Expert Guide: Safe and Effective Nutrition for Obesity Management

According to the World Health Organization, 30% of adults in economically developed countries are overweight. In our country, 26% of adults suffer from obesity. Obesity is a significant factor contributing to the development of atherosclerosis, hypertension, and diabetes. Individuals with obesity have higher mortality rates and tend to die at a younger age. Leonid Meleshko, a physician from the Minsk City Clinical Center for Psychiatry and Psychotherapy, shares insights on combating obesity.

Types of Obesity and Their Treatment

Excessive fat accumulation in the body can be an independent disease or a syndrome accompanying various illnesses. Obesity can be generalized or localized, characterized by fat deposits in the form of lipomas, mainly in the subcutaneous fatty tissue.

Primary Obesity

Primary obesity develops due to excessive calorie intake, particularly from animal fats and carbohydrates, and irregular eating habits (consuming most of the daily ration in the evening). Even with low-calorie diets, obesity can develop if physical activity is drastically reduced. Hereditary factors also play a crucial role, as obesity often runs in families.

Secondary Obesity

Secondary obesity can result from endocrine disorders and central nervous system diseases.

Degrees of Obesity

Depending on the severity of symptoms, primary obesity is classified into four degrees:

Degree I: Body weight exceeds normal by 15-29%;
Degree II: Body weight exceeds normal by 30-49%;
Degree III: Body weight exceeds normal by 50-100%;
Degree IV: Body weight exceeds normal by more than 100%.

Comprehensive Treatment

Treatment is always comprehensive, aiming to create a negative energy balance in the body by drastically reducing calorie intake. This is achieved by reducing the intake of animal fats and carbohydrates, especially refined ones, and increasing physical activity.

Dietary Guidelines

The minimum calorie intake per day should not be less than 600-800 kcal. Such a diet contains the physiological quota of protein and is prescribed only in inpatient settings for no more than two weeks. More commonly, a diet with an energy value of 1700-1800 kcal is used. Reducing calories to 1200-1300 kcal is possible for severe degrees of obesity.

Nutrition and Diets for Obesity

Diet plays a crucial role in managing obesity. Low-calorie diets have been developed by the Institute of Nutrition of the Russian Academy of Medical Sciences for treating patients with obesity.

Sample Daily Diet Plans

800 kcal Diet Plan

First Breakfast: Vegetable salad with vegetable oil – 150-170g; black coffee without sugar – 200g;
Second Breakfast: Apple – 100g;
Lunch: Vegetarian borscht or soup – 250g; boiled chicken – 120g;
Afternoon Snack: Rosehip infusion – 200g;
Dinner: Vegetable stew – 150g;
Before Bed: Kefir (or yogurt) without sugar – 200g.

1200 kcal Diet Plan

First Breakfast: Boiled meat – 50g; non-starchy vegetables – 100-150g; coffee or tea with milk – 200g;
Second Breakfast: Low-fat cottage cheese – 100g; tea without sugar with milk – 1 cup;
Lunch: Vegetarian borscht or soup – ½ portion; beef stroganoff – 50g; stewed vegetables – 120-150g; compote without sugar – 1 cup;
Afternoon Snack: Apple – 100g;
Dinner: Boiled fish – 100g; boiled potatoes – 100g; tea without sugar with milk – 1 cup;
Before Bed: Kefir (or yogurt) without sugar – 1 cup.

Fasting Days: Types and Applications

Fasting days are prescribed in conjunction with a low-calorie diet, typically once a week. The energy value of fasting days ranges from 750 kcal (apple day) to 1000 kcal (sour cream day). The most significant weight loss occurs with apple-vegetable fasting days (up to 1 kg per day), while the least occurs with fat fasting days (up to 300 g).

Protein Days

Protein days are easier for patients to tolerate. They typically involve consuming meat, cottage cheese, kefir, yogurt, or milk. Non-fat meat (300-350 g divided into 5 portions) is most commonly used. Non-fat varieties of boiled fish can also be used in the same quantity. Vegetable garnishes from salad vegetables can be added. In the morning and evening, a glass of rosehip infusion or weak tea with milk without sugar is recommended.

Cottage Cheese Day

500 g of cottage cheese is divided into 5-6 portions. A small amount of chopped greens (dill, parsley) can be added to the cottage cheese. Throughout the day, black coffee without sugar is consumed, and in the morning and evening, a glass of rosehip infusion is recommended.

Karelian Diet

This diet consists of milk (6 glasses) with a gradual inclusion of other products (bread or rusks, eggs). The Karelian diet is more appropriate for individuals with cardiovascular insufficiency.

Carbohydrate Days

These days involve consuming carbohydrates rich in dietary fiber. For example, apple days involve eating 1.5 kg of apples (preferably several varieties) divided into 5-6 portions every 2-3 hours. Other fruits, except grapes and bananas, can also be used.

For carbohydrate fasting days, various vegetables are often used: cucumbers, cabbage, tomatoes, radishes, lettuce, etc. Carbohydrate days result in the most significant weight loss, although they are harder for patients to tolerate. They are contraindicated in acute gastritis or colitis, and chronic gastritis or colitis in the exacerbation stage.

Cucumber Days

On these days, a person eats about 2 kg of cucumbers divided into 5-6 portions. A small amount of table salt is added. Cucumbers (more than cabbage) contain tartronic acid, which reduces the conversion of glucose into fat.

Fat Fasting Days

These days are less commonly used. They involve consuming 200-300 g of sour cream per day in 3 portions. Additionally, 2 cups of coffee with milk (50 g per cup) without sugar and 1-2 cups of rosehip infusion are recommended. Cream (500-750 ml per day) is given in equal portions every 3 hours (a total of 5 portions) in pure form, with coffee or tea without sugar.

The use of fat fasting days is contraindicated in the presence of cholecystitis, pronounced atherosclerosis, and certain forms of colitis.

Combined Fasting Days

These days involve using various, predominantly similar, products in different combinations (meat and fish, apples, vegetables, and berries, etc.). Protein-carbohydrate fasting days, such as cottage cheese and vegetable days, can also be prescribed: 250 g of cottage cheese and 500 g of vegetable salad for the whole day.

To simplify low-calorie nutrition, specially developed nutritional mixtures and cocktails containing a complex of vitamins, microelements, amino acids, and enzymes are now available on the market. There are products in the form of low-calorie cocktails that replace one or several meals.

For more information, visit the World Health Organization website.

Expert Guide: Safe and Effective Nutrition for Obesity Management