Bariatric treatments for adult obesity - Institute of Health Economics

dietary therapy is to reduce total energy intake from food by either reducing calories or by changingthe intake of carbohydrate, fat, or protein. 6TypesDietary strategies for the treatment of obesity can be broadly divided into five categories (see TableT.1): 6-8low-fat dietlow-calorie dietvery-low-calorie dietlow-carbohydrate dietlow glycemic index dietTable T.1: Types of dietary therapyTypeLow-fat dietLow-calorie dietVery-low-calorie dietLow-carbohydrate dietLow glycemic index dietDescriptionRestricts fat intake to less than 25% to 35% of daily energy intake.Reduces the amounts of all macronutrients, including fat, to achieve a daily caloricintake of 800 to 1200 kcal.Provides a daily caloric intake of < 800 kcal and invariably restricts fat andcarbohydrate while maintaining a near-normal protein intake.Provides either a modest restriction of carbohydrate intake and an increase inprotein intake or a severe restriction of carbohydrate intake and an increase inprotein and fat intake.Maintains carbohydrate intake, but the type of carbohydrate consumed is changedto deliver a lower glycemic load.Sources: 4,6-8Low-fat dietHigh carbohydrate, low-fat diets became popular about 20 years ago, when it was thought thatcalories from carbohydrates were less fattening than the same number of calories from fat. 9Low-fat diets are probably one of the most commonly recommended diets because fat is energydense,poorly satiating, and easy to over-consume. Fat consumption is high in developed countrieswhere obesity rates are high. 7Low-calorie dietSeveral mechanisms have been suggested for the possible added value of low-calorie diets inpromoting weight loss including:(1) higher amounts of protein, which promote satiety more than carbohydrates(2) ongoing gluconeogenesis, which is an energy-consuming process, to compensate for thebody’s carbohydrate needs(3) increased diuresis(4) loss of glycogen stores and their associated waterBariatric treatments for adult obesity 64