Losing weight - information & doctors for bariatrics

Losing weight and staying slim requires patience and the consistent implementation of a diet plan. If you are overweight, it is advisable to consult a bariatric specialist. Here you will find further information and selected doctors who can help you lose weight.

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Dieting - weight reduction methods - Further information

Is it possible to lose weight without dieting?

Yes and no. Because a diet is not a diet. There is a broad and a narrow definition of "diet".

In a broader sense, diet simply means a special form of nutrition for the prevention or treatment of illnesses. This also includes, for example, the recovery diet after operations and the light diet.

Nowadays, however, diets are often only thought of as slimming diets. The aim is to lose weight in a short period of time. A long-term change in eating habits is not the aim.

A diet in the sense of a permanent change in eating and behavioral habits is usually necessary for long-term weight reduction.

A slimming diet is not necessary to lose weight. In most cases, it only leads to short-term success and can cause damage.

Erfolg beim Abnehmen
Losing weight successfully and staying slim in the long term is important for many people © sabine hürdler | AdobeStock

And what about losing weight without exercise?

Weight loss occurs when the energy intake is permanently lower than the body's energy requirements. This is referred to as a negative energy balance.

Energy intake can be reduced by changing your diet and energy requirements can be increased through physical activity. Theoretically, it is sufficient to tackle one component of the energy balance, such as diet, in order to lose weight. It is therefore perfectly possible to lose weight without exercise.

However, integrating exercise into your weight loss efforts has a number of advantages. Exercise increases energy expenditure, which contributes to the success of weight loss and even more so to weight maintenance afterwards. An increase in everyday activity can have a similarly positive effect as a structured exercise program. If muscles are built up, the basal metabolic rate increases, which also makes it easier to lose weight.

However, sporting activities also have another positive effect on weight loss. If you lose a lot of weight, the skin that was once overstretched may not return as easily. Sport can help to strengthen and tighten connective tissue and skin.

It is difficult to achieve significant weight loss through exercise alone, i.e. without a change in diet. Very few people can afford the time required for this. Calorie consumption during sporting activities is quickly overestimated.

For example, an hour's walk does not make up for a bar of chocolate. The combination of a changed diet and increased physical activity is the best way to lose weight.

Dickere Frau macht Pause beim Sport
Exercise is strenuous and time-consuming, but it really helps to achieve a healthy energy deficit © LIGHTFIELD STUDIOS | AdobeStock

Can you lose weight without starving yourself?

As part of a healthy and balanced reduced mixed diet, there are many foods available to satiate you. For example, satiety can be maintained if less fat and sugar is accompanied by more fruit and vegetables.

Starving yourself to lose weight is therefore not necessary and may even mean that you are not yet on the right track.

But I want to lose weight very quickly and become slim!

Diets where very few calories are consumed (around 800 to 1200 kcal/day) lead to significant weight loss in a short period of time. However, this is often not permanent in the long term.

When losing weight, energy consumption decreases. When you return to your previous diet and exercise habits, you gain weight again. It often even exceeds the initial weight(yo-yo effect). It therefore makes sense to practice a diet that can be maintained in the long term (preferably for life).

In addition to the yo-yo effect, losing weight too radically and quickly can also lead to serious health problems. The risk of developing gallstones is increased anyway when you lose weight. It increases further if you lose weight quickly and significantly.

There is also a risk of worsening heart failure and a decrease in bone density.

So there is much to be said for losing weight more slowly and in a "healthy" way.

Jojo-Effekt beim Abnehmen
The aim of a diet should be to avoid the yo-yo effect and stabilize your weight © Simon Ebel | AdobeStock

What does "healthy weight loss" mean? How can you lose weight without the yo-yo effect?

The three components should be

  • Changing your diet,
  • increased exercise and
  • behavioral change

should be taken into account. In order to achieve long-term success, it is therefore necessary to change behavioral patterns that you have been used to for a very long time. Ingrained behavior patterns can only be permanently changed slowly and step by step. Only a permanent (lifelong) change will protect you from the yo-yo effect.

Healthy weight loss must take place at a moderate pace. In addition, all the necessary nutrients must be supplied in sufficient quantities. Extremely one-sided diets (e.g. total fasting) have no long-term success and carry a high medical risk.

To reduce weight, it makes sense to give preference to foods with a low energy density:

  • low fat and sugar content,
  • high water and fiber content.

An energy-reduced mixed diet is recommended for losing weight. In most cases, an energy deficit of 500 to 800 kilocalories is aimed for. The following breakdown applies:

  • Fat ≤ 30 percent of the total energy intake
  • Carbohydrates ≥ 55% of the total energy intake
  • Protein approx. 15 percent of the total energy intake.

Mediterrane Küche
A balanced diet is based primarily on lots of carbohydrates © aamulya | AdobeStock

But I want to lose a lot of weight!

It is important to set yourself a realistic goal when losing weight. A weight loss of 5 to 10 percent of the initial weight is considered a success from a medical point of view, as this already improves many parameters.

A moderate weight reduction of 0.5 to 1.0 kilogram per week in the first 6 to 12 or 24 weeks is a healthy approach and a good basis for weight stabilization after losing weight.

Particular attention should be paid to the phase after losing weight: stabilizing the body weight achieved.

Are there any tips for losing weight - how can weight loss be made easier?

To lose weight, it is advisable (in the early stages) to keep a food and exercise diary. This will make it easier for you to determine how many calories you are consuming and how much you are losing through exercise.

It is best to monitor your weight once a week. These factors have a positive effect on weight stabilization after losing weight:

  • regular doctor/patient contact,
  • involvement in a self-help group and
  • support from relatives and friends.

Training flexible (rather than rigid) behavioral controls can help with weight loss. This means setting resolutions for a manageable period of time and not for an indefinite period. The quantity target should be realistic and specific and be around 10 to 20 % below (or above) the usual quantity. For example, "I'll try to get by with half a bar of chocolate next week" instead of "I'll never eat chocolate again".

With these weight reduction measures, a sense of achievement can be achieved that stabilizes the new behaviour. The goals achieved can be recorded in the food diary. In the case of rigid resolutions ("never again"), even a small "slip" can lead to the thought "it doesn't matter now" and possibly the abandonment of all resolutions.

In addition to time-consuming sport, increased everyday activity can also make it easier to lose weight. For example, you can replace previous inactivity with activities such as

  • Climbing stairs instead of using the elevator,
  • walking instead of driving.

Phases without measurable weight loss with constant eating and exercise behavior are normal. The only thing that helps is to persevere - weight loss often works even better afterwards.

Further tips for losing weight:

  • A beautifully set dining table,
  • enough time to eat,
  • good chewing,
  • Don't shop on an empty stomach and only with a shopping list,
  • small snacks (e.g. fruit) as required to avoid cravings

Losing weight with only a few carbohydrates? (Keyword: Atkins diet)

You can achieve relatively rapid weight loss with a low-carbohydrate diet at first. After a year, however, the weight progression of this type of diet no longer differs from that of a balanced hyocaloric mixed diet.

The disadvantages of a diet with very few carbohydrates are, for example

  • no drop in LDL cholesterol,
  • lack of long-term data

It is therefore only suitable for short-term weight reduction.

Is it easier and quicker to lose weight with the help of surgery?

It is true that bariatric surgery can be very effective. Depending on the procedure, the weight reduction is between 21 and 38 kg after one year and 15 to 28 kg after ten years.

  • With gastric banding, excess weight loss of 41-54 % is achieved,
  • 62-75 % with gastric bypass,
  • 66-74 % with biliopancreatic diversion or duodenal switch.

was observed.

Darstellung eines Magenbandes
Illustration of an implanted gastric band © bilderzwerg | AdobeStock

However, weight loss surgery (bariatric surgery) is also associated with perioperative and postoperative risks. The perioperative mortality rate is around 1%.

You should only consider weight loss surgery if other measures have not been successful over a period of at least 6-12 months.

No doctor will be able to justify bariatric surgery if you only have a few extra pounds on your hips. It is only indicated if you have a BMI > 35 kg/m with serious concomitant illnesses or a BMI > 40 kg/m.

You should also not assume that bariatric surgery is the end of the treatment and that losing weight is a matter of course. In any case, consistent (lifelong) follow-up treatment is required. Only in this way can long-term success be guaranteed and complications avoided or detected in good time.

Particularly with restrictive procedures (e.g. adjustable gastric banding, vertical gastroplasty), good cooperation and compliance on the part of the patient is very important for weight reduction. So losing weight with the help of surgery is not "easy" either.

Plastic surgery procedures are not suitable for losing weight in the usual sense. Liposuction is limited to a local reduction of fatty tissue.

References

Quellen: 

  • Deutsches Ernährungsberatungs- und Informationsnetz DEBInet: http://www.ernaehrung.de/tipps/ 
  • Diagnose und Behandlung der Adipositas. Evidenzbasierte Leitlinie der Dt. Adipositas-Gesellschaft (DAG) et al. Version 2019: https://www.awmf.org/uploads/tx_szleitlinien/050-001p_S3_Adipositas_Pr%C3%A4vention_Therapie_2019-01.pdf
  • Medizinische und ökonomische Beurteilung der bariatrischen Chirurgie (Adipositaschirurgie) gegenüber konservativen Strategien bei erwachsenen Patienten mit morbider Adipositas. HTA-Bericht 73: http://portal.dimdi.de/de/hta/hta_berichte/hta203_bericht_de.pdf 
  • Therapie der Adipositas im Kindes- und Jugendalter. Evidenbasierte Leitlinie der Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalert et al.: https://www.adipositas-gesellschaft.de/fileadmin/PDF/Leitlinien/AGA_S2_Leitlinie.pdfChirurgische Therapie der extremen Adipositas. Evidenzbasierte Leitlinie der Deutschen Gesellschaft für Chirurgie der Adipositas und Deutschen Adipositas Gesellschaft: https://www.aerzteblatt.de/archiv/201856/Adipositaschirurgie-und-Therapie-metabolischer-Erkrankungen
  • Website des Kompetenznetzes Adipositas: http://www.kompetenznetz-adipositas.de/
  • Pudel, Volker (2003): Adipositas. Göttingen / Bern / Toronto / Seattle: Hogrefe-Verlag.
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