ירידה במשקל, הפחתה באחוזי השומן התת-עורי, שיפור האסתטיקה באופן ממשי בכל מעגלי החיים היא מטרת האימון השכיחה ביותר בקרב האוכלוסייה.
על מנת להפחית משקל ובד בבד – אחוזי שומן, מושקעים מאמצים רבים וממון רב בקרב האנשים הסובלים מהשמנה בדרגות שונות (קלה עד מורבידית) וכן נעשים גם מדי שנה בישראל אלפי ניתוחים בריאטרים (ניתוחים כירורגים שונים הנעשים לאנשים כבדי משקל). בחלק מהניתוחים מדובר על הצלת חייו של המטופל מכיוון שהשמנה הנה מחלה שכיחה שקשורה לירידה בתפקודי גוף שונים, הרעה משמעותית בתפקוד היומיומי, החברתי ובעצם – בכל מישורי החיים.

השמנה: מחלה שכיחה שקשורה לירידה בתפקודי גוף שונים. צילום: CC BY TOBYOTTER
חשוב לדעת, שגם לאחר הניתוחים השונים, ללא אימוץ אורח חיים בריא, האדם עלול לחזור למשקלו הקודם למרות הניתוח שעבר. אותה עלייה במשקל תהיה מאופיינת באסתטיקה גרועה במיוחד ובתסכול רב מצד האדם. לפיכך, החינוך לאורח חיים בריא הנו משמעותי וחשוב מעין כמוהו לכלל האוכלוסייה ולאלה הבוחרים במסלול של דיאטה לירידה במשקל – בפרט וחיוני ממש עבור אלה שעברו ניתוח בריאטרי. נציין שלעיתים הפיתוי לעבור ניתוחים בריאטריים גדול במיוחד בשל התוצאות המהירות והשינוי הדרסטי במשקל הגוף, אך כאמור, הניתוח עצמו לא מספק במקרה זה.
מדוע יורדים במשקל אך נשארים עם אחוזי שומן גבוהים?
נקודה חשובה במיוחד הנה ההתייחסות המשמעותית למשקל הגוף ופחות להרכבו. ידע חסר של האוכלוסייה, לעיתים, מביא למחשבה שמשקל הגוף הנו החשוב בעיקר, כאשר בפועל, להרכב הגוף (היחס בין מסת הגוף השמן לבין מסת הגוף הרזה: מסת שריר ועצם) חשיבות רבה יותר. אי לכך, ניתן להבחין באנשים לא מעטים שעברו תהליך של דיאטה (ממוצעת או אף קיצונית), הפחיתו בצורה מעוררת הערצה לעיתים במשקל הגוף אך אחוזי השומן בגופם רבים במיוחד!
הסיבות העיקריות לכך הן: ירידה מהירה מדי במשקל הגוף תוך איבוד תמידי של מסת הגוף הרזה, אימוץ דיאטה שאינה מומלצת מבחינה בריאותית ופוגעת ברקמות הגוף, אי ביצוע כלל של פעילות גופנית או ביצוע אימונים לא מתאימים- אפקטיביים ועוד. לכך השפעות שליליות מבחינה בריאותית (אחוזי שומן גבוהים מהממוצע קשורים להרעה במצב הבריאותי), לירידה בהופעה האסתטית ועוד. נוסיף ונאמר שעל מנת לטפל בבעיית עודף המשקל בצורה טובה אין מנוס מלבצע אימונים אירוביים ואימונים אנאירוביים על בסיס קבוע וכן דיאטה מושכלת שניתן לאמצה למשך שנים רבות!

יורדים במשקל אך מאבדים גם את מסת השריר. צילום:MAX DIGITAL
נקודה נוספת לציון הנה היכולת האנאירובית המשתנה בעת ביצוע תהליך של ירידה במשקל בכל דרך שהיא ובשנים האחרונות נערכו מחקרים רבים בנושא ההשפעה של ירידה במשקל וניתוחים בריאטריים על פרמטרים שונים ועל ההשפעה על היכולת האנאירובית – בפרט.
להלן שני מחקרים בנושא:
1. נערך במחלקה למדעי הפעילות הגופנית, אוניברסיטת קוויבק, קנדה (Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Québec, Canada.).
נמצא כי אנשים כבדי משקל שעברו ניתוח או עשו דיאטה חוו ירידה במסת השומן. יש חששות כי ירידה במסת השומן החופשי עלולה להביא לתפקודים לקויים. מטרת המחקר הנוכחי לחקור את ההשפעה של ירידה במשקל ושל בקרת הכוח אצל גברים הסובלים מהשמנת יתר או השמנה מורבידית. הגברים שהשתתפו במחקר התחלקו לשתי קבוצות – הסובלים מהשמנת יתר הורידו במשקל על ידי דיאטה והסובלים מהמשנה מורבידית עברו ניתוח קיצור קיבה. נבדקה יכולת הגברים להחזיק 15% ו-40% מהכוח המירבי שלהם בפלג הגוף העליון והתחתון. המדידות נלקחו בתחילת הניסוי, אצל קבוצת הדיאטה – לאחר הירידה במשקל ואצל קבוצת הניתוח – שנה לאחר הניתוח.
בנוסף, גברים במשקל תקין שימשו כקבוצת ביקורת ועברו מבדקים בתחילת הניסוי, לאחר חצי שנה ולאחר שנה. בתחילת הניסוי לא נמצאו הבדלים בין הקבוצות מבחינת היכולת לייצר כוח מירבי ולשמר רמות כוח מירבי. קבוצת הדיאטה ירדה בממוצע 11% ממשקלה וקבוצת הניתוח הורידה בממוצע 46% ממשקלה. קבוצת הדיאטה איבדה לאחר הדיאטה 10% מהכוח המירבי בגפיים התחתונות ולא נראה שינוי בכוח המירבי בגפיים העליונות. קבוצת הניתוח איבדה 33.5% מהכוח בגפיים התחתונות ונראתה ירידה של 14.4% בכוח המירבי של הגפיים העליונות. כשמשווים את השינויים ביחס לירידה במשקל נראה כי הדיאטה לא הביאה לשינוי בכוח המירבי המיוצר בפלג הגוף העליון והתחתון ואילו הניתוח הביא לעליה יחסית של הכוח המירבי המיוצר בפלג הגוף העליון והתחתון. לא נמצא הבדל משמעותי ביכולת לשמר את רמות הכוח המירבי בקרב קבוצות הניסוי. אם כן, למרות איבוד הכוח הרב, בעיקר בקרב קבוצת המנותחים, היחס בין הכוח ומשקל הגוף דווקא השתפר והיכולת לשמר את הכוח המירבי המיוצר השתמרה.
2. נערך על ידי המחלקה למדעי הבריאות, קולג' קרני, נברסקה (Department of Health and Physical Education, Kearney State College, Nebraska.) ובדק את השינויים בכוח הגופני אצל נשים הסובלות מהשמנה מורבידית שעשו דיאטה קיצונית.
109 נשים הסובלות מהשמנה חמורה השתתפו במחקר (בממוצע –46% שומן). 40 נשים עשו דיאטה נוקשה בת 520 קלוריות ליום ללא פעילות גופנית. 23 נשים עשו את אותה הדיאטה בשילוב תרגילי כוח. 23 נשים עשו דיאטה חמורה בשילוב אימוני סיבולת ו-23 נשים עשו דיאטה חמורה עם תרגילי התנגדות ואימוני סיבולת. האימונים התקיימו ארבע פעמים בשבוע והניסוי ארך שלושה חודשים. הממצאים הראו הבדלים משמעותיים בכוח המקסימלי שהנשים ייצרו בתחילת הניסוי ואחריו והבדלים משמעותיים בין הקבוצות. הנשים התבקשו לבצע שכיבות סמיכה אל ספסל, פשיטת ברך ומתח. נמצא כי קבוצת הדיאטה שעשתה גם אימוני התנגדות הראתה עליה בכוח המקסימלי למרות הירידה במסת הגוף הרזה. בקרב קבוצת הדיאטה ואימוני סיבולת לא הייתה השפעה על איבוד מסת הגוף הרזה. נראה כי העלייה בכוח נובעת מהאימונים שהשפיעו על מערכת העצבים המרכזית ולא על היפרתרופיה של השרירים, מאחר ומסת הגוף הרזה ירדה אצל כל הקבוצות.
בשורה התחתונה
תהליך ירידה במשקל מכול סוג, חשוב שיתבצע בליווי מקצועי ומושכל של איש מקצוע על מנת לא לפגוע בהרכב הגוף ובמשתנים נוספים שלהם השפעה רבה על התפקוד הגופני והנפשי במהלך החיים ויפה שעה אחת קודם.
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