Professor, Doctor of Medicine Mavrodiy Volodymyr Mykhailovych talks about body weight correction especially for us.

You shall change the psychology of nutrition in order to achieve a normal body weight. First, it is 5 times meal; small breaks in food, dinner should be light. Exclude high-calorie products (buns, cookies, sweets, lard), you need to eat slowly, chewing food thoroughly as the increase in level of glucose in the blood begins after 20 – 25 minutes since food enters the stomach, which determines the suppression for feeling of hunger.

Shortly before meals, drink a glass of cold water in small sips. This will reduce the excitability of the stomach’s nervous system. Do not forget that pepper, horseradish, mustard, sauces, pickles and especially alcohol are the appetite stimulants. Eat unsalted food. The feeling of hunger is difficult to overcome. Take low-calorie foods (carrots, cabbage, apples, kefir) between meals to calm it down.

You may substitute the products. For example, the fried for boiled potatoes, red for white meat – poultry or fish, pasta for “coarse” porridge. The calorie content of the diet is 1,600 kcal/day. WHO’s experts recommend reducing the body weight by 6-12 kg in 20-24 weeks of treatment, i.e. an energy deficit of 500-600 kcal/day.

Achieve the emotional well-being in order to reduce food consumption. This is due to the fact that regulating the feeling of hunger is adversely affected by stressful situations: nervousness, increased anxiety, depressed mood. In order to “suppress” such centers for negative indignation of the central nervous system, a person sometimes adapts to use the excessive amounts of food, which form a feeling of food satisfaction. People with a certain type of higher nervous activity try to achieve a favorable comfortable state due to additional, and therefore excessive, food. A person begins and gets used (sometimes from early age) to seek for comfort in stressful life in food.

A number of authors consider obesity as a kind of food neurosis. And vice versa, a slim figure and a reduction in excessive body weight are the indicators of self-control and psychological well-being. The combating system against excessive weight organically includes the elements of self-training, psychotherapy, good self-irony, and support of loved ones.

It is a mistake when overweight patients try to starve, refuse from food during the day in order to “wait” for evening, arrange “hungry” days, etc. forgetting that it is contraindicated in everyday work conditions. In addition, hunger leads to gluconeogenesis and lipolysis, possible intoxication with ketone bodies. Hunger is prohibited!

The special diets are designed for a limited number of people, they are not available for everyday life. There are a number of products, necessary for normal human activity, which primarily contain proteins: eggs, cheese, meat, poultry, fish. They contain the essential substances and energy-intensive products for the body: bread products, coarse types of porridge (corn, pearl barley). For example, the daily amount of bread (100-200 g) can be taken in the first half of the day in the form of black and gray varieties, preferably with bran additives.

The fat metabolism is not disturbed at excessive body weight. Vice versa, the physiological content of easily digestible fat in food (oil) inhibits the transfer of carbohydrates into the fat cell and promotes the formation of feeling of satiety. Exclude the consumption of refractory animal fats that solidify. In general, just following a diet reduces the body weight by 5-6 kg/year. It is good as insulin works on fat cells.

Remember that fat deposits are best eliminated by physical education. The physical therapy does not require any special skills, therefore it belongs to available forms for increase of motor activity: intensive walking, swimming, gym.

Before starting the physical therapy, it is necessary to conduct a tolerance test for dosed physical load – walking path “Treadmill”. A set of morning exercises should be repeated during the day every hour for 5 minutes if you want to reduce the fat mass.

Many people prefer intensive walking. Start it with 5 minutes, gradually increasing the duration day by day to 60 minutes. Until this period, the duration of intensive walking is a certain part of daily walk for an hour.

After mastering the fast walking, you can move on to jogging. Start with 3 minutes, gradually increase its duration by 3 minutes during a cycle of 10-20 weeks, depending on age. The rest of the one-hour exercise is filled with walking or physical exercises. Maybe just walking from 1,000 up to 10,000 steps a day with pedometer. It is quite enough to spend 20 – 30 minutes. jogging or exercising every other day, or 45 minutes 3 times a week. The effectiveness of physical exercises means minus up to 6-7 kg/year.

The main rule to increase the motor load is gradualness, regularity, preservation of good health, cheerfulness, absence of adverse body reactions. During physical exercises, the pulse rate should not exceed 140 min. It is important that a gradual increase in motor activity does not increase your appetite (energy expenditure per exercise is 300-500 kcal).

In general, today, the belief in “miracle” diets is either a misunderstanding of essence of obesity, or stupidity. In fact, we wander in 2 birches, or rather in 2 arrows, only one is down and the other is up.

Fig. 1. Scheme for gradual correction of body weight

All methods for treatment of obesity belong to long-term, practically lifelong recommendations, since the essence of excessive weight lies in the disturbed type of energy metabolism, inherent to specific person. Sometimes the patients have been waiting for the end of “treatment” course in order to return to the former routine of eating and living. The pills therapy of obesity “helps” only on TV, in particular, “in one session”.

It is important that reducing the risks of obesity, losing the weight should be slightly more than 13% of the initial body weight per year. The abovementioned recommendations should become a part of lifestyle for those ones, who are determined to get rid of excessive weight. Therefore, the family doctor makes a work plan for the patient for at least a year, and the achieved results should be fixed for life, i.e. form a new way of life.