April 2024 is the 36th National Patriotic Health Month. The theme of this year's event is "Healthy Towns, Healthy Weight". Weight management is a comprehensive process that involves multiple aspects such as diet, exercise, psychology, etc. This issue of "In-depth Interpretation" column focuses on how obese people can lose weight scientifically. If obese people want to lose weight successfully, they need to use 3 magic weapons - keep their mouths shut, open their legs, and keep their hearts to make weight management more scientific and effective.
Keep your mouth shut: reasonable diet, nutritious matching
Department of Clinical Nutrition, Peking Union Medical College Hospital, Sun Mingyao, Chen Wei
Obesity is one of the biggest public health problems in the world today, and it is a great challenge to individual health and social burden.
Obesity is associated with a higher risk of early mortality and increases overall mortality. At present, overweight and obesity have become the fifth leading cause of death in the world, and are associated with the occurrence of various chronic diseases such as diabetes, stroke, coronary artery disease, hypertension, respiratory diseases, osteoarthritis, etc., as well as the occurrence of a variety of tumors. In addition, the obesity epidemic has also placed a heavy burden on the national economy.
Weight loss has a significant impact on health
Overweight and obesity can lead to many complications, such as high blood pressure, diabetes, dyslipidemia, etc., and weight loss can help improve chronic complications and improve the treatment of complications. Weight loss is recommended for obese or overweight patients with any of the diseases such as diabetes, hypertension, and dyslipidemia.
Losing 5%~10% of body weight is usually recommended for obese people. Population-based studies have shown that even a 5% weight loss in obese people can improve insulin sensitivity in adipose tissue, liver and muscle, and pancreatic β cell function, while improving metabolic function in multiple organs. Further weight loss can help lower blood pressure, triglyceride levels, increase HDL cholesterol levels, prevent the development of type 2 diabetes, and reduce the use of glucose-lowering drugs in diabetic patients. Weight loss also has a role in improving sleep apnea and fatty liver. In the long term, weight loss can also help reduce the risk of cardiovascular disease and cancer.
Manage the right way to choose your weight
Lifestyle management is the cornerstone of obesity treatment, and even medical and surgical treatment must be based on lifestyle intervention to achieve better results. Whole lifestyle management refers to the simultaneous implementation of a variety of lifestyle intervention strategies for overweight and obese patients, mainly including three elements: diet management, physical exercise and behavioral intervention.
In terms of dietary intervention, energy-restricted diet refers to reducing energy intake by 500~1000 kcal per day on the basis of target energy intake, or reducing total energy by 1/3 compared with the recommended intake. Energy-restricted diet is currently recognized as a more effective weight management method, which can reduce the weight and body fat content of obese people, thereby reducing the body's inflammatory response, reducing the component of metabolic syndrome, and reducing the risk factors of cardiovascular disease. There is no consensus on the effectiveness of other dietary interventions, such as high-protein dietary therapy, low-carbohydrate diet, and intermittent energy restriction, for weight loss. In addition, a very low-energy diet (less than 800 kcal per day) can only be used in certain special cases and must be carried out under the close supervision and guidance of a multidisciplinary medical team to avoid unnecessary risks and other health problems.
Special populations are focused
Children and adolescents are a special population for weight loss management, but the management model is different from that of adults. It is suggested that the "Dietary Guidelines for Chinese Residents (2022)" should ensure the demand for high-quality protein, minerals, vitamins and other nutrients for the growth and development of children and adolescents, and at the same time limit the total energy intake in combination with the needs of obese children and adolescents to control their weight, and recommend the intake of foods with high dietary fiber content such as cereals, potatoes, cereals, vegetables and fruits.
In addition to children and adolescents, obese elderly people are also a special population for weight loss management. Not only should they limit their energy intake appropriately, but they should also supplement with adequate protein, vitamins, and minerals. Older adults should avoid a very low-energy diet for weight loss, as this may downregulate protein synthesis in skeletal muscle and accelerate protein breakdown, resulting in reduced skeletal muscle mass and strength, and an increased risk of fluid and electrolyte imbalances.
Scientific weight loss pays attention to details
On the premise of controlling total energy, weight losers can reasonably choose some low-energy, high-satiety foods such as high potassium, high fiber, and high protein, such as lettuce and broccoli. Compound carbohydrates should be chosen as much as possible for staple foods, such as wheat cakes, multigrain rice, rice, flour, etc. Complex carbohydrates are digested more slowly, providing a longer feeling of fullness and less likely to gain weight. It is recommended that those who lose weight replace 30%~50% of their staple foods with coarse grains such as mixed jicama and whole grains.
Pay attention to your oil and salt intake during weight loss. It is recommended to limit the daily cooking salt to less than 5 grams, and those with high blood pressure or kidney disease should limit it to less than 3 grams per day, and reduce the intake of other foods and seasonings with high salt content. It is recommended that the daily cooking oil dosage is 25~30 grams. It is recommended to eat raw, mix, steam, boil, and stew, and avoid cooking methods such as high oil, sugar, and salt.
Step out of your legs: Exercise moderately to avoid injury
Department of Sports Medicine, Huashan Hospital, Fudan University, Sun Yang, Zhang Shurong, Ge Yunshen
Scientific weight loss is inseparable from the right way to exercise. It is recommended that overweight or obese people develop a reasonable exercise plan under the guidance of a professional physician according to their own health status and personal preferences, and insist on exercising.
Exercise has many health benefits
Exercise burns calories. Weight loss occurs when exercise consumes more energy than is consumed through food.
Exercise improves sleep quality. Studies have shown a strong link between good sleep and weight control. A good night's sleep promotes recovery and maintains muscle health.
Exercise has a positive impact on mental health. When exercising, the brain releases "happy hormones" such as endorphins, which are chemicals that can relieve stress, reduce anxiety and depression, reduce emotional eating and mindless overeating to some extent, and help manage weight.
Choose the right way to exercise
Obese people should choose the appropriate exercise mode, and should lose weight reasonably within the range that the body can bear, and avoid sports injuries.
Aerobic exercises such as jogging, swimming, etc. are all good options. When you first start exercising, you should focus on moderate intensity and ensure that it is gradual to avoid increasing the risk of sports injuries. Usually at the beginning, exercise for 30 minutes 3 times a week. After that, gradually increase the number of exercises to 5 times a week for 30 minutes each time, depending on the individual's situation, to achieve the World Health Organization's recommended 150 minutes of moderate-intensity aerobic exercise per week. In addition, resistance training is also essential, such as dumbbells, barbells and other equipment training, which can enhance muscle strength and improve metabolic levels. It is recommended to do resistance training 2~3 times a week, 2~4 sets of main muscle groups, and the number of repetitions in each group can be maintained at 8~15 times according to the ability level and exercise goal.
Different age groups exercise in different ways
For people of different ages, the choice of weight-loss exercise will also have special factors to consider to avoid sports injuries.
Obese children: Weight-loss exercises should be based on play and fun exercises, with the goal of increasing activity rather than stressing them. Parents can encourage their children to participate in outdoor activities.
Obese adolescents: Adolescence is a critical time to develop healthy lifestyle habits, so exercise programs should be varied to maintain their interest and participation in sports. You can choose a variety of ball games, which are competitive and social. At the same time, it is supplemented by aerobic exercises such as running and swimming to enhance cardiorespiratory endurance, as well as freehand strength training, etc., to help them achieve better cardiorespiratory endurance levels and musculoskeletal health during the critical period of puberty.
Obese middle-aged people: Due to the limited daily exercise time, they can choose to plan high-intensity interval training flexibly and efficiently to achieve greater health benefits in a short period of time. At the same time, such people can try to improve the spinal problems caused by sitting for a long time by practicing yoga and Baduanjin.
Obese older adults: They exercise not only to lose weight, but also to maintain muscle strength, flexibility and balance, and to prevent falls. Therefore, you can choose exercises with lower intensity and less physical load, such as walking, tai chi, etc.
Keep a good heart: emotional stability, unity of knowledge and action
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Guo Li, Tan Jianyu, Zhai Jian, Yang Liu
On the path of weight loss, we will meet two elves who live inside: one is the "weight loss elf" and the other is the "indulgent elf".
Chubby Dun is a college student who has always longed for a healthy and light body. With this thought in mind, he embarked on a weight-loss journey, hoping to one day be able to stand confidently in the crowd and no longer be shy about his size.
Early that morning, Fat Dun woke up to passionate music and decided to carry out his own weight-loss plan. The "weight-loss elf" said: "Come on, as long as you are brave enough to step out of the door, you will be one step closer to the success of weight loss." The "indulgent elf" said: "It's too hot today, how comfortable it is to lie down and blow the air conditioner at home, don't go to exercise." Eventually, Fat Dun decided to take a day off and start again tomorrow.
Throughout the day, Chubby tried to lose weight by controlling his eating to reduce the guilt of not exercising. Under the supervision of the "weight loss elf", he ate almost nothing for the whole day, except for some water and a few slices of lettuce. But when night fell, loneliness and hunger began to invade his heart. The "Indulgent Elf" buzzed around his head: "You're so tired from studying today, what's wrong with indulging?" and he ordered a takeout - skewers, milk tea, and cream cake. After eating, Fat Dun felt unprecedented guilt and loss.
After a few days of "struggling", Fat Dun began to wonder if his efforts to lose weight were worth it. Slowly, because of the delay in weight loss, he began to feel depressed and overeat. In desperation, he went to the school's psychological counseling room and asked the psychology teacher for help. After hearing about his experience, the psychology teacher told him that in the journey of scientific weight loss, he should achieve the goal of weight loss in the company of the "weight loss elf", and also learn how to live with the "indulgent elf". With these methods in hand, you can achieve your desire to lose weight scientifically.
Mood and weight are closely related
For many people, emotions and diet are inextricably linked. Emotional problems such as stress, anxiety or depression often lead to eating disorders, such as overeating or loss of appetite, both extremes can lead to weight problems. Studies have shown that people who are in a depressed state have a higher risk of obesity. This phenomenon is partly due to unhealthy eating habits caused by emotional instability, such as mood eating, which is the tendency to consume high-energy, high-fat foods for comfort when feeling stressed or depressed. In addition, long-term stress can also lead to changes in hormone levels in the body, increasing fat storage, which may eventually lead to obesity.
To shape the "body", we must first shape the "heart"
As the saying goes, you can't get a big fat man by eating one bite. Similarly, weight loss is not immediate. Before losing weight, you must first do a good job of psychological construction.
Set a reasonable weight loss goal: If you have a weight loss goal that is too high, it is easy to disappoint yourself and lose confidence. It is recommended to subdivide your goals, such as losing 0.5 kg per week, and gradually achieve them. This not only increases the confidence to lose weight, but also increases the motivation to lose weight.
Change your self-blame thinking: Don't blame yourself too much for being tempted by the "indulgent elf" once. For example, if you eat high-energy food one day, or if you don't achieve your goal, don't blame yourself too much and want to give up, but take this indulgence as a small reward. It should be noted that you still have to stick to your original intention of losing weight, and you can't often be affected by the "indulgent elf" and shake your determination to lose weight.
Find someone who supports you in losing weight: For example, with a "weight-loss elf", for example, you'll be more likely to stick with it. You can also share your weight-loss goals with family and friends and ask them to be your supporters.
Develop a positive self-image: Tell yourself every day that I am becoming healthier and more beautiful. Give yourself positive mental cues instead of focusing too much on your weight.
Develop the habit of exercising scientifically and having a regular schedule: Find the exercise you like and stick to it, and make your routine regular, which can not only help you lose weight, but also release your inner stress, anxiety and other bad emotions.
In the process of weight loss, it is important to maintain emotional stability and alignment of knowledge and action. Only by maintaining a good mindset and actively coping with the challenges encountered in weight loss with the encouragement of the "weight loss wizard" can we achieve the goal of healthy weight loss.
Weight Reduction, Health Improvement
Xu Weisheng, researcher at the Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention
Overweight and obesity have become serious problems that threaten human health around the world. Among them, the problem of childhood obesity cannot be ignored. According to the Report on the Status of Nutrition and Chronic Diseases in China (2020), the combined overweight and obesity rates of children and adolescents aged 6~17 in mainland China are nearly 20%, and the combined overweight and obesity rates of children under 6 years old are 10%. Compared with the report released in 2015, the rate of overweight and obesity among children and adolescents aged 6~17 and children under 6 years old is increasing.
Childhood obesity is very harmful to children's health. It not only affects the growth and development of individual children and their physical and mental health, but also causes harm to the development of families and society. Studies have proved that the health hazards of childhood obesity not only affect the eventual occurrence of obesity in adulthood, but also have an impact on the occurrence of cardiovascular and cerebrovascular diseases and psychological problems.
Influenced by traditional concepts, many parents think that it is a blessing for their children to be able to eat, and it is better to be fat. As everyone knows, children are fat when they are young, and they are often fat when they grow up, which will cause an increase in chronic diseases in adulthood, which will affect his health, longevity and quality of life throughout his life. The causes of overweight and obesity in children have a lot to do with parents' incorrect perceptions, but there are also other factors, such as genetic factors, dietary factors, physical activity, social and cultural environment, etc.
The prevention and control of childhood obesity requires the joint participation of families, schools and society, and parents are the first responsible persons for the prevention and control of childhood obesity. If a parent doesn't like to eat a certain food, the child may not be able to eat it, and if the parent is reluctant to go outdoors, the child may not be physically active or develop a habit of being active. Therefore, parents should improve health literacy, establish the concept of being responsible for their own health and behavior, develop healthy eating behaviors, actively carry out physical activities, and encourage and support children to develop good behavior habits through behavioral demonstration.
In addition to leading by example, parents should also consciously and regularly monitor their children's height, weight and other indicators, timely detect children's nutritional and health problems, and make corresponding dietary and exercise adjustments to avoid overweight and obesity and ensure the healthy growth of children.
Helping children develop good living habits is not only to prevent overweight and obesity, but most importantly, to enable children to benefit for life, with their weight down and healthy up.
Editor: Liu Yang, Yang Zhenyu
Proofreader: Li Shiyao
Review: Guan Zhongyao, Xu Bingnan