Weight loss interventions

Hello Steemits

Weight loss intervention:

It has been discovered that obesity can increase the risk of a severe Covid-19 infection, therefore you are more likely to have significant complications from Covid-19 if you contract it. It is hence, an opportune time to consider healthy weight loss if you are overweight or obese.

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However, many people find weight loss incredibly difficult and, as everyone reacts differently to different eating plans due to physiology, genetics, culture and emotions to name a few, there is no perfect one-size-fits-all way to healthy weight loss. This blog aims to discuss the research behind different methods to try and break the facts away from the fads. It is important to remember that “diets” do not tend to work as they tend not to create long term dietary and lifestyle changes which are necessary to achieve long term sustainable weight loss.

What’s the deal with calories?

Calorie counting is what many people focus on and there are inherent problems with a calorie focused approach. Someone trying to lose weight might have a low calorie breakfast cereal, then at lunch-time they choose a low calorie ‘Meal deal’ that includes a sandwich plus an apple; and perhaps for supper some pasta and low fat sauce; and maybe some low calorie treats (like biscuits or a snack bar). This kind of diet is likely to provide what is considered an appropriate range of calories for weight loss, between 1000 to 1500 calories per day. But eating these foods will have a disastrous impact on blood sugar for many people, resulting in high levels of insulin, and when insulin is high the body goes into fat storage mode! So, you will have come across people who say they are counting calories and can’t lose weight!

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The focus on calories should not be the whole story – whilst it is true that if you eat more calories than you need you will gain weight, it is not necessarily true that reducing calories will lead to weight loss. The idea that weight management is about balancing a ‘calorie’ equation – calories in versus calories out – is over-simplified.

The other problem is that many foods that are selected on the basis of their calorie or fat content are not nutrient dense. Hence, they do not have significant quantities of micronutrients – vitamins and minerals. Of course, they will provide some vitamins and minerals but mostly what these foods provide is ‘empty calories’, calories that are devoid of or low in essential micronutrients, in the form of carbohydrates and not the good carbohydrates.

So food is more than calories – it provides nutrients – and the food’s nutrient density will determine how the body responds to it. So rather than focus on calories, we would do better for overall health (and weight) to focus on eating foods that are nutrient dense.

✓Support

A substantial proportion of people do not adhere to weight loss interventions. Programmes supervising attendance, offering social support, and focusing on dietary modification have better adherence than interventions not supervising attendance, not offering social support, and focusing exclusively on exercise.8

✓Satiety

The hormone leptin is designed to modulate a stable weight in individuals. It is one of the hormones released after a meal to make you feel full or satisfied and is produced by adipose tissue. Therefore, the more adipose tissue (or fat) you have the more leptin you produce, therefore the more satisfied you feel and the less you eat, reducing adipose tissue thereby maintaining a stable weight. However, many things can influence leptin signalling such as inflammation and high cortisol (stress). Also, hunger/satiety feedback mechanisms are ignored, i.e. you eat when you are not hungry, excess leptin is produced which can contribute to leptin resistance, this is a problem as then satiety feedback mechanisms do not work and hunger prevails, thereby increasing caloric intake, and adipose tissue and therefore leptin which is ineffective. Therefore, factors mentioned which impair leptin signalling need to be considered and attenuated in individuals.1,2

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The body has other satiety mechanisms which can be useful to utilise to support healthy weight loss. Gastric stretch receptors detect the distension of the stomach wall in the presence of food, which directly stimulates neuronal pathways to the brain to trigger satiation and appetite reduction. Therefore low density foods which contain a high amount of fibre, will fill the stomach more readily and stimulate stretch receptors with a lower calorie intake. High fibre from vegetables with healthy fats and protein in a meal are a good combination for stimulating stretch receptors and release of satiety hormones and neuropeptides in response to food consumption.3

It should be noted that satiety mechanisms have always been thought to be solely reliant on macronutrient satiety (i.e. adequate protein, carbohydrates and fat). However, micronutrient levels are also essential for satiety. If cells are devoid of adequate micronutrients, the brain will signal the body to increase nutrient intake. Therefore, if food is not micronutrient dense the body will not feel adequately satisfied and will crave further nutrition. This can lead to an increase of caloric intake.
#weight

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