 |
|
Very Low-Calorie Diets
National Task Force on the Prevention and Treatment of Obesity;
Richard L. Atkinson, MD;
William H. Dietz, MD;
John P. Foreyt, PhD;
Norma J. Goodwin, MD;
James O. Hill, PhD;
Jules Hirsch, MD;
F. Xavier Pi-Sunyer, MD;
Roland L. Weinsier, MD, DrPH;
Rena Wing, PhD;
Susan Zelitch Yanovski, MD;
Van S. Hubbard, MD, PhD;
Jay H. Hoofnagle, MD
JAMA. 1993;270(8):967-974.
Abstract
| |
Objective.
—To provide an overview of the published scientific information on the safety and efficacy of very low-calorie diets (VLCDs) and to provide rational recommendations for their use.
Data Sources and Extraction.
—Original reports obtained through a MEDLINE search for 1966 through 1992 on VLCDs or reducing diets plus obesity, supplemented by a manual search of bibliographies and the opinions of experts in the field of nutrition and weight loss therapy for obesity. Only studies of humans were cited.
Data Synthesis.
—Current VLCDs are usually provided in the context of comprehensive treatment programs, during which usual food intake is completely replaced by specific foods or liquid formulas containing 3350 kJ/d (800 kcal/d) or less. Weight loss on VLCDs averages 1.5 to 2.5 kg/wk; total loss after 12 to 16 weeks averages 20 kg. These results are superior to standard low-calorie diets of 5020 kJ/d (1200 kcal/d), which lead to weight losses of 0.4 to 0.5 kg/wk and an average total loss of only 6 to 8 kg. There is little evidence that intakes of less than 3350 kJ/d (800 kcal/d) result in better weight losses than 3350 kJ. Intake of at least 1 g/kg of ideal body weight per day of protein of high biologic value appears to be important in helping to preserve lean body mass. Serious complications of modern VLCDs are unusual, cholelithiasis being most common.
Conclusions.
—Current VLCDs are generally safe when used under proper medical supervision in moderately and severely obese patients (body mass index [weight in kilograms divided by height in meters squared] >30) and are usually effective in promoting significant short-term weight loss, with concomitant improvement in obesity-related conditions. Long-term maintenance of weight lost with VLCDs is not very satisfactory and is no better than with other forms of obesity treatment. Incorporation of behavioral therapy and physical activity in VLCD treatment programs seems to improve maintenance.
(JAMA. 1993;270:967-974)
Author Affiliations
Department of Veterans Affairs, Hampton, Va; New England Medical Center, Boston, Mass; Baylor College of Medicine, Houston, Tex; HEALTH WATCH Information and Promotion Service, New York, NY; Vanderbilt University, Nashville, Tenn; Rockefeller University, New York, NY; St Luke's-Roosevelt Hospital Center, Columbia University, New York, NY; University of Alabama, Birmingham; University of Pittsburgh [Pa] School of Medicine; National Institutes of Health, Staff Members.; Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bethesda, Md
From the National Task Force on the Prevention and Treatment of Obesity, National Institutes of Health, Bethesda, Md.
Footnotes
Reprint requests to Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bldg 31, Room 9A23, Bethesda, MD 20892 (Jay H. Hoofnagle, MD).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Anemia After Bariatric Surgery: More Than Just Iron Deficiency
von Drygalski and Andris
Nutr Clin Pract 2009;24:217-226.
ABSTRACT
| FULL TEXT
Nutrition Review: Dietary Considerations for Obesity Treatment
Melanson
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2007;1:433-436.
ABSTRACT
Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging.
Colles et al.
Am. J. Clin. Nutr. 2006;84:304-311.
ABSTRACT
| FULL TEXT
Diet in the management of weight loss
Strychar
CMAJ 2006;174:56-63.
ABSTRACT
| FULL TEXT
Weight Management Using Lifestyle Modification in the Prevention and Management of Type 2 Diabetes: Rationale and Strategies
The American Diabetes Association et al.
Clin. Diabetes 2005;23:130-136.
FULL TEXT
Systematic Review: An Evaluation of Major Commercial Weight Loss Programs in the United States
Tsai and Wadden
ANN INTERN MED 2005;142:56-66.
ABSTRACT
| FULL TEXT
Primary Care Perspective on Bariatric Surgery
Presutti et al.
Mayo Clin Proc. 2004;79:1158-1166.
ABSTRACT
Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition
Klein et al.
Am. J. Clin. Nutr. 2004;80:257-263.
ABSTRACT
| FULL TEXT
Weight Management Through Lifestyle Modification for the Prevention and Management of Type 2 Diabetes: Rationale and Strategies: A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition
Klein et al.
Diabetes Care 2004;27:2067-2073.
FULL TEXT
The Disappearance of Insurance Coverage for Weight Reduction Surgery
Marks
Clin. Diabetes 2004;22:105-106.
FULL TEXT
Obesity Hypertension in Children: A Problem of Epidemic Proportions
Sorof and Daniels
Hypertension 2002;40:441-447.
ABSTRACT
| FULL TEXT
Benefits of Lifestyle Modification in the Pharmacologic Treatment of Obesity: A Randomized Trial
Wadden et al.
Arch Intern Med 2001;161:218-227.
ABSTRACT
| FULL TEXT
Dieting and the Development of Eating Disorders in Overweight and Obese Adults
National Task Force on the Prevention and Treatmen
Arch Intern Med 2000;160:2581-2589.
ABSTRACT
| FULL TEXT
Obesity: What Mental Health Professionals Need to Know
Devlin et al.
Am. J. Psychiatry 2000;157:854-866.
ABSTRACT
| FULL TEXT
Instructions for Authors
Nutr Clin Pract 2000;15:2-2.
Invited Review: The Medical Management of Obesity and the Role of Pharmacotherapy: An Update
Apovian
Nutr Clin Pract 2000;15:5-12.
ABSTRACT
Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit • Commentary: results are unlikely to be as good in routine practice
Danielsson et al.
BMJ 1999;319:490-494.
ABSTRACT
| FULL TEXT
Treating the Obese Patient: Suggestions for Primary Care Practice
Anderson and Wadden
Arch Fam Med 1999;8:156-167.
ABSTRACT
| FULL TEXT
Weight Loss Management: A Path Lit Darkly
Hawks and Gast
Health Educ Behav 1998;25:371-382.
ABSTRACT
Very Low-Calorie Diets for Obesity
Kaplan and Stifler
JAMA 1994;271:24-24.
ABSTRACT
|
