Foundation Diet and Health
Diet and Health
QR Code
The best perspective for your health

Lose weight healthily

You can lose weight healthily and permanently in a natural way - if you know the basics and learn how to avoid yo-yo effects.

A coach explains further procedures for healthy and permanent weight loss.© Bought from kitzcorner, shutterstock
A weight loss coach explains the procedure for healthy and permanent weight loss.


This article explains how you can lose weight permanently with the necessary background knowledge about healthy nutrition - in combination with sufficient exercise. The path to permanent weight loss (weight reduction) therefore requires basic knowledge. That is why the goal is difficult for most people to achieve. Anyone who suffers from the problem of excessive body weight usually uses the path of least effort (resistance).

Thus, these people fall into the numerous traps of big promises like "belly fat gone overnight". The "weight loss industry" is a huge business that targets desperate people. One can say: The faster you lose weight with one-sided reduction diets, the faster you put the weight back on - usually even more than before (yo-yo effect).1

Losing weight is defined as a negative energy balance. Basically, ten hormones control this process (we name them below and explain the effects). Whether we get impulses for gaining weight or losing weight and how strong they are, is in our hands with our way of life, but not with the supply of individual hormones because that can also lead to dangerous resistance and damage our health.

Technically, only the difference between calorie intake and calorie expenditure determines our body weight, nothing else. After all, we exhale every consumed calorie as CO2 and give off 16% as water.

In addition to essential information about food intake and calorie burning, we inform you in the second part about the practical steps that you can take. We also address methods that are not recommended and describe emergencies.


Obesity and its Consequences

Obesity (severely overweight with a BMI more than 30) is an important health risk factor. Obesity-related morbidity and complications generate enormous costs for individuals, families, healthcare systems and society at large. When the BMI is 30 or more, one would have to go to the doctor to determine the waist-to-height ratio (WtHR) for the first time. This way you know more about the distribution of fat that is crucial for your health. It should also be used to rule out rare diseases that can lead to this condition. They are briefly described below.

Through our lifestyle, we can epigenetically influence gene expression. Gene expression means how strongly the gene works in us (with penetrance and expressivity - for more, we refer to specialist literature). A successful weight loss plan for people who are severely overweight starts with a medical investigation of whether a metabolic syndrome is present and whether it has genetic causes - for example, hypothyroidism.

According to the CDC, your behaviour and environment cause epigenetic changes. They change the way the body reads a DNA sequence and alter gene expression. However, unlike genetic inheritance, epigenetic changes are reversible.86

In this context, a study underscores the need for medical professionals to provide information to women who wish to have children. This mainly concerns health issues such as smoking and eating habits before and during pregnancy. In many cases, this could prevent the child from becoming obese as both smoking and the eating habits of the mother have a significant impact on the child's health. The corresponding full-text study has been published by the National Library of Medicine (NIH) as an online article in PubMed Central (PMC).62

In general, politicians would have to tax certain products and invest this tax money in making natural foods cheaper. Lobbying prevents that; as a result, healthcare costs are also increasing and this is having a negative impact on our life expectancy. Both increasing life expectancy and the consequences of visceral obesity are putting a massive strain on healthcare costs, much more than they used to. Another study explains the global effects of these phenomena and the clear differences between various countries with impressive aspects (e.g., regarding child mortality and life expectancy).63 Actually, the health-adjusted life expectancy (HALE) is the most important criterion for us - and not the individual lifetime itself.64,65

The Lancet Commission on Obesity explains, among other things, the failure of politics and, thus, also of our society, even going so far as to describe the obesity situation as a pandemic. According to their report, there is no way around addressing the spread of obesity in a larger context (the so-called Global Syndemic) and at the same time looking at it with climate change, i.e., with our global footprint. The text suggests solutions, including the taxation of unhealthy products and the promotion of natural foods.70

Why is obesity rising?

The numbers are alarming: in OECD countries, on average, every second person is overweight, and every sixth person is obese. Before 1980, obesity rates were below 10%. Working and living conditions have changed since then. Industrially processed food (fast food and convenience food) is always and everywhere available and enjoys intensive advertising. Stress and significantly less physical work and exercise are additional factors.3

The award-winning book Salt Sugar Fat by Michael Moss illustrates how general obesity came about in the Western society. Read our in-depth book review to learn how the food industry controls the legislature and compromises your health for ever-growing sales.4

The main reasons for this fatal development are: an increased calorie intake with usually less physical work than once, combined with an incorrect choice of food.

To help you rely on a healthy choice of food, here are two important links to start with:

Recipes for Losing Weight

The recipes are pre-sorted by "calorie to fiber ratio"; so you will find the most fiber-rich recipes at the top. We explain this strategy below, and consider high-fiber recipes — along with spices — as an important key to success.

Foods for Weight Loss

In the case of foods, we show the order for each 100 g. However, at the top you will also find ingredients with a relatively large amount of dietary fiber that are only consumed in small amounts, such as spices. Certain spices such as Ceylon cinnamon or chili pepper also have other effects that help you lose weight.2 Below the ingredient texts, you will usually find recipes that contain a lot of this ingredient.

Probably the most important reasons - apart from genetic factors and diseases - are irregular meals (especially "snacks"), sugar, fast food, alcohol, lack of exercise, poor sleep, stress - or even metabolic cures. In the future, there will be more and more children with epigenetic changes due to their parents' wrong eating habits. Industrialized countries have a worse situation than the developing countries.

New genetic tests have led to the identification of obesity-related genes that control hormones. For example, leptin (LEP), leptin receptor (LEPR), proopiomelanocortin (POMC), prohormone convertase 1 (PCSK1), melanocortin-4 receptor (MC4R), single-mind homolog 1 (SIM1), "growthfactor" brain-derived neurotrophic factor (BDNF), and neurotrophic tyrosine kinase receptor type 2 gene (NTRK2) have been described as obesity causing hormones.82 Thousands of DNA variants determine the genetic risk for obesity, which is a major challenge for genetics-based treatment of obesity.83

Hormones control whether we gain or lose weight

As mentioned above, it is primarily certain hormones that control our eating habits and the internal processes involved in reducing or building up our fat mass. However, how many hormones our body releases depends on our lifestyle. If you would like to know more, click on the "vertical arrow", also called CLICK FOR. Above all, there are references to the hormone GLP-1 and what we should do to increase our production of GLP-1 in the intestine instead of buying it as an injection with side effects.

What do the hormones do?

  1. Leptin
    This is the satiety hormone that regulates appetite in the hypothalamus, an important part of the brain. Obesity creates leptin resistance over time; so leptin becomes almost useless and the body makes more of it.30 Inflammation also plays a role. Mechanisms of leptin resistance also include mutations in the genes encoding leptin and its receptors, as well as proteins involved in the self-regulation of leptin synthesis and blood-brain barrier permeability.31
  2. "Insulinhormone"
    Obesity is strongly linked to the development of "insulinresistance".32 Our bodies secrete the "insulinhormone" primarily during the day and in larger amounts almost proportionally after meals. This hormone then transfers glucose from food into our cells to use glucose for either energy or storage, depending on the body's current needs. With excessive or improper food intake over time, "insulinresistance" can develop, preventing cells from taking up glucose that is being released. As a result, blood sugar levels remain high,33 leading to type 2 diabetes and heart disease.32
  3. Ghrelin (Receptor identified in 1999)
    This peptide hormone is virtually the opposite of leptin.34 Paradoxically, obese people have low levels of ghrelin, but the organs are more sensitive to it, which can lead to overeating. It is the hunger hormone that the stomach sends as a message to the "growthhormone" secretagogue receptor (GHSR) to indicate that it is empty. Ghrelin's main function is to increase appetite. It also affects glucose metabolism, cardiovascular functions, gastric acid secretion and motility, and immune functions.35 This metabolic hormone has been discussed in 2016 in the context of obesity and its relation to ghrelin resistance.36 Restless sleep, for example, produces ghrelin and suppresses leptin, which greatly increases the feeling of hunger.73
  4. Cortisol
    The adrenal cortex produces this stress hormone from cholesterol.37 Cortisol plays an important role in various bodily functions and promotes inflammation.38 Together with adrenaline, it is responsible for the fight-or-flight response. Elevated long-term levels of cortisol, measured in scalp hair, are closely associated with abdominal obesity and certain mental disorders.39 Ingestion of high-glycemic foods, poor sleep patterns, and chronic stress can cause elevated cortisol levels. This chronic release can lead to heart disease, diabetes, low-energy levels, high blood pressure, trouble sleeping, and weight gain. Obesity also increases cortisol production, and therefore it is called a negative feedback loop.39
  5. Estrogen
    The female sex hormone also regulates the immune, skeletal and vascular systems. Obesity increases this level, increasing the risk of certain types of cancer (such as breast cancer) and other chronic diseases.40 Conversely, levels that are too low are also harmful and can promote central (visceral) obesity, which can lead to high blood sugar, high blood pressure, and heart disease.41 Lifestyle is crucial.40
  6. Neuropeptide Y (NPY)
    The hormone NPY is produced by certain brain cells and the nervous system. It stimulates appetite and reduces energy expenditure when fasting or during stress. However, it is also associated with cardiovascular disease, hypertension, atherosclerosis, ischemia/infarction, arrhythmia, and heart failure.42 Neuropeptide Y and peptide YY have functions closely related to appetite regulation and the formation of obesity. They typify the regulatory role in the gut-brain axis.43 They also promote inflammation.44
  7. Peptide hormone 'Glucogan-like Peptide-1' (GLP-1)
    The hormone GLP-1 is produced in the intestine when nutrients enter, keeping blood sugar levels stable and thus creating a feeling of satiety. But the effects go far beyond that. GLP-1 also has cardioprotective and neuroprotective effects, reduces inflammation and apoptosis, and has implications for learning and memory, reward behavior, and palatability.45 GLP-1 also promotes orexin secretion.46 The orexin (hypocretin) system regulates sleep and wakefulness through interactions with systems that regulate emotion, reward, and energy homeostasis.46
  8. Cholecystokinin (CCK)
    CCK (gallbladder mover) is formed in the duodenum and in the adjacent jejunum - mainly through fatty and amino acids in the chyme - and triggers a feeling of satiety. It also increases the release of leptin.47 People with obesity may have reduced sensitivity to the effects of CCK, which can lead to chronic overeating. This, in turn, can further reduce CCK sensitivity and create a negative feedback loop.48
  9. Peptide YY (PYY)
    This gut hormone reduces appetite. NPY and PYY have functions closely related to appetite regulation and occurrence of obesity.43
  10. Oxyntomodulin (OXY)
    This peptide hormone is released by the small intestine during food intake. OXY creates a feeling of satiety and promotes energy turnover. However, OXY does not change the resting energy expenditure.49 The hormone also inhibits gastric emptying and thus leads to a feeling of satiety.

This list does not exhaust the number of hormones, some of which produce effects simultaneously in the brain and in the intestine or are produced there. For example, melanocortins control the proinflammatory cytokines and the central control of thermoregulation, depending on the physiological situation. Physiology describes the processes inside and outside the cells in the body.

Research on the "fat mass and obesity associated gene" FTO is not yet very advanced. However, results from genome-wide studies indicate that genetic variants in the FTO gene are linked not only to human obesity and metabolic disorders, but also to cancer, a disease that is strongly associated with obesity.72

We influence the type and amount of these hormones

When one examines numerous studies on one's influence on these important hormones (which also contribute to weight control, or in some cases almost exclusively to weight control), one finds that vigorous exercise, e.g. brisk walking or training the core muscles etc., has the most powerful positive effects. The next major influence comes from eating a healthy diet with a good omega-6 to omega-3 ratio, followed by good sleep. The latter is disturbed above all by stress, which can be caused by watching TV in the evening, playing computer games, etc. The antidote would be Mindfulness-Based Stress Reduction (MBSR). See the post: How do we get good, healthy sleep? Nuts and seeds, as well as vegetable oils, are particularly rich in omega-3 and -6 fatty acids. Detailed nutritional comparisons for ingredients can be found here.

It's not the amount of food you eat, but the composition of what you eat or drink that ultimately controls the hormones. The biggest helpers here are the right carbohydrates, namely dietary fibers, or those with a low glycemic load (GL). Dietary fibers are important because they provide practically no calories, but create satiety. Carbohydrates with a low GL are important because they make you feel full for a long time, and they hardly increase the sugar level. In addition, the amount of energy is small compared to the satiety they bring about. Foods with single and double sugars, such as white bread, pizza, and cakes, have a high GL.

How can we influence these hormones?

  1. Intense physical activity
    One study focused on the key hormones involved in appetite regulation: leptin, ghrelin, GLP-1, CCK, PYY, and oxyntomodulin. In normal weight and overweight individuals, the response to most of these hormones depends on the intensity of physical activity and training. However, there is insufficient clarity for the obese in this regard.50 Other studies also show the effects of exercise on "insulinresistance", cortisol, estrogen and NPY.
  2. When and how often to eat something
    Intermittent fasting, e.g. only eating two meals a day within 8 hours (16:8 diet or 8-hour diet) or using individual fasting days (e.g. 1:1, i.e. one day of fasting and one day break) helps because it also has an epigenetic effect, at least if you also increase physical activity. You rarely stick to this for years because it must be combined with a real change in diet, which also helps without intermittent fasting. You also have to do without snacks. Real fasting for a maximum of ten days is even life-prolonging with enough water or pure vegetable juice, but few people have the will to persevere. And it's "only" a good start.
  3. Helpful community
    There are certainly organizations or self-help groups that do not aim for their own profit as their first goal, and therefore do not sell any products. In Switzerland, you can easily find around 20 established groups that individually cover certain areas. If your family plays an important role in your life, they should be able to help; otherwise it probably won't work.
  4. Type of diet
    The Dietary Guidelines for Americans (DGA) recommend reducing saturated fat and added sugars to 10% of calories and salt consumption to about 5 g daily.51 This is combined with an increase in total carbohydrate intake as part of a DGA-based diet, which reduces circulating cortisol and dampens cortisol responsiveness caused by psychological stress.52 Natural, nutrient-dense nutrition is an important key to success. Legumes, nuts and seeds increase B vitamins and important anti-stress hormones. Eat in peace, chew long and intensively. For actual weight loss, you will find practical information and further links below.
  5. Ratio of omega-6 to omega-3
    This ratio is not only decisive for losing weight, but is also effective against inflammation, i.e. also against the severe course of diseases. Unfortunately, this is not easily measurable in the blood, but only through a relatively expensive determination of the fat status in the blood. Since this is essential for inflammation and weight, we list the LA to ALA ratio in every food and recipe when it exceeds a certain minimum. Stick to foods with a ratio below 5:1.
  6. Sleep
    The quality and duration of sleep depend on many factors, which is why you should also read the article "How do we achieve good, healthy sleep?" mentioned above. The search word "sleep" (entered in the SEARCH box) takes you to further information and, above all, to videos on the subject of sleep.
  7. Stress Reduction
    The stress hormone cortisol can be easily measured from hair samples. So you can easily know if the problem of stress applies to you, and influence and control with "autogenic training" or meditation or lifestyle changes. Pay attention to relaxation every day, which can also be very different, e.g. a longer soothing bath, soothing music, reading a book or doing handicrafts. Alcohol-free and drug-free chilling can also be the way. Mindfulness-based interventions, i.e. "Mindfulness-Based Stress Reduction" (MBSR) or attention control courses, greatly reduce inflammatory cytokines - and thus stress resistance (as an alternative to unavoidable stress).53
  8. Sufficient Sunlight
    Sunlight promotes vitamin D, which in turn reduces cortisol levels. In winter, you should take vitamin D3 if the sun is weak in your area, and you do not live above 1500 m above sea level. A blood test can inform you about your vitamin D status.

Fat is not just fat

The so-called body mass index (BMI) is a well-known method for assessing body weight. It can be calculated as follows:

Body-Mass-Index (kg/m²) = Body Weight in Kilogram (kg) / Square of Height in Meters (m²)

According to the World Health Organization (WHO), a BMI of 18.5-24.9 kg/m² is normal weight. BMI equal to and above 25 kg/m² is overweight, and BMI of 30 kg/m² and more is considered obese (obesity). The BMI alone is only conditionally meaningful as a value, since it does not consider the individual stature and above all the distribution of body mass (fat and muscle tissue).5

A better measure is the waist-to-hip ratio. According to the WHO, the ratio "waist < 0.85 to hips of 1" is optimal for women and "less than 0.90" for men. For example, a person with a waist circumference of 71 cm (27.9 in) and a hip circumference of 83 cm (32.6 in) has a waist-to-hip ratio of 0.85. All values ​​above this fall within the definition of abdominal obesity.4

Adipose tissue serves as insulating fat in the hypodermis (subcutaneous fat), which should make up about two-thirds of the total fat. Stored or depot fat accounts for 10 to 25% of people of normal weight, where it occurs primarily in the subcutaneous tissue of the abdomen, peritoneum and buttocks. However, adipose tissue also plays a role in energy metabolism through the secretion of hormone-like substances. In some places it is building fat as mechanical protection, e.g. under the soles of the feet, at joints or as organ storage.

The problematic visceral fat tissue, on the other hand, sits in the abdominal cavity and accumulates around the internal organs. Above all, we should recognize visceral fat, i.e. abdominal fat, as a serious threat to a healthy life and fight against it. A person with a body mass index (BMI) of 21 or 22 (meaning a slim person) but with a waist circumference of more than 88 cm for women or 102 cm for men has a higher risk of cardiovascular disease than a plump person without extreme visceral abdominal fat.6 Slightly firmer people with this abdominal problem are called the apple type.

Unfortunately, only a minimal percentage of people succeed in stopping or even reversing a trend toward the apple shape that has already started.10 If this is successful, the most intensive interventions are usually behind it: close supervision, nutrition plans, an exercise program, preferably in a group, and support from the primary social environment.

Obesity, fat distribution and associated fat metabolism disorder can be genetically predisposed.7 However, this does not mean that nothing can be done about it - but the effort for a successful result can be much greater than for a person without a genetic predisposition for a fat metabolism disorder.

In medicine today, visceral adipose tissue is regarded as a hormonally active organ.8 The subcutaneous adipose tissue is tangible, but the visceral adipose tissue is not! It can be seen directly with a CT or MRI scan of the abdomen. In men, this is also called adrenal-cortical obesity. The messenger substances of visceral fat promote inflammation throughout the body and increase the risk of arteriosclerosis, higher blood pressure, stroke, diabetes, hormonal diseases, Alzheimer's and cancer (e.g. breast cancer). The hormone leptin increases with the body fat content and actually controls the feeling of satiety. In morbidly obese people, this perception of the leptin level is disturbed. Too much saturated fat in the diet can lead to leptin resistance and even promote diabetes in the later stages.9

Our fat cells are constantly being remodeled. Reducing calorie balance can reduce stored fat, but only by depleting existing fat cells. Fat cells that you have acquired in addition remain as a permanent indicator of hunger. This shows why early intervention against obesity is of great benefit.

Brown adipose tissue occurs primarily in animals that need to hibernate, which, with the participation of UCP1 (instead of ATP synthesis), can serve to generate heat, i.e. burn energy. It is sparsely found in adult humans. Further, portions of brown fat cells discovered in 2009 turned out to be diffusely distributed cells in the white fat tissue, which are now called "beige fat cells". Unfortunately, they have a significantly lower concentration of UCP1 than brown fat cells. Muscles release the hormone irisin as a messenger substance, which could possibly also activate heat production when it is cold.84

Where do the calories come from?

We consume hundreds of food components with the diet; however, we only mention the irreplaceable ones (approx. 35) vitamins, trace elements or minerals and micronutrients.

Only three classes of substances contribute calories - namely the fats or fatty acids, most of the carbohydrates and the proteins (amino acids). These three macronutrients and water make up by far the greatest weight in our diet.

Fats have more than twice the energy density (approx. 9 kcal/g pure fat) compared to carbohydrates and proteins (approx. 4 kcal/g).11 A change in movement patterns (many sedentary activities) and in food intake is currently being observed among young people, where, in addition to too little dietary fiber and potassium, too much salt and fat (especially saturated fatty acids) predominates.12

Foods that are high in water and fiber (such as fruit and vegetables) have a low-energy density and therefore larger amounts can be consumed. To lose or maintain weight, you should favor foods with low-energy density. Natural foods of plant origin usually have a low-energy content and at the same time a high nutrient density.11

Many people follow diet trends and believe that carbohydrates automatically make you fat. This goes so far that some people, who want to lose weight, avoid all carbohydrates, including vegetables and fruits. Natural harvested products are not the problem. Products from the food industry that mainly consist of simple and double sugars, such as white bread (baked goods), pasta (e.g. noodles, pasta, spaghetti), pizza, cakes or sweet drinks (soft drinks) should be viewed critically. These simple carbohydrates (monosaccharides) enter the blood quickly and increase blood sugar levels. However, this quickly drops, which means that we are soon hungry again.12 The same applies to highly processed products (finished products), including those made from potatoes (French fries, chips, etc.).13 A moderate intake of carbohydrates is important because both, too much and too little carbohydrates, can negatively impact health.14

Dietary fiber is also a carbohydrate, but has little or no calories. They offer many nutritional benefits and have a low-energy density (approx. 2.3 kcal/g).11 Recommended carbohydrates in the form of polysaccharides and fiber are mainly found in plant-based foods such as whole grains, vegetables, fruit and legumes. Digestion breaks down fiber-rich foods into glucose more slowly, so that blood sugar does not rise as much or as quickly, resulting in a feeling of satiety for a longer period.15 The glycemic index (GI) and glycemic load (GL) of food are simplified methods of assessing the effect on blood sugar levels and can be used as guides. Have your doctor check your long-term blood sugar level, HBA1c, sporadically.

The many (mostly artificial) additives in industrially produced foods should also be viewed critically. The flavor enhancer monosodium glutamate (MSG) intervenes massively in appetite regulation and causes us to eat increasingly without feeling full.16

Politicians could effortlessly control the choice of food through taxes on certain ingredients - and in exchange finance the price-reduction for natural food. In addition, it could have an enlightening effect with a possible surplus, but the successful lobbying of agriculture and the food industry prevents this (see the link to the book review above).

What happens to the calories you eat?

The digestive tract breaks down food into energy-rich compounds (e.g. fatty acids or glucose) and absorbs them through the intestinal mucosa. The body either uses up the calories through "work" or needs them to build new cells. Our body stores all additional, excess calories in two energy stores (buffers for times of need). On the one hand in the form of glycogen (carbohydrate storage) in the muscle tissue and the liver, on the other hand in the form of lipids in the fat cells (fat tissue). Depending on the level of training and nutrition, we store up to 500 g of glycogen in the liver and in the muscle cells (this corresponds to approx. 2000 kcal). Our fat deposits represent the much larger energy store. A person of normal weight has approx. 80,000 to 100,000 kcal stored in the form of fat deposits.17

Our body uses energy 24/7. The basal metabolic rate (or resting energy expenditure) is the total number of calories that the body needs at rest (when lying down or sleeping) for basic, life-sustaining functions. This depends on age, gender, size, weight and lean body mass. Lean, muscular people with a low body fat percentage generally have a higher basal metabolic rate, and men have a higher rate than women.18

In addition to the basal metabolic rate, our body needs energy to be able to do work or physical activities - this is referred to as the activity energy expenditure. This is strongly dependent on physical activity at work and in leisure time. The so-called PAL value ("physical activity level", measure of physical activity) can be found in the literature.

The individually total energy requirement of our body is therefore made up as follows: Total energy requirement = basal metabolic rate + activity energy expenditure + thermogenesis (energy consumption to digest food).18 You will find simplified formulae for calculating an approximate total energy requirement on the Internet.

Diseases can cause obesity

There are gene mutations that can cause adiposity (severe obesity), such as Prader-Willi Syndrome (PWS), which is found in 1 out of 15,000 newborns. Self-help organizations that can be found on the Internet can be very helpful. Unfortunately, there are other gene variants that have a strong influence on appetite, such as the melanocortin-4-receptor gene (MC4R), which can ensure that you remain extraordinarily thin or, conversely, that you don't stop wanting to eat. In children, this often occurs together with ADHD.71 KSR2, for example, is an essential regulator of AMP kinase (AMPK, an endogenous protein), that is involved in energy consumption and "insulinsensitivity", and protects our cells from a lack of energy. A little more than 2% of people suffer from a genetic defect in KSR2, known as the "fat gene", which leads to obesity.76 We were unable to clarify whether this is becoming more common in children.


What do we have to do to lose weight?

Losing weight sustainably means that the intake of calories must be less than the calories burned in our body (plus little extra for cell renewal). As mentioned at the beginning, losing weight is also called a negative energy balance. Of course, we can have fat removed by surgery, but even that is not sustainable without a change in lifestyle. Any other type of losing weight leads to yo-yo effects, i.e. inevitably to higher weight again - often even higher than before. In general, the faster you lose weight, the faster you gain weight again.

For example, you can lose weight quickly with low-carb diets because the body first uses the glycogen stores in the muscles and liver, which also has to do with water loss. You don't burn fat, but up to a few kg of glycogen. Other remedies, for example, drain important water from the body. It is therefore easy to lose a few kg without losing a gram of fat!

Basically, it is important to recognize weight gain early on, to take it seriously and to counteract it with suitable methods.

One kilogram of dietary fat corresponds to approx. 9,000 kcal, but both the build-up and breakdown of body fat require energy for these metabolic transformations. That is why the body only provides approx. 7,000 kcal per kg of fat. This means that if you want to lose half a kg of fat per week, you have to eat 500 kcal less per day or burn more.19 Unfortunately, there is another problem: the body first removes all other unused (calorie-containing) substances before attacking the fat deposits. So the body uses little or not used "musclemass" at first! This is precisely why physical exertion is important, not just because of the consumption of calories during exercise. In addition, the so-called "afterburneffect" shows an increased energy consumption up to 48 hours after a sports session.20 Below you will find a detailed overview of this process in CLICK FOR.

The Mathematic of Losing Weight

This impressive video shows what happens to the different types of calories stored when we lose weight: The Mathematics of Losing Weight by Ruben Meerman. In his presentation, the physicist vividly explains that 84% of the mass of a fat molecule is converted into carbon dioxide (which we exhale) and 16% into water (which we excrete). The first part of weight loss doesn't happen with fat, so the math is different, but that too is ultimately exhaled CO2.

Chemical composition of our body fat: C55H104O6 . 10 kg Fat = 8.4 kg CO2 + 1.6 kg H20 (Water)

On average, a 70 kg person at rest exhales approx. 33 mg CO2 per breath, i.e. 8.9 mg carbon. 12 breaths per minute, 8 hours of sleep per day (night) yields approximately 740 g CO2 (203 g carbon) at rest. Just for comparison: 500 g sucrose contains approx. 2000 kcal and thus 210 g carbon.

If we now replace one hour of rest with one hour of exercise (e.g. jogging), the metabolic rate increases sevenfold. This is how we lose 39 g of carbon - this brings the daily total to around 240 g. It is important to note that physical activity is often affected by relatively small amounts of excess food. For example, if we eat 100 g of a muffin, that accounts for about 20% of the daily energy requirement.54

So to lose weight, we need to release the carbon stored in fat cells (via the lungs), which means we have to "eat fewer calories and move more".

The question of proteins

Our body needs proteins - and if possible, in an ideal composition.19 Too much protein puts a strain on the body and leads to diseases. The food industry along with nutritional medicine19 and their research promotes the impression that we are consuming too little protein. In addition, it has always promoted animal proteins instead of plant ones. This means that the western diet actually contains far too much of it and the wrong amino acids. You can lose weight quickly with protein-rich food because our bodies can only convert proteins into fat with great difficulty and with a lot of effort (Thermic Effect of Food, TEF). However, a much better way is to eat a diet rich in fiber instead of even more protein, which puts a strain on our kidneys and damages our entire health.66

A 2020 meta-study supports the finding that excess intake of land animal meat (as opposed to fish), particularly the proteins high in nitrogen (N) or phosphorus (P), leads to higher odds of cancer, while equivalent intake of vegetables is associated with lower odds of cancer. This is shown for the overall cancer probability as well as for colon cancer, lung cancer, breast cancer and prostate cancer. The authors also discuss conflicting results from research (caused by country-specific circumstances or different parameters) and the amplifying negative impact of alcohol consumption.56

Take concrete steps

Losing weight healthily and sustainably requires a holistic lifestyle change. Here are a few helpful tips to get you started:

  • Take a close look at your eating habits. It can help to write down everything you eat for a few days. Be honest with yourself! You may recognize certain patterns or nutritional errors as a result. Some questions to ask yourself: What do I eat and when? When can I cook? When do I eat out? Will I have access to healthy food when I eat out? How can I replace unhealthy foods with healthy foods?
  • Eat as much fresh, unprocessed food as possible. Fruits and vegetables are low in calories, but provide a wealth of vitamins, macro-minerals, trace elements and filling fiber.11 A good guideline recommended by the WHO is the 3 servings of vegetables and 2 servings of fruit a day. When shopping, pay more attention to your future well-being than to current cravings or old habits.Try not to shop when you're hungry to reduce the temptation to give in to cravings and buy unhealthy snacks or convenience foods. Choose healthier alternatives, such as organic snacks or whole-grain products. Instead of pasta and rice, use quinoa, lentils, konjac noodles, or buckwheat. For snacks, for example, buy mixed nuts (unsalted and unroasted) and plain rice cakes. This way, when you're hungry or looking for a snack, you only have healthy options to choose from. You'll be surprised at how filling a small amount of these foods is compared to a bag of chips. Start small: It's better to nibble on rice cakes than to eat croissants/chocolate rolls - over time, you can replace the rice cakes with an apple and a carrot.
  • If possible, cook it yourself - then you really know what's in it. Even supposedly healthy food, such as purchased Asian food, usually contains sauces with a lot of sugar, salt and flavor enhancers. Also take a close look at the sauces and spice mixtures you use and completely avoid finished products. Instead, season your food with aromatic herbs, spices, garlic and onions. It takes about three months for our taste buds to get used to less sugar and salt again.21
  • Make homemade foods accessible. The best method for this is "meal prepping". If you work full-time during the week and often eat out or in the canteen for breakfast/lunch, it is helpful to choose a day on the weekend to prepare your food for the week. For example, take two hours on Sunday afternoon to cook two different meals that you can freeze for lunch during the week. If you are not intermittent fasting and like to eat breakfast, prepare some "oatmeal-to-go" before bed that you can easily grab and eat in the morning. Try not to eat out every night. Instead, treat yourself to special occasions a few times a month when you eat out. Try to eat something healthy at home before you go to a restaurant so you can opt for a smaller, healthier order. If you have to eat out or order food at the canteen, try to choose healthier options, such as vegan or vegetarian options, and only a few added sauces.
  • Bring more movement into your everyday life. Regular physical activity increases calorie consumption and boosts metabolism. Continuous sports activity and more "musclemass" (instead of fat) can also increase energy consumption at rest.20 New sporting hobbies are helpful, but often difficult to implement. Therefore, try to integrate as much exercise as possible into your normal everyday life: take the stairs instead of the elevator, walk, do your shopping by bike if possible, arrange to meet friends for a walk instead of in a café, etc. If you are very overweight, strenuous swimming or cycling are particularly easy on the joints and are recommended sports. Participating in a beginner fitness class or organizing a group sport with colleagues/friends can also motivate you to be active. To ensure continuity, book the course in advance and make it a routine, e.g., one hour per week. Gradually increase the activity level.
  • Drink enough liquid, preferably water or unsweetened herbal tea. The recommendation of the European Food Safety Authority (EFSA) for an adult man is 2.5 liters and for women, 2 liters of liquid per day. This has to do with the entire water balance, not just with drinking - because we also consume up to a liter of liquid through healthy food. Fruits have a high water content of up to 95%. A person's actual water needs vary with age, weight, exercise, air temperature, humidity, and other factors.22 For example, breathing will lead to loss of 170-500 mL per day depending on temperature and humidity, and a heart rate of 140. Thus, you would lose 1.6 L in 24 hours.60 The values measured for the army in hot climates are: Input (drink: 1200 mL; food: 900 mL; oxidation: 300 mL ; a total of 2400 ml) and output (urine 1400 ml; lungs and skin: 900 ml; faeces: 100 ml; a total of 2400 ml).61 The water balance is correct if you urinate one to two liters a day, with a maximum of seven urinations, of which a maximum of two per night. This can easily be measured with a measuring cup. Research on school children with weight problems showed that a glass of pure water some time (30-80 min) before eating led to weight loss.74 Other studies show that drinking pure water within 60 minutes of eating significantly increases energy expenditure.75
  • Avoid sweet drinks and alcohol: Concentrated fruit juices contain a lot of fructose and quickly raise the blood sugar level without leaving a feeling of satiety. In addition to the high calorie content, fruit juices also increase the risk of diabetes.23
  • Practice mindfulness when eating. Our current eating culture revolves around overconsumption and distracted eating. Use smaller plates and start with smaller portions at mealtimes. Eat slowly, and limit distractions. In particular, watching TV, working, and using our cell phone while eating can cause us to eat too quickly and consume more than necessary. To make the transition easier, try eating while listening to a favorite podcast or music instead. Then try more and more to eat without distraction. This leads to a better feeling of satiety.
  • Restful sleep of sufficient duration is important for our well-being and our performance. Sleep also plays an important role in regulating appetite and weight. Lack of sleep increases our cravings for high-calorie, fatty, and sweet foods and increases hunger.24
  • Be patient with yourself and your body. Small steps are often more effective than a rapid change, which is then difficult to maintain. It takes time for new habits to form. A study with 96 volunteers who implemented a new behavior in relation to drinking, eating or exercise in their everyday life concluded that it takes between 18 and 254 days for someone to firmly establish a new habit in their everyday life.25 It is important not to lose sight of one's own motivation.

The good and bad foods for losing weight

Diets often have more disadvantages than advantages. A few diets like "5 a day" can be recommended. In this diet, you eat 5 portions including approx. 80 g each of fruit (2 portions) and vegetables (3 portions) - or up to 650 g/day. This is not a weight loss diet, but a step towards healthy eating. For people with type 2 diabetes mellitus, a Glyx diet considering GL (glycemic load) rather than GI can be used, with particular emphasis on high-fiber diets. However, the decisive factor is always the amount of fiber in relation to the calories.

That is why you will find our recipes and our food descriptions here again, sorted in the order of "ratio of calories to fiber content", i.e. at the top the most fiber-rich recipes, which help to feel full for a much longer period of time without "eating a lot". A high-fiber and well-seasoned diet plus more exercise is the key to success.

Recipes for Losing Weight

Foods for Weight Loss

Several factors determine the overall effect of individual ingredients (recipe ingredients). Therefore, different focal points can lead to different orders (e.g. the measuring calories vs fiber, the omega-6 to omega-3 ratio and the direct effects on our hormones, intestinal peristalsis or on intestinal bacteria). If you only pay attention to one effect, e.g. to hormones, you quickly end up with ranking lists that are not effective in the long term. Every food and spice has both positive and negative properties. Studies usually only emphasize one thing! Don't be influenced by one-sided opinions. For example, you can compare this study Dietary capsaicin and its anti-obesity potency: from mechanism to clinical implications77 with our description of the food chili pepper, red, raw (organic?).

Foods that have a positive effect

  1. Spices and Herbs
    Seasoning with natural herbs and spices certainly helps. For example, black pepper is an appetite suppressant. It is digestion-stimulating and leads to better blood supply, which also causes an increase in the basal metabolic rate (piperine, piperonal). But to really have an effect, you need to consume a lot of it. Some players in the weight loss industry call cinnamon a "fat burner", but this cannot be proven and, above all, cheap cinnamon should be ruled out as far as possible because of the much too high coumarin content. See our food descriptions, e.g. for cinnamon - especially under the heading "Ingredients - Nutritional Values ​​- Calories". In general, however, one can advise eating plenty of herbs and spices to support weight loss and health. In addition to black pepper, turmeric, curry (a turmeric mixture), ginger (or Thai ginger), sumac, rosemary, oregano, real coriander (seeds or leaves), marjoram, fennel seeds, caraway seeds, basil, real thyme, chili -Paprika (or paprika powder, active ingredient capsaicin), cloves, etc. may also be included. We would like to call "good seasoning" without salt as the "secret of losing weight".
  2. High Fiber Diet
    Konjac (also called devil's tongue) has the highest known water-binding capacity of all natural products. It can bind 50 times the amount of water. Glucomannan is obtained from the root of devil's tongue (Amorphophallus konjac). Shirataki noodles (konnyaku, also called moyusi or juruosi in China) contain the dietary fiber glucomannan. However, they are not glass noodles, instead they are fiber-rich and gluten-free noodles. The Shirataki rice is similar. See, for example, the recipe for lemony Shirataki noodles with fennel and paprika, which weighs 500 g (and has a lot of volume) and only contains about 240 kcal. Psyllium also binds an extraordinary amount of water. Drinking enough water is important for both. Depending on the intestinal flora, it can lead to metabolism in the large intestine, which releases CO2 in the intestine. The European Food Safety Authority (EFSA) considers (on December 9th, 2010) it to be scientifically justified to take at least 3 g of glucomannan daily in 3 portions of at least 1 g each with 1–2 glasses of water before a meal to reduce body weight.85 Other foods that are also very high in fiber are: wheat bran, carob powder, chia seeds, lupine flour, linseed, legumes, nutritional yeast, etc.
  3. Green Vegetables
    Even if you would like to give preference to fruits, vegetables should be the next priority after spices and high-fiber foods. Spinach, for example, has thylakoids that increase GLP-1 levels, i.e. reduce the feeling of hunger and the craving for tasty food or cravings for sweet or junk food (hedonic hunger). To do this, eat spinach before the first meal of the day.55 A long-term study on humans from Sweden showed remarkable effects with spinach, and it can be deduced that other green vegetables could have a similar effect.
  4. Sugarless Fennel Tea or Fenugreek Tea (made from crushed seeds) before meals suppresses appetite.57 The crushed seeds are placed in cold water for a few hours and then boiled briefly.
  5. Seeds and Nuts
    Flaxseed not only reduces the lipemia that occurs after eating in diabetes, i.e. the increase in triglycerides (fats) in the blood, but also suppresses appetite.58 This is probably due to the effect on our hormone ghrelin. In general, we should use seeds and nuts instead of oil, which also improves heart health significantly and provides the necessary proteins, instead of practically only the fatty acids. Prominent heart specialists in the USA, such as Dr. Med. Dean Ornish, Dr. Med.John McDougall, Dr. Med. Joel Fuhrman, Dr. Med. Neal Barnard and Dr. Med. Caldwell B. Esselstyn totally condemn vegetable oils. Flaxseed fiber is particularly effective against postprandial lipemia (fats in the blood) and lowers HbA1c blood sugar levels.67
  6. Fruit
    Eating some fruit just before a meal has a large effect on GLP-1 levels and can reduce subsequent consumption by 18.5%, but it does not increase blood glucose levels.59 According to a study, apple polyphenols such as quercetin are particularly effective.
  7. Berry
    You can easily integrate berries into your daily meal. Strawberries, blueberries, raspberries, blackberries and cranberries can be added to breakfast and are effective. They lower "insulinspikes".
  8. Pure Water before Meals
    An interesting study with schoolchildren shows the benefits of drinking a glass of water (2dl) or a little more, to help reduce obesity.74

Sufficient magnesium is another factor in promoting ideal weight. This is especially true for older people who like to do sports. Magnesium is recommended at least when muscle cramps occur. We also recommend checking the blood zinc status and other nutrients that are often considered critical.

In addition, natural substances, such as 2 ml of black cumin oil (Nigella sativa) per day68 or mangosteen (under the name Garcinia camboia),69 can help, but we do not recommend this because it is ultimately not a goal-oriented strategy. You can use black cumin instead. However, products such as spirulina, fish oil and many other natural products (including certain herbs or berberine from barberries) are quite commercially motivated.

Negative Foods

  1. Sweet beverages
  2. Easily absorbable carbohydrates (high GL)
    Sugar, highly sweetened jam, white bread, bread, pasta such as noodles and spaghetti, baked goods such as pizza, cakes, crispbread, and porridge.
  3. Heavily processed products
    Processed products such as snacks, French fries, too many animal products, animal fat, cooking oil (e.g. coconut oil). Choose instead seeds and nuts, but don't snack on too many of them.

However, rice, potatoes and even melons, bananas and carrots are not exactly good for losing weight either.

To lose weight, you have to avoid snacking; even starting with just two main meals, where possible, lunch and early dinner. The feeling of hunger only arises after the first meal of the day - with products with a high GI. With a diet that goes in the direction of vegan raw food, weight loss is guaranteed. Knowing the advantages and disadvantages of this is a basic requirement. That is why you will find the link to the article, "Vegans often eat unhealthily. Avoidable nutritional mistakes" here.

Dietary Supplements

Obesity has increased so much that a large industry with very different product offerings has emerged. This also includes the industry of dietary supplements for weight loss, and their distributors. A comprehensive literature review focusing on most dietary supplements marketed in 2020 classifies them according to their purported or real mechanism of action. It concludes with a combination of dietary supplements that utilizes all mechanisms of action that can potentially lead to a synergistic effect and greater weight loss in the absence of foreseeable side effects.78

The conclusion is: However, no dietary supplement can induce clinically relevant weight loss, with the most effective resulting in a reduction of only 2 kg. But if someone wants to go this route and also bear the risks of side effects, then the study shows the "maximum" route with the arguments:

Phaseolus vulgaris extract (PVE) is said to inhibit the absorption of nutrients. This at a dosage of 3000 mg (1000 mg per meal) daily and epigallocatechin (EGCG) from green tea at a dosage of 500 mg per day. To reduce appetite and potentially increase energy expenditure, the study recommends use of coffee-derived caffeine (300 mg/day) and chlorogenic acid (200 mg/day). It also proposes capsaicinoids or capsinoids derived from chilli pepper at a dosage of 10 mg and 3 mg respectively, together with L-carnitine at a dosage of 2 g daily. This is said to increase fat mobilization. Resveratrol and conjugated linoleic acid (CLA) would similarly enhance beta-oxidation and inhibit lipogenesis. This at a dosage of 200 mg or 4 g daily. One could regulate carbohydrate metabolism with glucose-lowering lipoic acid at a dosage of 600 mg daily, which would also support the treatment of T2D (type 2 diabetes).78

We believe that taking most supplements is dangerous and not conducive to maintaining a healthy weight and staying healthy. Still, we're putting it ahead of the "wrong methods" because you can just include appropriate foods - and that does not have to be coffee, either.

Further explanations on this

For readers who want to know the exact mechanism of action:
Green tea inhibits pancreatic lipase, amylase and glucosidase in the gastrointestinal tract, which reduces the absorption of nutrients and leads to the presence of undigested carbohydrates in the gastrointestinal tract, which in turn affects the microbiota (microbiome refers to the whole body ) and stimulates the production of short-chain fatty acids (SCFA). It also inhibits lipogenesis and induces lipolysis through an AMPK-dependent mechanism. So there is nothing wrong with this natural food.

Phaseolus-vulgaris-Extract (PVE) contains phaseolin, an α-amylase inhibitor whose function interferes with the absorption of carbohydrates. Phaseolin is the main reserve protein of the bean genus Phaseolus (all "New World"). Examples of beans are garden beans, Lima beans, kidney beans, pinto beans etc. The old-world genus Vicia (e.g. field beans) also contains phaseolin, but it is not as well known.

Caffeine suppresses hunger and stimulates energy expenditure through increased sympathetic nervous system (SNS) excitability, increased fat oxidation and brown adipose tissue (BAT) activation. Coffee is also high in chlorogenic acid, which slows down the absorption of sugar into the blood after a meal. With a healthy diet, you get these substances automatically. For example, chlorogenic acid is contained in blueberries, grapes, apples, walnuts, artichokes, potatoes, lemon balm, nettles, St. John's herbs, etc. However, chlorogenic acid is believed to cause problems in coffee drinkers with sensitive stomachs; therefore, it is reduced with special roasting processes of the coffee beans.

Capsaicinoids activate the transient receptor potential channel vanilloid type-1 (TRPV1), resulting in glucagon-like peptide-1 (GLP-1) release, increased lipid oxidation, and increased sirtuin-1 expression (SIRT1). They also suppress ghrelin release and increase expression of adiponectin, PPARα and PGC-1α. They eventually regulate the genes for gluconeogenesis and glycogen synthesis, which improves "insulinresistance". Capsaicinoids are mainly found in red chili peppers, which can also be eaten as pickled jalapeños. Paprika and chili contain various capsaicinoids such as capsaicin, dihydrocapsaicin and nordihydrocapsaicin, with capsaicin usually making up two-thirds to three-quarters of the total capsaicinoid content. However, the Federal Institute for Risk Assessment (BfR) warns against too many hot peppers: Based on these considerations, the BfR considers the intake level of 5 mg total capsaicin/kg body weight to be a maximum dose for adults that may occur as part of a meal made using chillies or chili preparations. The BfR expressly points out that this maximum dose can also trigger undesirable effects in individuals who are not used to chili preparations or who are sensitive.79 You should be even more cautious with an enriched product.

L-Carnitine is said to improve "insulinresistance" and increase the supply of acetyl-coenzyme A and glucose to the brain, which leads to increased energy expenditure. It facilitates the transport of activated long-chain fatty acids into the mitochondria and plays an important role in β-oxidation. L-Carnitine also modulates fat metabolism. The body produces enough L-carnitine with a normal supply of lysine and methionine, vitamins B3, B6, B12 and C as well as folic acid and iron (approx. 16 mg/day). Because our gut bacteria turn L-carnitine in red meat into trimethylamine, which the liver has to convert into the toxic trimethylamine-N-oxide (TMAO), which promotes atherosclerosis. Comparing vegans to omnivores, the latter showed a significantly increased risk of both prevalent cardiovascular disease (CVD) and serious adverse cardiac events (MI, stroke or death), but only in subjects with concomitantly high TMAO levels.80 This is not the case with a plant-based diet. Several studies have shown that plasma and urine levels of trimethylamine N-oxide (TMAO) are a reliable predictor of cardiovascular disease risk. This meta-study shows that a high-protein diet, especially one of animal origin, such as a diet high in fish or red meat, greatly increases TMAO levels.81 This promotes deposits in the blood vessels. Incidentally, meat eaters have a different intestinal flora than vegans and also produce trimethylamine from choline. Legumes are the solution here, and tempeh is the most concentrated source of L-carnitine. But potatoes, mushrooms and avocados also have a lot of it.

Resveratrol increases SIRT-1 expression, decreases adipogenesis and viability in maturing preadipocytes, and modulates lipid metabolism in mature adipocytes. There is a lot of resveratrol in the skin of grapes, raspberries, mulberries, plums and peanuts. More recent studies cannot prove weight reduction and a Cochrane Review from 2020, e.g. on type 2 diabetes, cannot confirm other health claims either.

Conjugated Linoleic Acid (CLA) reduces the size of adipocytes, changes the differentiation of adipocytes, regulates lipid metabolism and activates PPAR-γ receptors. The European Food Safety Authority (EFSA) found no effect on lean body mass (LBM) or body weight in 14 (out of 16) human intervention studies on Regulation No. 1924/2006. The EFSA also does not see an influence on "insulinsensitivity" as proven - nor an antioxidant effect or stimulation of the immune system. Incidentally, this most common isomer is one of the trans fatty acids!

(Alpha-)Lipoic Acid increases GLUT4 expression on the cell membrane of skeletal muscle and adipocyte cells, leading to increased glucose uptake and thus improved glucose tolerance.78 Too much of this sulphur-containing fatty acid produces psychomotor agitation or clouded consciousness, up to and including generalized seizures and hypoglycemia. Lipoic acid can also inhibit biotin. But the positive effect is the elimination of heavy metals such as mercury, copper, iron and platinum. Good sources of alpha lipoic acid are vegetables like spinach, broccoli, and tomatoes. Clinical studies show positive effects on obesity when taken together with the right diet.

The wrong Methods

Often, desperation is so big, people resort to whatever offer is available, feeding a very influential and financially attractive "industry". Diet products (light products) are tempting but not effective, even if they mean good business for many. Sweeteners, for example, often lead to an increased desire for sweets and ultimately to increased consumption.26

Even worse are the appetite suppressants (anorectics), which also include amphetamines (such as cathine or amfepramone). They affect the central nervous system, are addictive and can negatively impact the cardiovascular system.27 The intake of prescription hormones (HCG, "growthhormone", thyroid hormone L-thyroxine or androgens) or other prescription drugs should not be misused as weight loss aids. Over-the-counter weight loss medications such as diuretics (water pills) or laxatives can also have serious side effects.28

Other more harmful methods include high-protein, low-carbohydrate foods such as the Dr. Aktins diet.66 High-protein (and low-carbohydrate) diets are linked to cardiovascular problems, such as plaque buildup on the artery walls.29 The opposite is true, weight loss drinks with a calorie intake of around 1000 kcal/day. Both methods produce short-term weight loss, but they cannot be sustained without damaging the body. Ultimately, you will find yourself with a rather higher weight if you do not change your lifestyle permanently.

When is professional help necessary?

The thinking brain is not enough for a permanent change because you need all your conviction and willpower to lose weight consistently. But if you feel like you can't do it on your own and have a BMI > 30, you should get professional medical help. The life expectancy of severely obese people (BMI between 40 and 45) is 8–10 years less than that of people of normal weight. During your lifetime, you are more likely to develop diseases such as diabetes, cardiovascular disease and cancer.3

Seek medical and psychological help if you have an eating disorder, such as Binge Eating Disorder (BED). This can lead to metabolic syndrome, also known as the fatal quartet. In the case of bulimia (Bulimia nervosa), on the other hand, you usually do not take in too many calories because you eliminate them again through vomiting. Such eating disorders, including anorexia nervosa, often occur unknowingly and should be accompanied by psychotherapy and other treatment strategies. Good self-help groups can contribute to recovery for both eating disorders and weight problems.

Emergency Steps

In difficult cases, a non-surgical attempt with a gastric balloon is often recommended. It is an alternative that is worth considering, but a change in lifestyle is also necessary here. The gastric balloon is recommended for a BMI of 28 to 44 for a maximum of 6 months. However, this is actually just preparation for a surgery and tends to lead to rapid weight gain after weaning because the wrong impulses come from the psychological point of view.

After all, surgeries (bariatric surgery) are the last resort when someone cannot move life in a healthy direction. However, they are only recommended for grade III obesity. The usual procedures are gastric band, gastric sleeve, gastric bypass or biliopancreatic diversion with duodenal switch (BPD-DS). The latter is a complex surgical intervention in bariatric surgery.

Unfortunately, one often starts when the BMI reaches 35 or 40 kg/m2, instead of the waist circumference or, even better, the waist-hip ratio (THV or THI/THQ, WHR). The mentioned BMI, i.e. morbid obesity or obesity permagna, leads to serious and often incurable comorbidities.


Note: Use the two horizontal arrows to jump back and forth between posts and the eye icon to get people, institutions, etc. in different fonts (emphasis added).

Bibliography - 86 Sources


MacLean PS, Higgins JA, Giles ED, Sherk VD, Jackman MR. The role for adipose tissue in weight regain after weight loss. Obes Rev. 2015;16(S1):45-54.


Mousavi SM, Rahmani J, et al. Cinnamon supplementation positively affects obesity: A systematic review and dose-response meta-analysis of randomized controlled trials. Clin Nutr. 2020; 39(1):123-133.


OECD. Obesity and the Economics of Prevention: Fit not Fat. OECD Publishing. Paris. 2010.


Michael Moss. Salt Sugar Fat. How the Food Giants Hooked Us. Random House, New York. 2013.


WHO. A healthy lifestyle - WHO recommendations. Mai 2010.


Ross R, Neeland IJ, Yamashita S et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol. 2020;16:177–189.


Mach F, Baigent C, Catapano AL et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European Heart Journal. 2019;41(1):111-188.


Hutley L, Prins JB. Fat as an endocrine organ: relationship to the metabolic syndrome. Am J Med Sci. 2005;330(6):280-289.


Koch CE, Lowe C, Pretz D, Steger J, Williams LM, Tups A. High-fat diet induces leptin resistance in leptin-deficient mice. J Neuroendocrinol. 2014;26(2):58–67.


Klem ML, Wing RR, McGuire MT et al. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. The American Journal of Clinical Nutrition. 1997;66(2):239–246.


Bechthold A. Food Energy Density and Body Weight. Ernährungs Umschau. Januar 2014;61(1):2-11.


World Health Organisation. Report of a Joint WHO/FAO Expert Consultation: Diet, Nutrition and the Prevention of Chronic Diseases. WHO Technical report Series 916. Geneva. 2003.


Veronese N, Stubbs B, Noale M et al. Fried potato consumption is associated with elevated mortality: an 8-y longitudinal cohort study. Am J Clin Nutr. 2017;106(1):162-167.


Nestel PJ, Mori TA. Dietary patterns, dietary nutrients and cardiovascular disease. Rev Cardiovasc Med. 2022;23(1):17.


Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLoS Med. 2020;17(3):e1003053.


Hermanussen M, García A, Sunder M et al. Obesity, voracity, and short stature: the impact of glutamate on the regulation of appetite. European Journal of Clinical Nutrition. 2006;60:25–31.


Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz Österreich. Bewegung & Energiestoffwechsel. Gesundheitsportal. Wien. Dezember 2020.


Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz Österreich. Gesunde Ernährung: Basis-Info. Der Energieverbrauch. Gesundheitsportal. Wien. Juli 2020


Biesalski HK, Bischoff SC, Pirlich M et al. Ernährungsmedizin. 5. Auflage. Thieme: Stuttgart, New York. 2018.


Osterberg KL, Melby CL. Effect of acute resistance exercise on postexercise oxygen consumption and resting metabolic rate in young women. Int J Sport Nutr Exerc Metab. March 2000;10(1):71-81.


Blais CA, Pangborn RM, Borhani NO, Ferrell MF, Prineas RJ, Laing B. Effect of dietary sodium restriction on taste responses to sodium chloride: a longitudinal study. The American Journal of Clinical Nutrition. August 1986;44(2):232–243.


EFSA European Food Safety Authority. Dietary reference values for nutrients summary report. EFSA Supporting Publications. 2017;14(12):e15121E.


Muraki I, Imamura F, Manson JE, Hu FB, Willett WC, van Dam RM, Sun Q. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. August 2013;347:f5001.


Greer S, Goldstein A, Walker M. The impact of sleep deprivation on food desire in the human brain. Nat Commun. 2013;4:2259.


Lally P, van Jaarsveld CHM, Potts HWW, Wardle J. How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology. 2010;40(6):998–1009.


Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008;16(8):1894-1900.


James WP, Caterson ID, Coutinho W et al. Effect of "sibutram..." on cardiovascular outcomes in overweight and obese Subjects. N Engl J Med 2010;363:905-917.


Arbeiterkammer OÖ. Schlank durch Wundermittel? Pillen, Kapseln und Säfte auf dem AK-Prüfstand. Juni 2022.


Lagiou P, Sandin S, Lof M, Trichopoulos D, Adami HO, Weiderpass E. Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study. BMJ. 2012 Jun 26;344:e4026.


Izquierdo AG, Crujeiras AB, Casanueva FF, Carreira MC. Leptin, obesity, and leptin resistance: where are we 25 years later? Nutrients. 2019;11(11):2704.


Gruzdeva O, Borodkina D, Uchasova E, Dyleva Y, Barbarash O. Leptin resistance: underlying mechanisms and diagnosis. Diabetes Metab Syndr Obes. 2019 Jan 25;12:191-198.


Barazzoni R, Gortan Cappellari G, Ragni M, Nisoli E. "Insulinresistance" in obesity: an overview of fundamental alterations. Eat Weight Disord. 2018 Apr;23(2):149–157.


Yaribeygi H, Farrokhi FR, Butler AE, Sahebkar A. "Insulinresistance": Review of the underlying molecular mechanisms. Journal Cellular Physiology. 2019 Jun;234(6):8152–8161.


Young ER, Jialal I. Biochemistry, Ghrelin. NIH July 19, 2022.


Wang W, Tao YX. Ghrelin receptor mutations and human obesity. Progress in Molecular Biology and Translational Science. 2016;140:131-150.


Zigman JM, Bouret SG, Andrews ZB. Obesity impairs the action of the neuroendocrine ghrelin system. Trends in Endocrinology & Metabolism. 2016 Jan;27(1):54–63.


Thau L, Gandhi J, Sharma S. Physiology, Cortisol. August 29, 2022


Jones C, Gwenin C. Cortisol level dysregulation and its prevalence—Is it nature’s alarm clock? Physiol Rep. 2021;8(24):e14644.


Van der Valk ES, Savas M, van Rossum EFC. Stress and obesity: are there more susceptible individuals? Curr Obes Rep. 2018;7(2):193–203.


Sampson JN, Falk RT et al. Association of estrogen metabolism with breast cancer risk in different cohorts of postmenopausal women. Cancer Research. 2017;77(4):918–925.


Kapoor E, Collazo-Clavell ML, Faubion SS. Weight gain in women at midlife: a concise review of the pathophysiology and strategies for management. Mayo Clinic Proceedings. 2017;92(10):1552–1558.


Tan CMJ, Green P et al. The role of neuropeptide y in cardiovascular health and disease. Front Physiol. 2018;9:1281.


Wu Y, He H, Cheng Z, Bai Y, Ma X. The role of neuropeptide y and peptide yy in the development of obesity via gut-brain axis. CPPS. 2019 Jun 27;20(7):750–758.


Zhang Y, Liu CY et al. Regulation of neuropeptide Y in body microenvironments and its potential application in therapies: a review. Cell Biosci. 2021;11:151.


Müller TD, Finan B et al. Glucagon-like peptide 1 (GLP-1). Molecular Metabolism. 2019 Dec;30:72–130.


Sakurai T. The neural circuit of orexin (Hypocretin): maintaining sleep and wakefulness. Nat Rev Neurosci. 2007;8(3):171–181.


Okonkwo O, Zezoff D, Adeyinka A. Biochemistry, Cholecystokinin. May 8, 2022.


Cawthon CR, de La Serre CB. The critical role of CCK in the regulation of food intake and diet-induced obesity. Peptides. 2021;138:170492.


Wynne K, Park AJ et al. Oxyntomodulin increases energy expenditure in addition to decreasing energy intake in overweight and obese humans: a randomised controlled trial. Int J Obes. 2006;30(12):1729–1736.


Zouhal H, Sellami M et al. Effect of physical exercise and training on gastrointestinal hormones in populations with different weight statuses. Nutrition Reviews. 2019;77(7):455–477.


USDA Dietary Guidelines for Americans. History of the Dietary Guidelines.


Soltani H, Keim NL, Laugero KD. Increasing dietary carbohydrate as part of a healthy whole food diet intervention dampens eight week changes in salivary cortisol and cortisol responsiveness. Nutrients. 2019 Oct 24;11(11):2563.


Hoge EA, Bui E et al. The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder. Psychiatry Research. 2018;262:328–332.


Meerman R, Brown AJ. When somebody loses weight, where does the fat go? BMJ. 2014;349:g7257–g7257.


Stenblom EL, Egecioglu E et al. Consumption of thylakoid-rich spinach extract reduces hunger, increases satiety and reduces cravings for palatable food in overweight women. Appetite. 2015;91:209–219.


Penuelas J, Krisztin T et al. Country-level relationships of the human intake of n and p, animal and vegetable food, and alcoholic beverages with cancer and life expectancy. IJERPH. 2020 Oct 3;17(19):7240.


Bae J, Kim J, Choue R, Lim H. Fennel (foeniculum vulgare) and fenugreek (trigonella foenum-graecum) tea drinking suppresses subjective short-term appetite in overweight women. Clin Nutr Res. 2015;4(3):168.


Kristensen M, Savorani F et al. Flaxseed dietary fibers suppress postprandial lipemia and appetite sensation in young men. Nutrition, Metabolism and Cardiovascular Diseases. 2013;23(2):136–143.


Abdul Hakim BN, Yahya HM et al. Effect of sequence of fruit intake in a meal on satiety. IJERPH. 2019 Nov 13;16(22):4464.


Zieliński J, Przybylski J. [How much water is lost during breathing?]. Pneumonol Alergol Pol. 2012;80(4):339–342.


Institute of Medicine (US) Committee on Military Nutrition Research. Nutritional Needs in Hot Environments: Applications for Military Personnel in Field Operations. Marriott BM, editor. Washington (DC): National Academies Press (US); 1993.


Stephenson J, Heslehurst N et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. The Lancet. 2018;391(10132):1830–1841.


Our Wold in Dattani S, rodes-Guirao L et al. Life Expectancy. 2013.


Wolfson MC. Health-adjusted life expectancy. Health Rep. 1996;8(1):41-46.


WHO World Health Organzation, The global health observatory. Life expectancy at age 60 (years).


Kitada M, Ogura Y, Monno I, Koya D. The impact of dietary protein intake on longevity and metabolic health. EBioMedicine. 2019 May;43:632–640.


Villarreal-Renteria AI, Herrera-Echauri DD et al. Effect of flaxseed (Linum usitatissimum) supplementation on glycemic control and insulin resistance in prediabetes and type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2022 Nov;70:102852.


Safi S, Razmpoosh E, Fallahzadeh H et al. The effect of Nigella sativa on appetite, anthropometric and body composition indices among overweight and obese women: A crossover, double-blind, placebo-controlled, randomized clinical trial. Complement Ther Med. 2021 Mar;57:102653.


Golzarand M, Omidian M, Toolabi K. Effect of Garcinia cambogia supplement on obesity indices: A systematic review and dose-response meta-analysis. Complement Ther Med. 2020 Aug;52:102451.


Swinburn BA, Kraak VI et al. The global syndemic of obesity, undernutrition, and climate change: the lancet commission report. The Lancet. 2019 Feb;393(10173):791–846.


Aykut A, Özen S et al. Melanocortin 4 receptor (Mc4r) gene variants in children and adolescents having familial early-onset obesity: genetic and clinical characteristics. Eur J Pediatr. 2020 Sep;179(9):1445–1452.


Zhao X, Yang Y, Sun BF, Zhao YL, Yang YG. Fto and obesity: mechanisms of association. Curr Diab Rep. 2014;14(5):486.


Schmid SM, Hallschmid M, Jauch-Chara K, Born J, Schultes B. A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. Journal of Sleep Research. 2008;17(3):331–334


Muckelbauer R, Libuda L, Clausen K, Toschke AM, Reinehr T, Kersting M. Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial. Pediatrics. 2009;123(4):e661–e667.


Boschmann M, Steiniger J, Franke G, Birkenfeld AL, Luft FC, Jordan J. Water drinking induces thermogenesis through osmosensitive mechanisms. The Journal of Clinical Endocrinology & Metabolism. 2007;92(8):3334–3337.


Pearce LR, Atanassova N et al. Ksr2 mutations are associated with obesity, insulinresistance, and impaired cellular fuel oxidation. Cell. 2013 Nov;155(4):765–777.


Zheng J, Zheng S, Feng Q, Zhang Q, Xiao X. Dietary capsaicin and its anti-obesity potency: from mechanism to clinical implications. Biosci Rep. 2017 Jun 30;37(3):BSR20170286.


Watanabe M, Risi R et al. Current evidence to propose different food supplements for weight loss: a comprehensive review. Nutrients. 2020 Sep 20;12(9):2873.


BfR Bundesamt für Risikobewertung. Zu scharf ist nicht gesund - Lebensmittel mit sehr hohen Capsaicingehalten können der Gesundheit schaden. 2011.


Koeth RA, Wang Z et al. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med. 2013;19(5):576–585.


Lombardo M, Aulisa G, Marcon D, Rizzo G. The influence of animal- or plant-based diets on blood and urine trimethylamine-n-oxide (Tmao) levels in humans. Curr Nutr Rep. 2022;11(1):56–68.


Mahmoud R, Kimonis V, Butler MG. Genetics of obesity in humans: a clinical review. IJMS. 2022 Sep 20;23(19):11005.


Bouchard C. Genetics of obesity: what we have learned over decades of research. Obesity. 2021;29(5):802–820.


Wenz T, Rossi SG, Rotundo RL, Spiegelman BM, Moraes CT. Increased muscle PGC-1α expression protects from sarcopenia and metabolic disease during aging. Proc Natl Acad Sci USA. 2009 Dec;106(48):20405–20410.


Efsa Europäische Behörde für Lebensmittelsicherheit. Scientific Opinion on the substantiation of health claims related to konjac mannan (glucomannan) and reduction of body weight (ID 854, 1556, 3725), reduction of postprandial glycaemic responses (ID 1559), maintenance of normal blood glucose concentrations (ID 835, 3724), maintenance of normal (fasting) blood concentrations of triglycerides (ID 3217), maintenance of normal blood cholesterol concentrations (ID 3100, 3217), maintenance of normal bowel function (ID 834, 1557, 3901) and decreasing potentially pathogenic gastro-intestinal microorganisms (ID 1558) pursuant to Article 13(1) of Regulation (EC) No 1924/2006:14.


CDC Centers for Disease Control and Prevention. What is Epigenetics? Genomics & Precision Health. Aug 2022.


Tag Cloud
 weight   fat   Food   body   energy   eat   obesity   eating   blood   water   lose   foods   Diet   loss   hormone   calories   cells   hormones   effects   sugar   lead   intake   fiber   BMI   dietary   sleep   appetite   acid   increases   carbohydrates