect is normal as it is determined by this mechanism. But, on the other hand, “it happens when we go on a diet in which calories are severely restricted and, therefore, it cannot be maintained over time. So, when calories increase again, the lost weight is regained,” she explains.
To avoid the rebound effect, Dr. De Hollanda says that the ideal is to make lifestyle changes, both in terms of diet and exercise, that are progressive and can be maintained over time. “That is why we tend to refer to eating plans or dietary patterns rather than to a ‘diet’, which often implies the concept of being very different from the established dietary pattern,” she points out.
The endocrinologist also points out that, in more serious cases, such as obese people who have undergone bariatric surgery or who use medication, weight gain can also occur, as it is part of the physiology. “Obesity is a chronic and recurring problem. Understanding that this can happen, regardless of whether healthy habits are maintained, is important so as not to experience it as a failure,” she stresses.
BEWARE OF MIRACLE DIETS
Dr. De Hollanda stresses the importance of not falling into miracle diets, that is, diets that promise unrealistic results. “We must avoid very restrictive diets, those that prohibit or demonize a food group, such as carbohydrates, and also diets that use one or more foods as a priority, for example, the pineapple diet, the broth diet, etc.”, she says.
In this regard, the European Medical Institute of Obesity (IMEO) produces an annual ranking of the worst diets for losing weight. IMEO specialists point out that these are sensationalist and very restrictive diets, which promise to lose a lot of weight in a short time and which are unsustainable in the long term. They lack scientific support, the rebound effect is guaranteed and they have multiple side effects that can put health at risk. In short, IMEO stresses that they are not recommended for healthy weight loss.
Thus, in the top 5 of the least recommended diets for 2023 according to IMEO specialists, there are the diet of addictive substitutes such as alcohol, tobacco, or slimming pills; the Sirtfood diet; the apple diet; the anti-diabetic diet and the keto diet.
The addictive substitute diet consists of replacing a meal with tobacco, alcohol, or certain slimming or metabolism-boosting pills. For example, smoking a cigarette instead of breakfast. The Sirtfood diet, on the other hand, is based on the action of enzymes called sirtuins.
Its basic premise is to consume only foods that contain these substances or that activate them, such as apples, blueberries, capers, onions, kale, arugula, tofu, buckwheat, coffee, green tea, dark chocolate, nuts, parsley, turmeric, and virgin olive oil. “Despite being made up of healthy foods, this diet consists of three very low-calorie phases that aim for rapid weight loss,” says Carmen Escalada, a clinical nutritionist at IMEO. This diet presents a high risk of malnutrition.
Another of the diets that IMEO specialists rate the worst is the apple diet, “which consists of eating only this food for a long period, at least 2 or 3 weeks,” says Andrea Marqués, a dietician at IMEO. The entity states that, although the apple is excellent food, any mono diet involves excessive caloric restriction accompanied by a great lack of nutrients.
As for the keto diet, it is a diet plan that excessively reduces carbohydrates, increases fat consumption, and moderates protein intake. Its objective is for the body to start using ketone bodies produced from the breakdown of fat as an energy source instead of using glucose.
Finally, the anti-diabetic diet uses injections indicated for the treatment of type 2 diabetes, which produce weight loss as a side effect, since it decreases appetite and increases satiety. Its main danger is that it is not controlled by a medical team, since it can endanger the person’s health.
Likewise, Dr. De Hollanda explains that these drugs are also being studied for the treatment of obesity. However, self-medicating with them poses a health risk. “The side effects can be serious, such as nausea and vomiting that lead to dehydration and require attention in the emergency services.
At the same time, sudden weight loss can trigger mechanisms to regain the lost weight and, if there is no established plan afterwards, it is very likely to happen. In cases where weight loss is very significant, muscle loss is likely to occur, which can lead older people to a state of significant fragility,” explains the doctor.
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