With a rapidly increased overweight & obese population, India has raced to the 3rd position in the highest number of obese people worldwide. India has reported a very unique type of obesity, The ” thin-fat-Indian-phenotype”, which is very different from the rest of the world. The proportion of body fat, abdominal obesity, subcutaneous fat, intra-abdominal fat, and ectopic deposition of fat is reported higher in the Indian obese population. With a genetic predisposition for high lipoprotein levels, obese Indians are reported to be at higher risk of developing diabetes Mellitus, cardiovascular diseases & also death, particularly at a younger age than the rest of the world. Developmental & urbanization-associated habits like physical inactivity, increased intake of easy-to-grab fast food, better transport facility & overindulgence in the digital world have contributed to the rapid emergence of obesity in India.
Complications of obesity
Adverse complications & consequences can be seen when obesity affects the body’s various organ systems.
- Cardiac system- hypertension, congestive cardiac failure, coronary artery disease, & pulmonary embolism
- Respiratory system – dyspnea, asthma, & obstructive sleep apnea
- Neurological system- stroke & dementia
- Endocrine system – diabetes type 2, metabolic syndrome, dyslipidemia and & PCOD
- Gastrointestinal system – gall bladder stones, hernias, NAFLD & pancreatitis
- Urinary system -urinary incontinence
- Reproductive system – infertility & early puberty
- Musculoskeletal system – arthritis, gout, low back pain & immobility
- The body’s phycological system – body shaming, depression, & social stigmatization
Need for extreme rapid weight loss (RWL) diet plans
Currently, the young population is getting turned toward “extreme rapid weight loss (RWL) diets ” to achieve speedy weight loss, for cosmetic reasons & to avoid the above-mentioned health hazards. In the past decade, a lot of popularity has been gained by FAD diets. Unlimited social media usage and obsessiveness to be thin can be called the main reasons behind the viral nature of these diet plans. They are widely accepted by the urban young population irrespective of their unscientific base hidden under catchy advertisement claims. The underlying concept is led by temporary, often unproven, solutions for a long-term problem of excess weight.
Extreme rapid weight loss (RWL) diet characteristics
These mostly comprised of restricting food intake or fasting, fad dieting including only liquid diets etc, restricted fluid intake, excessive exercise training sessions, dehydration through extreme heat, sauna, water salt-unloading method, overloading water & salt intake and followed by restricting fluid intake for next 2 days, self-induced vomiting, weight loss drugs, meal replacements and supplements. Emphasis is given to quick-fix rapid weight loss solutions, unrealistic goal setting and results, severe calorie restrictions, omitting or overly focusing on one particular macronutrient such as protein, carbohydrates or fat, false claims of cleansing, detoxification or cleansing and rigid unmanageable rules and based on personal experience but lacking supportive scientific safety and efficacy data.
The Diet Cycle of Extreme rapid weight loss (RWL) diets
Focus is based on short-term rapid weight loss. This is achieved through extreme measures, like eliminating entire food groups or eating a very small amount of food each day. The repeated vicious cycle of an extreme rapid weight loss diet is started by restricted food intake, followed by sudden initial weight loss, depriving feelings, overeating, regaining weight, feeling disappointed, depressed and low self-worth.
Adverse Health Outcomes
Long-term severe side effects are caused post enrolling rapid weight loss plans. Physiologically, Psychologically and performance-wise body gets affected by sudden weight drops. Initially moderate to severe dehydration, followed by depressed immune function, hormonal imbalance, reduced bone density, temporary growth impairment, reduced blood and plasma volume, electronic imbalance, nausea, cramps, vomiting, fainting and in severe cases death can be witnessed. Mental fatigue with increased tension, sleeplessness, headaches, mood swings, reduced cognitive capacity, increased risk of eating disorder, reduced myocardial performance and decreased maximum oxygen consumption can be seen in most cases.
Best way to lose weight and combat obesity
Extreme RWL diets are easily picked up by the over-possessive health enthusiasts without analysing the authenticity of these virtual world viral health plans. After initial excitement people start feeling bored with these futile dietary patterns and develop a craving for getting back to normal life. Ideally, weight management should be done under an expert’s advice after considering the physical, biochemical, emotional and behavioural parameters of the individual. Weight loss and ideal weight maintenance should be included in the plan. Customized short and long-term practical easy-to-follow goals should be set. Eligible calorie restrictions should be recommended along with the easy-to-do physical activity. Continuous unconditioned monitoring, counselling and motivation should be provided. The epidemic of obesity in India should be handled with a simple, slow steady approach rather than opting for unscientific crash diets. Alertness should be offered to individuals following RWL diet plans. In case of any complications, early detection, recognition and right healthy interventions should be provided. Awareness should be created regarding the dangers of RWL diet plans so that serious adverse health outcomes can be prevented. Steady weight loss of 2kg/month should be targeted. A balanced diet, which is less restrictive and doable should be recommended. Portion size control should be encouraged. Self-belief and developing faith & hope toward tried and tested plans should be presented and suggested for a better quality of life.
Indian J Med Res 148, November 2018, pp 642-64