Very Low-Calorie Diets


	What is a Very Low-Calorie Diet (VLCD)? Who Should Use a VLCD? Health Benefits Associated with a VLCD Adverse Effects Associated with a VLCD Conclusion Obesity affects up to one-fourth of adult Americans, increasing risk of death from diseases like diabetes, high blood pressure, and heart disease. Traditional weight loss methods include low-calorie diets between 800 to 1,500 calories a day and regular exercise. An alternative method sometimes considered for bringing about significant short-term weight loss in moderately to severely obese people is the very low-calorie diet (VLCD).
What is a Very Low-Calorie Diet (VLCD)?	VLCDs are commercially prepared formulas of 800 calories or less that replace all usual food intake. VLCDs are not the same as over-the-counter meal replacements, which are meant to be substituted for one or two meals a day. VLCDs, when used under proper medical supervision, effectively produce significant short-term weight loss in moderately to severely obese patients.
Who Should Use a VLCD?	VLCDs are generally safe when used under proper medical supervision in patients with a body mass index (BMI) greater than 30. BMI is a mathematical formula that takes into account both a person's height and weight. To calculate BMI, a person's weight in kilograms is divided by height in meters squared. Use of VLCDs in patients with a BMI of 27 to 30 should be reserved for those who have medical complications resulting from their obesity. VLCDs are not recommended for pregnant women or breastfeeding women. VLCDs are not appropriate for children or adolescents, except in specialized treatment programs. Very little information exists regarding the usage of VLCDs in older individuals. Because individuals over 50 already experience normal depletion of lean body mass, use of a VLCD may not be warranted. Additionally, persons over 50 may not tolerate the side effects associated with VLCDs because of preexisting medical conditions or need for other medications. Therefore, a physician, on a case by case basis, must evaluate increased risks and potential benefits of drastic weight loss in older individuals. Additionally, people with significant medical problems or who are on medications may be able to use a VLCD, but this too must be determined on an individual basis by a physician.
Health Benefits Associated With a VLCD	Endnote: This e-text is a modified version of a previously published review article on very low-calorie diets, appearing in the August 25, 1993, issue of the Journal of the American Medical Association. Both the review article and this e-text were developed with the advice of the National Task Force on the Prevention and Treatment of Obesity, a subcommittee of the National Digestive Diseases Advisory Board.
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	NIH Publication No. 95-3894 March 1995 e-text last updated: 9 February 1998