Obesity prevalence has increased dramatically over the past 40 years: since 1980, this has doubled in more than 70 countries (GBD 2015 Obesity Collaborators et al., 2017).
In 2016, more than 1.6 billion people over the age of 18 worldwide were overweight, of whom 650 million were obese (WHO).
It's recommended for individuals classified as overweight or obese to lose weight gradually (1-2 lbs/week) through evidence-based methods for health benefits.
What is obesity and how is it measured?
The excessive fat accumulation that negatively impacts health is referred to as overweight and obesity. Body Mass Index (BMI) is a widely used method to assess these conditions in adults.
BMI is calculated by dividing a person's weight in kilograms by the square of their height in meters (kg/m2).
The World Health Organization (WHO) has established the following definitions for overweight and obesity in adults:
- Overweight is defined as a body mass index of 25 or more, up to 30.
- Obesity is defined as a BMI of 30 or higher.
BMI is considered the most practical measure of overweight and obesity in a population, as it is consistent for all ages and genders of adults. It is important to note that BMI is only an approximation and may not accurately reflect an individual's level of body fat.
What is metabolic syndrome?
Metabolic Syndrome is a group of associated risk factors, including elevated blood pressure, high blood sugar, abdominal obesity, and abnormal cholesterol or triglyceride levels.
These can culminate in the development of dangerous comorbidities like heart disease, stroke, or type 2 diabetes mellitus.
Having a single condition does not necessarily indicate the presence of metabolic syndrome, but it does increase the likelihood of severe health issues.
One sign that is visible is a large waist circumference.
What is intentional weight loss?
Intentional weight loss is the loss of some body mass due to efforts to improve fitness and health or to change appearance through slimming. Intentional weight loss has significant health benefits for people who are overweight and obese.
What are the benefits of intentional weight loss?
One of the most rapid changes following intentional weight loss is improving glycemia. The correlation between weight loss and changes in HbA1c levels in patients with Type 2 diabetes is well established.
The rapid reduction of liver fat and circulating triglyceride levels that follows rapid weight loss leads to improved insulin sensitivity in the liver and a potential decrease of fat in islet cells, thus potentially resulting in improved beta cell function from the pancreas.
The DIRECT trial provides significant evidence of the benefits of a low-calorie diet on liver fat, triglyceride levels, glycemic indices, and even diabetes remission in some patients. These findings are consistent with the robust epidemiological association between higher body mass index and increased risk of diabetes, with relative risks of over 10 times higher for those with a BMI over 30 than those with BMI above 21.
A meta-analysis of 15 randomized controlled trials of weight loss included 17,186 participants, obese and overweight adults, randomized to weight loss (53% female) with an average age of 52 years at baseline, showing a 15% reduction in all-cause mortality.
How to improve the diet?
The most preferred way to combat obesity is through changes in lifestyle, specifically diet.
Clinical data has consistently shown that eating nutritious, high-quality meals spaced evenly throughout the day and containing 20 to 40 grams of protein ("protein pacing") along with reduced consumption of processed foods, sugar, and fat, and increased fiber intake leads to significant reductions in body weight, fat mass, and visceral fat, while preserving fat-free mass and improving cardiovascular health.
Combining "protein pacing" with caloric restriction amplifies these positive outcomes.
Another dietary strategy that can be considered is intermittent fasting, on its own or in conjunction with caloric restriction.
What is intermittent fasting?
Intermittent fasting (IF) is an eating pattern that involves alternating between periods of fasting and eating. The practice has gained popularity in recent years, as research suggests it may have numerous health benefits.
- One of the primary benefits of IF is weight loss. Restricting the window of time in which one can eat IF can help reduce caloric intake and promote fat loss.
- This approach focuses on the timing and quantity of food intake and triggers a metabolic switch in the liver, which causes the body to switch from glucose to ketones during fasting periods.
- This switch can lead to improved insulin sensitivity, blood glucose regulation, stress resistance, and a reduction in inflammation.
- Intermittent Fasting has been shown to be effective in improving various health conditions, including obesity, type 2 diabetes, and cardiovascular diseases through weight reduction and improved metabolic parameters.
- Multiple randomized clinical trials, systematic reviews, and meta-analyses support the health benefits of intermittent fasting.
There are several methods of IF, including the 16/8 method, which involves fasting for 16 hours and eating within an 8-hour window, and the 5:2 method, which involves eating normally for five days and restricting caloric intake to 500-600 calories for two non-consecutive days.
It is important to note that intermittent fasting may not be appropriate for everyone, particularly those with a history of disordered eating or certain medical conditions.
It is important to consult with a healthcare provider before beginning an Intermitent Fasting regimen.
In conclusion...
Intermittent fasting has emerged as a promising approach for weight loss and improving various aspects of health. While further research is needed to fully understand the extent of its benefits, initial evidence suggests that IF may be a safe and effective dietary approach for many individuals.
In 2019, an alarming 5 million deaths were attributed to obesity-related health issues. These preventable deaths are a critical reminder of the importance of maintaining healthy lifestyles for all individuals worldwide. (World Obesity Federation 2022)
Unless drastic action is taken, by 2060 an alarming number of countries will likely have over 70% of their populations struggling with overweight and obesity - including children. (World Obesity Federation 2022)
- Sattar N. et al Impact of intentional weight loss in cardiometabolic disease: what we know about the timing of benefits on differing outcomes?- Cardiovascular Research (2022) 00, 1–5
- Gaesser G.A. et al, Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks Volume 24, Issue 10, 22 October 2021, 102995
- https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight accessed at 13.02.2023
- M. Moradi-Lakeh, et al. Health effects of overweight and obesity in 195 countries over 25 years, N. Engl. J. Med., 377 (2017), pp. 13-27
- https://doi.org/10.1016/S0140-6736(17)33102-1
- Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481–6.
- Kritchevschi B. et al, Intentional Weight Loss and Mortality, DOI:10.1371/journal.pone.0121993 March 20, 2015
- Arciero PJ et al, Intermittent fasting and protein pacing are superior to caloric restriction for weight and visceral fat loss, Obesity (Silver Spring).2023;31(Suppl. 1):139–149
- Okunogbe et al. The Economic Impact of Overweight & Obesity in 2020 and 2060; BMJ Global Health 2022
Patikorn C et al.,Intermittent Fasting and Obesity-Related Health Outcomes, JAMA Network Open. 2021;4(12):e2139558. doi:10.1001/jamanetworkopen.2021.39558
Please note that the information provided on this blog is for educational and informational purposes only. It is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
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