Position of the American Dietetic Association: very-low-calorie weight loss diets.
It has been well documented that a VLCD can produce large and rapid weight loss. A number of studies using appropriate levels of high biologic value protein, vitamin and mineral supplementation, and careful monitoring have shown that the VLCD can be safe. Careful monitoring by a physician experienced in such programs and by a registered dietitian is essential. The maintenance of weight loss must be of key importance throughout the program, necessitating the skills of a multidisciplinary team with medical, nutritional, and behavioral training. It must be recognized that the VLCD is only one part of a total weight management program. The complete program is needed for long-term success. Insurance reimbursement for the services of all members of the health care team, including dietitians, facilitates and supports the multidisciplinary team approach. Potential candidates for this program and health professionals must realize that VLCDs are not for everyone and can be harmful for persons who do not meet the following selection criteria: (a) at least 30% overweight, with a minimum body mass index of 32. (b) free from contraindicated medical conditions: pregnancy or lactation, active cancer, hepatic disease, renal failure, active cardiac dysfunction, or severe psychological disturbances. (c) committed to establishing new eating and life-style behaviors that will assist the maintenance of weight loss. (d) committed to taking the time to complete both the treatment and the maintenance components of a program. Dieters must receive careful medical and nutritional monitoring throughout the program and should continue with nutrition, exercise, and behavioral counseling after cessation of the VLCD until sound eating and life-style habits can be established. The length of time an individual is on the VLCD must be carefully monitored and the VLCD discontinued immediately if medical tests and/or weight loss indicate increased health risks to the client. Finally, potential clients must be adequately warned that there are limitations and risks involved with the VLCD. A VLCD is no magic cure. It requires considerable effort and commitment on the part of both practitioners and participants to ensure the program's success.
D000328:Adult; D004038:Diet, Reducing / Q000009:adverse effects*; D004046:Dietetics; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009751:Nutritional Requirements