Milly Gaines
Very-low-calorie diets (VLCDs) are diets of 800 kilocalories (3,300 kJ) or less energy intake per day. They are typically used for short-term weight loss and can be effective when used under careful medical supervision alongside behaviour changes, nutrition education, and an exercise programme. However, VLCDs are not recommended for the general public due to safety concerns and the potential for serious side effects, including starvation and sudden death. This article will explore the safety concerns, effectiveness, and potential risks associated with VLCDs.
| Characteristics | Values |
|---|---|
| Calorie Intake | 800 kilocalories (3,300 kJ) or less per day |
| Effectiveness | Rapid weight loss at the start but no better in the long term |
| Safety | Not recommended for the general public due to safety concerns; should only be used under medical supervision |
| Risks | Starvation, electrolyte imbalance, sudden death, serious illness, and weight regain |
| Recommended Duration | Maximum of 12–16 weeks |
| Nutritional Concerns | Ensuring adequate intake of essential vitamins and nutrients |
| Side Effects | Hunger, fatigue, low energy, anxiety, nervousness, mood changes, insomnia, headache, dizziness, tremors, dry mouth, constipation, itchiness, changes in sex drive |
| Medical Conditions | May be considered for individuals with obesity or weight-related medical conditions |
| Combination with Other Therapies | More effective when combined with other obesity therapies and lifestyle changes |
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What You'll Learn
VLCDs should be medically supervised
Very-low-calorie diets (VLCDs) are diets of 800 kilocalories (3,300 kJ) or less energy intake per day. They are not routinely recommended due to safety concerns. However, VLCDs can be used under medical supervision for rapid weight loss in obese individuals. Here are some reasons why VLCDs should be medically supervised:
Medical Supervision is Necessary for Safety:
VLCDs can pose safety risks, especially if not properly composed or supervised. In 1978, 58 people in the United States died after following VLCD liquid protein diets. This led the FDA to mandate that protein VLCDs providing fewer than 400 calories per day must carry a warning about potential serious illness and the need for medical supervision. While newer regulations have relaxed this warning, the risk remains. Unmonitored VLCDs can cause an electrolyte imbalance and even sudden death.
Medical Assessment and Monitoring:
Before starting a VLCD, individuals must be medically assessed to ensure the diet is suitable for them. During the diet, close medical monitoring is essential to prevent complications and address any side effects. A physician can help identify and mitigate risks, such as nutritional deficiencies, and may adjust medication regimens as needed.
Therapeutic Applications:
Medically supervised VLCDs have specific therapeutic uses, such as treating morbid obesity or preparing for surgery. They can be effective in these cases, but only under careful supervision and as part of a comprehensive weight management strategy. VLCDs should not be the first treatment option; lifestyle changes, such as diet and activity modifications, should be attempted first.
Short-Term Solution:
VLCDs are intended for short-term use only, typically a maximum of 12 weeks, and should be followed by a re-feeding period to reintroduce food gradually. This prevents issues like electrolyte imbalances and helps adjust eating behaviours. VLCDs are not a long-term weight management solution, and most people tend to regain weight after stopping the diet.
In conclusion, while VLCDs can be effective for rapid weight loss in specific circumstances, they should only be undertaken with medical supervision to ensure safety and address individual needs.
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VLCDs are not recommended for the general public
Very-low-calorie diets (VLCDs) are not recommended for the general public due to safety concerns. They are typically defined as diets of 800 kilocalories (3,300 kJ) or less energy intake per day, which is significantly lower than the recommended energy intake for adults of 2,000 calories for women and 2,500 calories for men. This restricted calorie intake can lead to a range of side effects, including hunger, fatigue, exhaustion, and low energy.
VLCDs are not a long-term weight management solution and should only be used under careful medical supervision for a maximum of 12-16 weeks. They are intended for individuals who are significantly overweight or obese and have struggled to lose weight despite making healthy diet and lifestyle changes. In some cases, they may be recommended for those with a Body Mass Index (BMI) greater than 30 kg/m2 or, in certain circumstances, for those with a BMI between 27-30 kg/m2 who have medical conditions linked to their weight that would benefit from rapid weight loss.
The potential risks associated with VLCDs include nutritional deficiencies, heart problems, and electrolyte imbalances. In the past, unmonitored VLCDs with insufficient macronutrient and mineral intake have even led to sudden deaths. Therefore, it is crucial that anyone considering a VLCD consults a medical professional to assess its suitability for their individual needs and to ensure proper supervision and monitoring throughout the diet.
VLCDs should always be followed in conjunction with other weight loss strategies, such as behavioural therapy, nutritional education, and an exercise programme. They should not be relied upon as a standalone solution but rather as part of a comprehensive weight management plan supervised by a healthcare professional. Additionally, a re-feeding period is recommended after completing a VLCD to slowly reintroduce foods and prevent adverse effects on the body's fluid and electrolyte balance.
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VLCDs can be effective for rapid weight loss
Very-low-calorie diets (VLCDs) are defined as diets of 800 kilocalories (3,300 kJ) or less energy intake per day. They are artificial formulas, usually in liquid form, that completely replace all the food you would usually eat. VLCDs can be effective for rapid weight loss, but they are not suitable for everyone and should only be used under careful medical supervision.
VLCDs have been shown to be more effective than behavioural weight loss programs or other diets, achieving approximately 4 kilograms (8.8 lb) more weight loss at 1 year and greater sustained weight loss after several years. When used in routine care, VLCDs can achieve an average weight loss of around 10 kilograms (22 lb) or about 4% more weight loss over the short term. This is because the body starts to break down its own fat stores and muscle tissue to produce energy, resulting in weight loss. On a VLCD, about three-quarters of the weight you lose is body fat, and one-quarter is muscle, once a minimum of 50g of protein is consumed each day.
VLCDs are particularly effective for people who are significantly overweight or obese and have struggled to lose weight despite eating healthily and making lifestyle changes such as reducing portion sizes, eating fewer high-calorie foods, and increasing activity levels. They may also be considered for people who have medical conditions linked to their weight that would benefit from rapid weight loss, such as severe obstructive sleep apnoea or before planned surgery.
However, VLCDs are not a long-term weight management strategy and should only be used as part of a wider weight management plan. Most people tend to gradually regain the weight they lost after coming off the diet. VLCDs are recommended for a maximum of 12-16 weeks only, as extreme calorie reduction can lead to nutritional deficiencies and even heart problems if followed for too long. It is important to follow up a VLCD with a long-term healthy eating and physical activity plan to maintain weight loss.
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VLCDs are not a long-term weight management strategy
VLCDs are recommended for a maximum of 12-16 weeks only, and there is very little published research on their use as a sole source of nutrition for longer than this. The National Institute for Clinical Excellence (NICE) 2014 guidelines also recommend that VLCDs may be used in the short term alongside a low-calorie diet in obese people who have reached a weight loss plateau.
VLCDs are not the first treatment plan for weight loss. Diet and lifestyle changes such as reducing portion sizes, eating fewer high-calorie foods, and increasing activity levels should always be tried first. If other weight loss methods have been unsuccessful, VLCDs may be considered when the body mass index (BMI) is greater than 30 kg/m^2^. If your BMI is between 27-30 kg/m^2^ (i.e., you are overweight but not obese), VLCDs may be considered if you have medical conditions linked to your weight that would benefit from rapid weight loss under medical supervision.
VLCDs should only be used under careful medical supervision, so you must be medically assessed before starting a VLCD. You will need to be monitored closely and may require medication prescriptions to be changed. An active follow-up weight maintenance program that includes behavioural therapy, nutritional education, exercise, and weight loss medications has been shown to improve weight maintenance after a VLCD.
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VLCDs can cause serious illness and even death
Unmonitored VLCDs with insufficient macronutrient and mineral intake can cause an electrolyte imbalance and sudden death via ventricular tachycardia, either by starvation or upon refeeding. The risk of starvation is considerable with an inadequately composed or supervised VLCD, so people attempting these diets must be closely monitored by a physician to prevent complications.
VLCDs are not recommended for the general public due to low evidence of their safety and effectiveness. They are also not suitable for children, pregnant women, or breastfeeding mothers. The routine use of VLCDs is not recommended, and they should only be used under medical supervision for rapid weight loss in obese individuals as part of a multi-component weight management strategy.
VLCDs are associated with several side effects, including hunger, fatigue, exhaustion, and low energy. They can also affect the brain, causing anxiety, nervousness, changes in mood or behaviour, insomnia, headaches, dizziness, and tremors. In addition, they can lead to nutritional deficiencies and heart problems if followed for an extended period.
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Frequently asked questions
VLCD stands for Very-Low-Calorie Diet. It involves consuming 800 calories or fewer per day, usually in the form of artificial formulas or liquids that replace all conventional meals.
VLCDs are not recommended for the general public due to safety concerns and limited published research. They are not a long-term solution and should only be used under careful medical supervision for a maximum of 12-16 weeks. VLCDs are not suitable for children, pregnant or breastfeeding women, and can cause serious side effects such as hunger, exhaustion, and in extreme cases, even death.
VLCDs are typically recommended for individuals who are significantly overweight or obese, with a BMI of 30 or higher. They may also be considered for those with a BMI between 27-30 who have weight-related medical conditions such as severe obstructive sleep apnea. Before starting a VLCD, it is crucial to consult a healthcare professional to assess its suitability and ensure proper monitoring.
VLCDs can achieve rapid weight loss, especially in the short term. They are more effective than behavioural weight loss programs and can be used as part of a multi-component weight management strategy. However, VLCDs carry risks such as nutritional deficiencies, potential for weight regain, and adverse side effects on physical and mental health. Unmonitored VLCDs can lead to starvation and serious health complications, including sudden death. Combining VLCDs with other obesity therapies and following up with a long-term healthy eating and exercise plan can improve weight maintenance.
