PREVENTION AND TREATMENT OF OBESITY

The causes of obesity are diverse and multifaceted. No one solution exists; however, to fail to tackle this problem would be to condemn future generations to shorter life expectancies than their parents (House of Commons Health Committee 2004). A combination of dietary changes and physical activity, in combination with behavioral counseling, is likely to be more effective in retaining weight loss than diet or exercise alone in adults.

Physical Activity

An increase in physical activity is a significant part of weight loss therapy (Ladabaum et al. 2014). Most epidemiological studies have shown a reduced risk of weight gain, overweight, and obesity in people who take part on a regular basis in moderate-to- large amounts of physical activity or exercise (Brown et al. 2015).

Dietary Patterns for Obesity Reduction

Educating overweight and obese patients about foods and eating habits to facilitate weight control is a vital component of all weight management strategies. Education should consider the following (National Institutes of Health 1998):

  • • Energy values of different foods
  • • Food composition: fats, carbohydrates and protein
  • • Food labeling
  • • New practices of purchasing
  • • Food preparation
  • • Avoiding the overconsumption of high-calorie foods
  • • Adequate water intake
  • • Decreasing portion sizes
  • • Limiting alcohol consumption

Some dietary patterns for weight loss are:

  • Low-calorie diets (LCDs) and very low-calorie diets (VLCDs): There are essentially two forms of calorie-restricted diets that are typically used. LCDs provide 1000-1500 kcal/day and VLCDs less than 800 kcal/day. VLCDs should not be used as routine for weight loss therapy and it is not recommended generally to have a diet containing less than 1200 kcal/day (WHO 1998). Clinical trials have shown that LCDs are as effective as VLCDs in producing weight loss after 1 year (Ladabaum et al. 2014).
  • Mediterranean diet: Research has found that high adherence to the dietary patterns of Mediterranean populations is associated with a lower prevalence of obesity in men and women (Schroder et al. 2004). Mediterranean diets are characterized by high intakes of vegetables, fruits, legumes, fish, cereals, and nuts with low-to-moderate consumption of meat and wine. This dietary pattern has been shown to significantly reduce weight, CVD, and cancer mortality rates, especially if followed for a long period (Mendez et al. 2006; Schroder et al. 2004).
  • Low-fat versus low-carbohydrate diets: It is still rather uncertain whether one is better than the other, especially among people of African origin since the number of studies is limited (Bazzano et al. 2014). Research has shown, however, that study participants following a low-carbohydrate diet lost more weight than those on a low-fat diet (Forster et al. 2010). Compared with a low-fat diet, a low-carbohydrate diet program tends to reduce the risk factors for CVD as well as help to maintain weight loss (Astrup et al. 2004; Bazzano et al. 2014; Yancy et al. 2004).
  • Low-glycemic index (GI) diet: Kong et al. (2014) reported an association between a low-GI diet and decreased calorie intake with healthier dietary composition and reduced BMI in obese adolescents. In another randomized control trial where participants were randomly assigned to a high-GI diet, a low-GI diet, or a low-fat diet reported that after 6 months, there was a significant reduction in BMI in the low-GI diet group compared with the low-fat group (Juanola-Falgarona et al. 2014).
 
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