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Cited by 371Diet and metabolism studiesPharmacology and Obesity TreatmentBariatric Surgery and Outcomes

The Evolution of Very‐Low‐Calorie Diets: An Update and Meta‐analysis

Tsai, Adam Gilden, Wadden, Thomas A.·2006·Obesity
DOI 10.1038/oby.2006.146
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Abstract

Objective: Very‐low‐calorie diets (VLCDs), providing <800 kcal/d, have been used since the 1970s to induce rapid weight loss. Previous reviews of the literature have disagreed concerning the relative efficacy of VLCDs vs. conventional low‐calorie diets (LCDs) for achieving long‐term weight loss. Research Methods and Procedures: We sought to update findings on the clinical use, safety, and efficacy of VLCDs and to perform a meta‐analysis of randomized trials that compared the long‐term efficacy of LCDs and VLCDs. Original research articles were retrieved by a Medline search and from prior reviews of VLCDs. Trials were included only if they were randomized comparisons of LCDs and VLCDs and included a follow‐up assessment at least 1 year after maximum weight loss. Data were abstracted by both authors regarding: duration of VLCD, total length of treatment, attrition, short‐ and long‐term weight loss, changes in weight‐related comorbidities, and adverse effects. Results: Six randomized trials were found that met inclusion criteria. VLCDs, compared with LCDs, induced significantly greater short‐term weight losses (16.1 ± 1.6% vs. 9.7 ± 2.4% of initial weight, respectively; p = 0.0001) but similar long‐term losses (6.3 ± 3.2% vs. 5.0 ± 4.0%, respectively; p > 0.2). Attrition was similar with VLCD and LCD regimens. Discussion: VLCDs did not produce greater long‐term weight losses than LCDs. In the United States, the use of liquid meal replacements as part of a 1000 to 1500 kcal/d diet may provide an effective and less expensive alternative to VLCDs. In Europe, VLCDs are used with less intensive medical supervision than in the United States, which reduces the cost of this approach.

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  • The experience of weight stigma increases the risk of psychological distress (e.g., depression and anxiety), disordered eating patterns, avoidance of physical activity, and physiological stress (evidenced by elevated levels of cortisol and inflammatory markers), all of which can hinder weight-management efforts.

    “The experience of weight stigma increases the risk of psychological distress (e.g., depression and anxiety), disordered eating patterns, avoidance of physical activity, and physiological stress (evidenced by elevated levels of cortisol and inflammatory markers), all of which can hinder weight-management efforts [99].”

    From Nutritional considerations with antiobesity medications (2024) · cites this paper as [99]

  • Combining lifestyle modification with high-protein, very-low-calorie diets (≤800 kcal/day) increases short-term weight loss to 12-20% but with more costs, side effects, and weight regain than less restrictive diets.

    “Combining lifestyle modification with high-protein, very-low-calorie diets (≤ 800 kcal/day) increases short-term weight loss to 12–20% but with more costs, side effects, and weight regain than less restrictive diets [29].”

    From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [29]

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Authors
Tsai, A. G., & Wadden, T. A.
Affiliations
University of Pennsylvania (US)
Corresponding author
Wadden, Thomas A.
ORCID
Venue
Obesity
Publisher
Wiley
Published
2006-08
Volume
14
Issue
8
Pages
1283-1293
ISSN
  • 1930-7381 (ISSN-L)
  • 1930-739X
DOI
10.1038/oby.2006.146
OpenAlex
W2083140947
Cited by
371
References
95
Citations by year
2026: 5 · 2025: 15 · 2024: 13 · 2023: 18 · 2022: 26 · 2021: 24 · 2020: 19 · 2019: 17 · 2018: 24 · 2017: 30 · 2016: 18 · 2015: 22 · 2014: 14 · 2013: 31 · 2012: 22
FWCI
1.24
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2228 d)
Locations
  • Obesity (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • European Commission
  • National Institutes of Health (5k24dk065018-10)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K24-DK-065018)
Topics
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
very low calorie diet, hypocaloric diet, weight loss, long-term weight maintenance, diet safety, attrition, weight-related comorbidities, obesity treatment
MeSH terms
Diet, Reducing, Humans, Obesity, Time Factors, Weight Loss, Randomized Controlled Trials as Topic, Caloric Restriction

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