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Thomas A. Wadden, PhD
University of Pennsylvania School of Medicine Philadelphia

Theodore B. Van Itallie, MD
Columbia University College of Physicians and Surgeons New York, NY

George L. Blackburn, MD, PhD
Harvard Medical School Boston, Mass

JAMA. 1990;263(21):2886-2887.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply. —

The purpose of our commentary was to alert physicians that verylow-calorie diets (VLCDs) are not a panacea for obesity, contrary to the tenor of advertisements recently placed in this and other journals. We advised practitioners that they have an obligation not only to ensure the safe use of these diets, but also to help patients obtain access to skills needed to facilitate long-term weight control.

We share Drs Flynn and Thompson's concerns about the long-term outcome of treatment by VLCD and behavior modification, but have a different view of this problem. A growing literature shows that a 10% reduction in pretreatment weight will greatly help 9 of 10 patients, specifically improving heart function, blood pressure, glucose tolerance, sleep disorders, respiratory function, and lipid profile.^1-3 Patients treated by VLCD and behavior modification typically lose 20% of their baseline weight. Thus, patients frequently enjoy improvements in health for . . . [Full Text PDF of this Article]

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