Well, in order to close the topic of various methods leading to weight loss (or complete bringing in shape), we need to talk about two approaches: weight loss clinics and surgical methods.

Slimming clinics

I heard a lot about clinics for weight loss in the old Soviet times. We had a good acquaintance of the family – a very overweight lady who periodically went to such a clinic, because the doctors told her that if she didn’t lose weight, she would risk dying soon enough from a heart attack (unfortunately, she has a heart naughty, but you can’t blame him for it – the lady was such, as they say, “in the body” that no heart could bear).

The lady hated these clinics with all her heart, and it was with great difficulty that they drove her there through the efforts of the whole family and family friends, but from her I knew how it all worked in Soviet times. Apparently, this was a concentration-type weight-loss clinic: the clients of the clinic (not to say – “guests”) were put on food with a level of somewhere between 700-800 kilocalories per day, and they also did not take much steam with food: black bread, boiled meat, cabbage, beets (for some reason), liquid broth and buckwheat porridge (for some reason). All – in the corresponding negligible quantities, and these unfortunate fascists also fed the unfortunate only three times a day, so that they went through all the circles of hell there.

Of course, on such a diet, people dropped five, seven and even ten kilos in a week, experiencing tremendous mental and physical suffering, then the happy ones returned to the family and there they ate to the previous level literally in the same week, if not faster.

What is the meaning of such bullying, I did not understand at all, because it was obvious that such clinics did not lead to any normal result, and the lady ended up getting more and more gorged.

Once she even ended up in the newest experimental clinic, where, in addition to food sadism, strictly scientific experiments flourished – also in the spirit of an enlightened concentration camp. They tried to wean the unfortunate fat men from any harmful food with the help of electric shocks. Picked up some kind of eclair – get such a non-acidic discharge. Grabbed a cupcake – another discharge. I tried to have time to put chocolate candy in my mouth – discharge, discharge, another discharge. I do not know, however, where these electrodes were attached to them, she did not tell. Hopefully not genitals after all.

By the way, after that she really developed a disgust for eclairs and she switched exclusively to biscuit cakes. 

All sorts of weight loss clinics around the world were quite common (especially in developed countries), and are now very common. I have sometimes come across descriptions of such clinics in fiction. I remember that Mario Puzo’s excellent novel Let the Fools Die described a clinic in North Carolina in which patients were put on a strict rice diet and exercise, promising them to lose at least five to seven kilos a week.

In another book I read about the famous clinic in which patients were put on a kefir-curd diet. I also heard about a clinic that exclusively practiced a raw food diet. And so on.

Some time ago I started consulting with a lady who is a professional and very knowledgeable dietitian. I wanted to know if I had come to the right conclusions on my own, if I had fallen into some dangerous heresy that terrifies the world of nutritional science. It turned out that he did not fall, that he drew completely correct conclusions, but that is not the point now.

I told her about that famous clinic from North Carolina, where patients were tortured with a rice diet, but they lost five, seven, or even ten kilos a week.

Weight loss clinics

– Do I understand correctly, – I asked the lady-nutritionist, – that this is the most classic mono-diet?

– Yes, that’s right, this is a mono-diet.

– Do I understand correctly that this is a thing in any distant future, not only meaningless, but also very harmful, because a person on a mono-diet, firstly, experiences serious suffering, and secondly, is losing weight at a dangerous rate, and thirdly, after returning to a normal diet, will he very quickly pick up everything that he lost, and at the same time, most likely, will get even more fat?

– Yes, that’s right, – answered the lady.

– But how then can these people call such an institution a clinic, and call themselves doctors? I asked naively. – It’s just a divorce of the unfortunate fat men.

“Of course, a divorce,” the lady replied. “But this is pure business, nothing personal. Look. You rent somewhere near Moscow some boarding house with a gym and a dining room, designed for a hundred people. Calling yourself “Dr. Exler’s Weight Loss Clinic” sounds solid, by the way. You give an advertisement: “To lose five to ten kilos in just a week.” Cost – well, for the same week – five hundred dollars. In two weeks – seven hundred and fifty. You buy a ton of rice for two kopecks. You hire staff – but even students, you don’t need any qualifications right away, and any woman Klasha can cook boiled rice in marketable quantities, who for the same money will also wash dishes. You advertise on your blog, of course, at the moment you recruit a hundred people, bring them to the boarding house. There you feed them only rice, show them movies on TV and drive them to the gym twice a day – let them have fun themselves, the simulators are there. Well, splurge on some prettier coach to keep the ladies happy. Well, that’s all – you raise $ 50 thousand in a week, the expenses will be about $ 5 thousand. Well, well, for $ 10 thousand, if you pay a lot to the coach. In a month you raise under $ 180 thousand, in a year – about two lemons in dollars. Okay, do you? you show movies on TV and drive them to the gym twice a day – let them have fun themselves, the simulators are there. Well, splurge on some prettier coach to keep the ladies happy. Well, that’s all – you raise $ 50 thousand in a week, the expenses will be about $ 5 thousand. Well, well, for $ 10 thousand, if you pay a lot to the coach. In a month you raise under $ 180 thousand, in a year – about two lemons in dollars. Okay, do you? you show movies on TV and drive them to the gym twice a day – let them have fun themselves, the simulators are there. Well, splurge on some prettier coach to keep the ladies happy. Well, that’s all – you raise $ 50 thousand in a week, the expenses will be about $ 5 thousand. Well, well, for $ 10,000 if you pay a lot to the coach. In a month you raise under $ 180 thousand, in a year – about two lemons in dollars. Okay, do you? $ 10 thousand if you pay a lot to the coach. In a month you raise under $ 180 thousand, in a year – about two lemons in dollars. Okay, do you? $ 10 thousand if you pay a lot to the coach. In a month you raise under $ 180 thousand, in a year – about two lemons in dollars. Okay, do you?

“Stop,” I said, “but this has nothing to do with medicine or nutrition. It’s more of a divorce for suckers. More precisely, this is the divorce of suckers. More precisely, the divorce of the unfortunate fat men.

– Of course, a divorce, – answered the lady nutritionist. – But two lemons a year. Would you like two lemons a year?

“I don’t want to,” I replied, “the divorces of fatty fatties are not my topic. This is bestiality, in my opinion.

“Well, that’s why you’re not a millionaire,” said the nutritionist lady quite rightly. “And these guys from North Carolina are probably millionaires. Like the owners of many other similar clinics, where “To lose five to ten kilos in just a week” and some kind of mono-diet. Actually, they are all the most harmful. And serious money is made just on this – “five to ten kilos per week.” Fast results. Who will pay you $ 500 per kilo a week? Nobody. But for five to ten kilos – they will pay. And this is just a mono diet. Well, and even before the heap of the gym to torment them – just so they don’t get bored.

In general, yes, all this is logical. Therefore, such clinics have existed, exist and will continue to exist. Well, how not to put on a few hundred or thousands of dollars’ worth of fat fat woman? And that for them it is both meaningless and harmful – well, who cares at all?

However, it should be noted here that there are also quite normal clinics that help people lose weight and get in shape. And everything is clear and understandable there: first, the patient undergoes a full examination in order to find out the state of his health, then the basic principles are explained in detail, the appropriate dietary regimen is selected for him and how to act. After that, the patient already at home fulfills the prescriptions that he received there, and periodically shows himself to the doctor who leads him in order to control his condition and get some tips and adjustments. If such a clinic employs good professional nutritionists and they are not bought on the vine by all sorts of herbalife and magic pills of the Chinese doctor Sun Won, then this approach is both correct and correct, and certainly not too expensive. Because really, when you don’t promise “five to ten kilos a week”, you won’t take a lot of money for it. But on the other hand, the conscience of a nutritionist is clear, and people really help to get in shape.

Surgical methods

Maestro, cut your march!
Bulgakov. Master and Margarita

As it turned out, it is not only the march that can be cut back. You can also cut your stomach.

There are and have been practicing for quite a long time various methods of intervention in the body, leading to weight loss. Indications for certain methods are usually prescribed in accordance with the body mass index (BMI), which is calculated as the weight in kilograms divided by the square of the height in meters. Well, that is, roughly speaking, from the level of excess weight.


The simplest method, which is not an operation, is the same gastric balloon , which was actively advertised on the Web some time ago.

The patient first undergoes gastroscopy in order to identify diseases in which the balloon cannot be used, after which an empty balloon, rolled into a tube, is inserted into his stomach. The balloon is then filled with 500 ml of water. Disconnect the tube from the balloon – and that’s it, the process is over.

Weight loss clinics

The scheme of action is extremely simple: the balloon occupies a significant part of the stomach, therefore, a person simply physically cannot eat much. Plus, the balloon constantly stimulates the saturation receptors (it tells them: the stomach is full, gentlemen, tell your owner-hostess that you can no longer eat), which are located in the upper part of the stomach, where the balloon is placed, so the person almost does not experience hunger.

By the way, immediately after installing the balloon, the body tries to inform its owner that something is wrong. A person experiences all sorts of unpleasant sensations, nausea, vomiting, diarrhea and other delights. But gradually the body adapts to the balloon and the discomfort disappears.

How it works? In principle, it works well – a person, of course, is losing weight, his body simply has nowhere to go: it will not be possible to eat much, and there is really no appetite.

So what’s the problem? The main problem is that this is not a lifetime recipe at all. A foreign body cannot be kept in the stomach forever; after a maximum of six months, the balloon will have to be removed. And what will happen to a man who has lost a lot of weight, who can now devour an elephant and who has finally returned to a brutal appetite? That’s right, it will go full in a couple of months with terrible force, which usually happens.

Hole in the right side

A more advanced method, which is usually shown for people with a higher BMI (40 to 50), is a gastric band, or as I call it, the hole in the right side. You can’t whistle with this hole, but nevertheless.

What is the essence of the method? A special ring (gastric band) is placed on the upper part of the stomach just below the esophagus. This operation is done using laparoscopy, that is, without incisions, but through small punctures. At first, the ring practically does not compress the stomach – it should take about two months for the stomach to adapt.

After two months, the doctor injects about five milliliters of liquid into the ring through a special port (a hole in the right side).

Weight loss clinics

At the same time, the ring contracts and noticeably reduces the gap between the upper and lower parts of the stomach. The upper part of the stomach above the ring has a volume of only fifteen to twenty milliliters, that is, roughly speaking, it is a tablespoon of soup.

And what happens when this happens? A person gets a feeling of fullness very quickly, and at the same time he eats very little, accordingly, he loses weight. Moreover, this person is going, for example, to go on vacation to Spain or Italy. And how to go to Spain or Italy and not be able to eat Spanish-Italian goodies? So, the question is solved. A person comes to the doctor, he, through a hole in his right side, pumps out the liquid from the ring, the person goes to Spain-Italy and eats there in three throats. He comes back, goes to the doctor, who pumps liquid through the hole in his right side – that’s it, we are losing weight again.

The method, by the way, is very popular in the world, I had several friends doing this operation and, in general, they were quite happy with the result – well, in the sense that they eventually regained normal weight. Moreover, the operation itself is laparoscopic, after it you recover very quickly, the integrity of the walls of the gastrointestinal tract is not disturbed and the method is completely reversible, that is, at any time you can remove the ring altogether and the anatomy of the gastrointestinal tract is completely restored.

What are the disadvantages? Although it was laparoscopic, it was an operation, a foreign body in the body, a hole in the right side. Also, for the entire period of the ring, there is a special diet: you can not mix solid food and liquid. Yes, yes, because the liquid erodes solid food, it slips into the lower part of the stomach, and that’s it – you want to eat. So drink only before meals and at the earliest an hour after meals. But it doesn’t suit everyone – for example, it doesn’t suit me.

Well, it’s clear that you don’t go through your whole life with a ring, after losing weight you will take it off, and then what? It is known that – hello, new kilograms, how long have I seen you!

Gastric bypass

Serious surgery, indicated for very overweight people. There are several different options, but one of the main ones is the so-called Roux-en-Y bypass. The essence of this operation is that a so-called “small stomach” with a volume of 20 to 50 ml is created, and then a loop of the small intestine is sutured to this “small stomach”.

Well, you know, like a plumber takes one gut from a pipe and connects it to another hole.

Here on the diagram it is clearly visible – before and after the operation.

Weight loss clinics

That is, after the operation, food goes according to the principle “We pass, citizens, we pass, we do not stay anywhere”. And purely physically, a person cannot eat a lot – the “small stomach” has a volume of only twenty milliliters. And what interesting sensations a person gets if he eats one teaspoon more than fits in this ventricle, and cannot be conveyed, they described it to me in all the details.

It works very well – from the point of view that a person returns to normal weight in about a year. For example, in the United States, such operations are done about two hundred thousand a year. They are also very popular in Europe, and in Russia too. Although wealthy people travel to Europe, the United States or Israel to do similar operations.

I personally know several people who have done similar operations and have come to normal weight from specific obesity. They told me in detail about all the peculiarities of life after such an operation.

General features of life after intervention in the stomach

What do people who have done any of the above tricks (gastric balloon, hole in the right side, gastric bypass) say? (By the way, there are other methods with similar action, but these are the main ones.)

All these people said that they had to go through very strong psychological and physical tests. And they all reacted to it in different ways. Some were so determined and motivated to get in shape that the inability to eat as much as you want, and any troubles at the slightest excess of the amount of food did not take them out of the rut. But the other first months of the new diet were recalled as, I quote, “it was a specific hell, just hell.”

And there, depending on the method, there are still all sorts of serious restrictions on the type of food. For example, with a stomach ring, as I was told by survivors of this case, you can only eat hot liquid food. Or just dry food, which you just have to wash down, as everything quickly and cheerfully runs back. You can’t drink cold either – the stomach pushes out. Certain types of food (including necessary ones) the stomachs of these people simply refused to accept, even when ground.

(According to one lady, “For the first two months I vomited three times a day,” I apologize for such naturalistic details.)

And many of them began to experience problems from a lack of trace elements and vitamins. This, of course, can be compensated in a certain way, but nevertheless.

Well, almost all of them talked about serious moral suffering when they understood that you cannot eat as much as you want, you cannot eat what you want and what you love, and they also all described their very unpleasant sensations at the slightest excess of the possible amount of food.

However, as the old saying goes, “no pain, no result!” It’s better to go through very unpleasant sensations, but return to normal weight and normal life, than to remain fat with all the ensuing problems, illnesses and the threat of death.

Such methods have helped, help and will help a large number of people who could not cope on their own, so everyone must decide for himself whether he will go for such a surgical method or not. (Well, note that almost all of these operations are very expensive.)

But I continue to insist that it is quite possible to cope on your own without any balloons, holes in the right side and surgical manipulations with the stomach.

From the next issue, we will already start talking about the specific techniques that should be used.