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Very low-energy and low-energy formula diets: effects on weight loss, obesity co-morbidities and type 2 diabetes remission – an update on the evidence for their use in clinical practice
Abstract
The role of formula very low‐energy diets (VLEDs, <800 kcal/day) and low‐energy diets (LEDs, 800–1200 kcal/day) within clinical practice has regained attention over the last few years. Formula diets can achieve clinically significant weight reduction in the short‐term (3–5 months) and new evidence demonstrates that long‐term weight loss maintenance (up to 4 years) is achievable. Weight reductions of between 10% and 15% bodyweight have been reported, which is associated with clinically meaningful health outcomes in a number of obesity‐related co‐morbidities including type 2 diabetes (T2D), obstructive sleep apnoea and osteoarthritis. Recent evidence indicates that using a formula LED with a weight loss maintenance programme can help people with overweight or obesity and T2D achieve remission. Despite this, few healthcare professionals in the UK routinely use LEDs. Concerns about adherence, risk of precipitating eating disorders, safety, cost and long‐term efficacy may, in part, contribute to their under use. To help inform healthcare professionals on the use of formula diets within clinical practice, this review examines the current evidence for the use of VLEDs and LEDs for weight loss and weight loss maintenance, and in the treatment of obesity‐related co‐morbidities, including T2D, osteoarthritis, psoriasis, obstructive sleep apnoea and secondary coronary prevention, with a particular focus on T2D remission.
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The most common complaints of VLEDs are constipation, fatigue/muscle weakness, headache, and dizziness.
“The most common complaints are constipation, fatigue/muscle weakness, headache, and dizziness [30].”
From International Society of Sports Nutrition position stand: diets for body weight reduction (2026) · cites this paper as [30]
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Cites
Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes
Schauer, P. R., Bhatt, D. L., Kirwan, J. P., Wolski, K., Aminian, A., Brethauer, S. A., Navaneethan, S. D., Singh, R. P., Pothier, C. E., Nissen, S. E., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1600869 · Cited by 2,934
Lean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K. G., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)33102-1 · Cited by 2,095 · cited 11×
“During the TDR phase, individuals can typically lose between 10 and 16 kg or 10% and 15% of bodyweight (Johansson et al. 2014a; Leeds 2014; Lean et al. 2017), with initial weekly weight losses varying between 1 and 3 kg (Lean 2011; Leeds 2014; Brown”
BackgroundMethodInfluentialLong-term weight loss maintenance
Wing, R. R., & Phelan, S. (2005) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.1.222s · Cited by 1,941 · cited 1×
“These three habits were similar to those factors identified in the National Control Weight Registry, which included eating a low-energy diet and self-monitoring weight (Wing & Phelan 2005), suggesting that these may be key to weight loss maintenance.”
ResultGarvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914
Long-term persistence of hormonal adaptations to weight loss
Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1105816 · Cited by 1,449
Lim, E. L., Hollingsworth, K. G., Aribisala, B. S., Chen, M. J., Mathers, J. C., & Taylor, R. (2011) · Diabetologia · doi:10.1007/s00125-011-2204-7 · Cited by 1,164
Changes in fat-free mass during significant weight loss: a systematic review
Chaston, T. B., Dixon, J. B., & O'Brien, P. E. (2007) · International Journal of Obesity · doi:10.1038/sj.ijo.0803483 · Cited by 493
Steven, S., Hollingsworth, K. G., Al-Mrabeh, A., Avery, L., Aribisala, B., Caslake, M., & Taylor, R. (2016) · Diabetes Care · doi:10.2337/dc15-1942 · Cited by 418
Hallberg, S. J., McKenzie, A. L., Williams, P. T., Bhanpuri, N. H., Peters, A. L., Campbell, W. W., Hazbun, T. L., Volk, B. M., McCarter, J. P., Phinney, S. D., et al. (2018) · Diabetes Therapy · doi:10.1007/s13300-018-0373-9 · Cited by 406 · cited 2×
“Similar to the results of the Look AHEAD trial, remission rates reduced over time in both studies (Esposito et al. 2014; Hallberg et al. 2018).”
BackgroundResultMechanisms of diabetes improvement following bariatric/metabolic surgery
Batterham, R. L., & Cummings, D. E. (2016) · Diabetes Care · doi:10.2337/dc16-0145 · Cited by 376
Johansson, K., Neovius, M., & Hemmingsson, E. (2014) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.070052 · Cited by 243
Wing, R. R., Blair, E., Marcus, M., Epstein, L. H., & Harvey, J. (1994) · The American Journal of Medicine · doi:10.1016/0002-9343(94)90302-6 · Cited by 228
Esposito, K., Maiorino, M. I., Petrizzo, M., Bellastella, G., & Giugliano, D. (2014) · Diabetes Care · doi:10.2337/dc13-2899 · Cited by 205 · cited 5×
“When compared with standardised diabetes care in those with T2D, using an intensive multicomponent lifestyle intervention that included meal replacements, a lowfat diet and physical activity has been found to produce greater weight loss, improvements in glycaemia and T2D remission (Gregg et al. 2012; Esposito et al. 2…”
BackgroundMethodResultInfluentialThe effect of rate of weight loss on long-term weight management: a randomised controlled trial
Purcell, K., Sumithran, P., Prendergast, L. A., Bouniu, C. J., Delbridge, E., & Proietto, J. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70200-1 · Cited by 201
Larsen, R. N., Mann, N. J., Maclean, E., & Shaw, J. E. (2011) · Diabetologia · doi:10.1007/s00125-010-2027-y · Cited by 197
Christensen, P., Meinert Larsen, T., Westerterp‐Plantenga, M., Macdonald, I., Martinez, J. A., Handjiev, S., Poppitt, S., Hansen, S., Ritz, C., Astrup, A., et al. (2018) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.13466 · Cited by 188
Astbury, N. M., Aveyard, P., Nickless, A., Hood, K., Corfield, K., Lowe, R., & Jebb, S. A. (2018) · BMJ · doi:10.1136/bmj.k3760 · Cited by 155
Kajaste, S., Brander, P. E., Telakivi, T., Partinen, M., & Mustajoki, P. (2004) · Sleep Medicine · doi:10.1016/j.sleep.2003.07.007 · Cited by 151
The Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial
Leslie, W. S., Ford, I., Sattar, N., Hollingsworth, K. G., Adamson, A., Sniehotta, F. F., McCombie, L., Brosnahan, N., Ross, H., Mathers, J. C., et al. (2016) · BMC Family Practice · doi:10.1186/s12875-016-0406-2 · Cited by 132
The effect of rate of weight loss on long‐term weight regain in adults with overweight and obesity
Vink, R. G., Roumans, N. J. T., Arkenbosch, L. A. J., Mariman, E. C. M., & van Baak, M. A. (2016) · Obesity · doi:10.1002/oby.21346 · Cited by 128
Borg, P., Kukkonen-Harjula, K., Fogelholm, M., & Pasanen, M. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0801962 · Cited by 128
Iepsen, E. W., Lundgren, J., Dirksen, C., Jensen, J.-E., Pedersen, O., Hansen, T., Madsbad, S., Holst, J. J., & Torekov, S. S. (2015) · International Journal of Obesity · doi:10.1038/ijo.2014.177 · Cited by 118
Parretti, H. M., Jebb, S. A., Johns, D. J., Lewis, A. L., Christian‐Brown, A. M., & Aveyard, P. (2016) · Obesity Reviews · doi:10.1111/obr.12366 · Cited by 118
Terranova, C. O., Brakenridge, C. L., Lawler, S. P., Eakin, E. G., & Reeves, M. M. (2015) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.12430 · Cited by 94 · cited 1×
“Nutrition Bulletin published by John Wiley & Sons Ltd on behalf of British Nutrition Foundation Nutrition Bulletin, 44, 7–24 (Franz et al. 2015; Terranova et al. 2015).”
BackgroundJohansson, K., Sundström, J., Marcus, C., Hemmingsson, E., & Neovius, M. (2014) · International Journal of Obesity · doi:10.1038/ijo.2013.83 · Cited by 89
Lean, M., Brosnahan, N., McLoone, P., McCombie, L., Higgs, A. B., Ross, H., Mackenzie, M., Grieve, E., Finer, N., Reckless, J., et al. (2013) · British Journal of General Practice · doi:10.3399/bjgp13x663073 · Cited by 87
Snel, M., Jonker, J. T., Hammer, S., Kerpershoek, G., Lamb, H. J., Meinders, A. E., Pijl, H., de Roos, A., Romijn, J. A., Smit, J. W. A., et al. (2012) · Obesity · doi:10.1038/oby.2011.390 · Cited by 80 · cited 2×
“…and have shown significant improvements in weight loss, low-grade inflammatory markers, body composition, surrogate markers of CVD including blood pressure, plasma lipids, quality of life and glycaemic control (Christiansen et al. 2000; Jazet et al. 2005, 2007, 2008; Snel et al. 2011, 2012a,b,c).”
BackgroundSnel, M., Gastaldelli, A., Ouwens, D. M., Hesselink, M. K. C., Schaart, G., Buzzigoli, E., Frölich, M., Romijn, J. A., Pijl, H., Meinders, A. E., et al. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-3178 · Cited by 74
McCombie, L., Brosnahan, N., Ross, H., Bell‐Higgs, A., Govan, L., & Lean, M. E. J. (2019) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12611 · Cited by 40
Flagged first, then by citations
Research works printed but not linked: 105
- 10.1016/j.joca.2011.03.006 · DOI
- 10.1056/NEJMoa1614362 · DOI · Paper page
- 10.2337/db09-1239 · DOI
- 10.1038/ijo.2014.52 · DOI · Paper page
- 10.1046/j.1467-789x.2000.00004.x · DOI
- 10.1002/acr.22805 · DOI
- 10.1016/j.joca.2014.04.018 · DOI
- 10.1038/ijo.2011.107 · DOI
- 10.1136/ard.2010.142018 · DOI
- 10.12968/jokc.2018.3.1.14 · DOI
- Brown A, 2015, Is there a place for low‐energy formula diets in weight management, British Journal of Obesity, 3, 84
- 10.1111/dom.13009 · DOI · Paper page
- 10.1111/cob.12204 · DOI
- 10.1186/1550-2783-7-24 · DOI
- 10.1111/j.1758-8111.2011.00006.x · DOI
- 10.1002/oby.20413 · DOI
- Christensen PBH, 2014, Long‐term intervention with weight loss in patients with concomitant obesity and knee osteoarthritis: the LIGHT study – a randomised clinical trial. T5: S25.54, Obesity Reviews, 15, 152
- 10.1159/000481138 · DOI · Paper page
- Christensen P, 2017, Long‐term weight‐loss maintenance in obese patients with knee osteoarthritis: a randomized trial, American Journal of Clinical Nutrition, 106, 755, 10.3945/ajcn.117.158543 · DOI
- 10.2337/diabetes.49.10.1691 · DOI
- 10.1002/14651858.CD003641.pub4 · DOI · Paper page
- 10.1016/j.clnu.2017.04.008 · DOI
- 10.1136/annrheumdis-2013-204763 · DOI
- 10.1186/1475-2891-11-34 · DOI · Paper page
- Diabetes UK(2018)Diabetes UK interim position statement on remission in adults with Type 2 diabetes. pp.1–6.
- 10.1001/jama.299.3.316 · DOI · Paper page
- 10.1007/s11695-017-2749-8 · DOI
- 10.1111/dme.13603 · DOI · Paper page
- 10.2903/j.efsa.2015.3957 · DOI
- 10.1001/archinte.160.14.2177 · DOI
- 10.1016/j.jand.2015.02.031 · DOI · Paper page
- 10.3945/ajcn.2010.29468 · DOI · Paper page
- 10.15252/msb.20167357 · DOI
- 10.1111/obr.12230 · DOI · Paper page
- 10.1001/jama.2012.67929 · DOI · Paper page
- 10.1017/S0007114509991474 · DOI
- 10.1016/S0140-6736(11)60812-X · DOI · Paper page
- 10.1016/j.jacc.2008.04.068 · DOI
- 10.1111/obr.12715 · DOI
- Haslam DW, 2010, Medical Management During Effective Weight‐Loss
- 10.1002/art.33394 · DOI
- 10.2337/diab.35.2.155 · DOI
- 10.1530/EJE-15-1116 · DOI · Paper page
- 10.2337/db12-1762 · DOI
- 10.1016/j.metabol.2005.06.017 · DOI
- 10.1016/j.diabres.2006.10.019 · DOI
- 10.1007/s00125-007-0862-2 · DOI
- 10.1159/000455840 · DOI
- Jensen P, 2013, Effect of weight loss on the severity of psoriasis: a randomized clinical study, Journal of the American Medical Association: Dermatology, 149, 795
- 10.2340/00015555-1824 · DOI
- 10.3945/ajcn.115.125849 · DOI
- 10.1136/bmj.b4609 · DOI · Paper page
- 10.1136/bmj.d3017 · DOI · Paper page
- 10.1001/jama.2014.10397 · DOI · Paper page
- 10.1038/s41367-018-0006-9 · DOI
- 10.1111/j.1758-8111.2010.00007.x · DOI
- 10.1073/pnas.91.23.10878 · DOI
- 10.1038/ijo.2009.245 · DOI
- 10.1111/nbu.12098 · DOI
- 10.1210/jc.2009-0584 · DOI
- 10.1111/cen.12254 · DOI
- 10.2147/IJWH.S100385 · DOI
- 10.1002/oby.20967 · DOI
- 10.1038/nrgastro.2013.119 · DOI
- 10.1017/S0007114512001924 · DOI
- Nerfeldt P, 2010, A two‐year weight reduction program in obese sleep apnea patients, Journal of Clinical Sleep Medicine, 6, 479, 10.5664/jcsm.27939 · DOI
- NICE (National Institute for Health and Care Excellence), 2014, Osteoarthritis: Care and Management in Adults. Clinical Guideline.
- NICE (National Institute for Health and Care Excellence), 2014, Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults: Partial Update of CG43
- Nield L, 2007, Dietary advice for treatment of type 2 diabetes mellitus in adults, Cochrane Database of Systematic Reviews, CD004097
- 10.1017/jns.2016.13 · DOI
- NIH (National Institutes of Health), 1993, Very low‐calorie diets. National Task Force on the Prevention and Treatment of Obesity, National Institutes of Health, Journal of the American Medical Association, 270, 967
- 10.1016/S2468-2667(18)30139-7 · DOI
- 10.1016/j.ijcard.2015.03.118 · DOI
- 10.1177/1403494810391524 · DOI
- 10.1177/2047487314545280 · DOI
- 10.1016/j.atherosclerosis.2016.01.001 · DOI
- Primary Care Sciences Oxford(2018)Total Diet Replacement Programes (“Crash Diets”) Resources for Health Professionals.
- 10.1111/dme.13426 · DOI · Paper page
- 10.1016/j.ejrad.2016.03.017 · DOI
- 10.2147/DMSO.S51151 · DOI
- 10.1111/ijcp.12300 · DOI
- 10.1007/s11695-016-2457-9 · DOI
- 10.1002/osp4.92 · DOI
- 10.1038/oby.2001.134 · DOI · Paper page
- SIGN (Scottish Intercollegiate Guidelines Network), 2010, Scottish Intercollegiate Guidelines Network 115 Management of Obesity: A National Clinical Guideline
- 10.1016/j.fct.2011.09.032 · DOI
- 10.1016/j.ejim.2011.07.004 · DOI · Paper page
- 10.1111/dme.12722 · DOI
- 10.1111/dme.13257 · DOI · Paper page
- 10.1038/ejcn.2013.90 · DOI
- 10.1007/s00125-008-1116-7 · DOI · Paper page
- 10.1016/j.cmet.2018.07.003 · DOI · Paper page
- 10.1038/oby.2006.146 · DOI · Paper page
- 10.1164/rccm.200805-669OC · DOI
- 10.2337/dc07-0326 · DOI
- 10.2337/diab.44.8.863 · DOI · Paper page
- Wadden TA, 1986, Controlled trial of very low calorie diet, behavior therapy, and their combination in the treatment of obesity, Journal of Consulting and Clinical Psychology, 54, 482, 10.1037/0022-006X.54.4.482 · DOI
- 10.1038/oby.2011.230 · DOI · Paper page
- Webster JD, 1984, The composition of excess weight in obese women estimated by body density, total body water and total body potassium, Human Nutrition. Clinical Nutrition, 38, 299
- 10.1136/bmj.i1472 · DOI
- 10.1001/archinte.1991.00400070100012 · DOI · Paper page
- World Health Organization, 2018, Noncommunicable Diseases
- World Health Organization, 2018, Overweight and Obesity World Health Organization
- Xin Y, 2018, Within‐trial cost and 1‐year cost‐effectiveness of the DiRECT/Counterweight‐Plus weight‐management programme to achieve remission of type 2 diabetes, The Lancet Diabetes & Endocrinology
- 10.1007/s11695-014-1460-2 · DOI
Cited by
Sorted by citations
Participant experiences in the Diabetes REmission Clinical Trial (DiRECT)
Rehackova, L., Rodrigues, A. M., Thom, G., Brosnahan, N., Barnes, A. C., McCombie, L., Leslie, W. S., Zhyzhneuskaya, S., Peters, C., Adamson, A. J., et al. (2022) · Diabetic Medicine · doi:10.1111/dme.14689 · Cited by 46
Edwards‐Hampton, S. A., & Ard, J. (2024) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.15819 · Cited by 17
Maston, G., Franklin, J., Hocking, S., Swinbourne, J., Gibson, A., Manson, E., Sainsbury, A., & Markovic, T. (2021) · PLOS ONE · doi:10.1371/journal.pone.0253127 · Cited by 14
Brown, A., Mellor, D., Makaronidis, J., Shuttlewood, E., Miras, A. D., & Pournaras, D. J. (2024) · Nutrition Bulletin · doi:10.1111/nbu.12700 · Cited by 9
Self-citationInternational Society of Sports Nutrition position stand: diets for body weight reduction
Aragon, A. A., Campbell, B. I., Schoenfeld, B. J., Stout, J. R., Kalman, D., Arciero, P. J., Arent, S. M., Kreider, R. B., Taylor, L. W., Bannock, L., et al. (2026) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2026.2740266
Metadata
- Authors
- Brown, A., & Leeds, A. R.
- Affiliations
- Centre for Obesity Research University College London London UK
- Department of Nutrition, Exercise and Sports Faculty of Science University of Copenhagen Copenhagen Denmark
- Venue
- Nutrition Bulletin
- Publisher
- Wiley
- Published
- 2019-02-20
- Volume
- 44
- Issue
- 1
- Pages
- 7-24
- ISSN
- 1471-9827
- 1467-3010
- Cited by
- 43
- References
- 29
- Language
- en
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