The Risks of Very Low Calorie Diets

By Ali Luke

Some diets promise extraordinarily fast weight loss – achieved by cutting calorie intake to (dangerously) low levels.

If you’re ever tempted to follow a Very Low Calorie diet, make sure you know the facts first.

What is a Very Low Calorie diet?

A Very Low Calorie (VLC) diet is one designed to promote rapid weight-loss at the start of a long-term dieting program. People on the diet consume below 800 calories per day.

Some well-known plans which are cut calories to VLC diet levels are:

When can you go on a VLC diet?

If a patient has a BMI of over 30 (putting them into the “obese” rather than just “overweight” category), their doctor may put them on a VLC diet. However, this is only done when the risks of remaining obese outweigh the health risks posed by the diet.

The article What is a Very Low Calorie Diet? explains:

[VLC diets] are intended for patients whose Body Mass Index (BMI) is greater than 30 with significant comorbidities (illnesses or diseases related to morbid obesity, such as diabetes or high blood pressure). VLC diets are not normally used for patients with a BMI between 27 and 30 unless they have medical conditions related to their weight.

You should never attempt to follow a VLC diet without medical supervision, as mentioned in Very Low Calorie Diets: Good or Bad?

What if you’re dieting for a special occasion?

There might well be times where you’re tempted to cut calories right down in order to lose weight that bit faster – especially if you’ve been dieting for a special occasion.

Try not to regularly drop below 1100 calories per day. If you don’t do any exercise, it won’t damage your health to occasionally eat only 800 – 1000 calories, but this certainly should never be for more than a few days at a time.

Do you really want to reach that special occasion feeling exhausted, ill and stressed because you’ve been starving yourself for days?

Surely the faster I lose weight, the better?

It can be frustrating to only lose a pound each week, but slower weight loss is much more likely to be permanent.

Following a VLC diet can often have a “yo yo” effect on your weight; you lose weight rapidly for a few weeks whilst on the diet, but when you start eating “normally” again, your metabolism has slowed to cope with the lack of food – and you pile the pounds back on.

Eating so little can have a number of side effects such as extreme tiredness, constipation, diarrhoea and nausea. If you are severely overweight when you start rapidly losing weight on a VLC, you also put yourself at more risk of developing gallstones.

What’s best for long-term weight loss?

When you lose weight fast, you often change your eating patterns radically. The three diets mentioned above all involve replacing meals:

  • The Cabbage Soup diet: no prizes for guessing what you eat a lot of here 😉
  • The Cambridge Diet and Lighter Life both involve meal replacements – bars, shakes and soups – which are designed to include the nutrients you need whilst remaining low calorie.

The problem with these plans is that you won’t be re-educating yourself to change your “normal” eating habits. If you go straight back to what you were eating before the diet … you’ll inevitably put on all the weight you lost.

If you want to keep the weight off for good, follow the common sense advice given by nutritionists down the years and increase the amount of exercise you do.

Maybe it’ll take you a few months longer to reach your goal – but isn’t that worth it, if you stay slim and healthy for the rest of your life?

Have you had long-term success using a VLCD?


  1. Devon

    Hi, I weigh 48kg (around 106/107 Ibs) and currently eat around less than 500 calories a day – keep in mind I don’t exercise much anymore. My BMR/Metabolism has stalled completely and anything I eat – including biscuits, nuts and such elicits my nausea and causes very visible bloating. I am losing all the muscles I used to have from dancing and I’m not sure how to start-up my metabolism again. Any suggestions?

    • Ted

      You have to start eating again at healthy calorie levels. I suggest you see a doctor about this because you have unfortunately developed an eating disorder.

  2. denise

    Hi my BMI IS way over 30. On VLC plan but after 3rd day, feeling good. Lost 6 lbs. this week. Yes its hard but so is 267 lbs. Going to doctor for bloodwork and take MV daily

  3. Logan Thompson

    I am 19 and started at 214lbs. I have been between 500cal and 1000cal a day for a week straight. Then I dropped it further, this is day four of going between 100 and 300 calories a day… no symptoms yet… Have not added extra exercise yet just sticking to my college schedual… I’m not obese I am a former “body builder” who lost time for the gym and packed on a few pounds… Week one I lost 12 lbs, my goal for week two is another 12 lbs to put me at 190. Then I will slowly raise calories up to 1000 a day and return to the gym to continue the loss… VLC work don’t let it scare you… don’t make excuses on why not to do it… empower yourself… you wont get better if you never push yourself…

    • Ted

      Hey Logan, You really don’t want to do this more than 2 weeks or you’ll stall your metabolism. You really should check out Flexible Dieting IIFYM to reach your goals. Check out this easy to use TDEE and macro calculator.

  4. lisa brown

    I love the vlcd. Once you get past 3-4 day mark it becomes relitively easy..The weight is flying off of me as we speak

    • Ted

      Right up until the time you stall your metabolism…. Just a word of caution.

      • Claire

        I have been on a medically supervised VLCD for 16 weeks, I lost 50 lbs. My metabolism hasn’t slowed. I do however have one “cheat MEAL” not “day” on Saturdays which I do to rev up my metabolism. Also, I am now at my mid weight goal (200), I will start to up my calories to about 1200 because I was told not to be on a VLCD more than 16 weeks. Anyway, slowed meta or “starvation mode” is a myth. As long as your steady and then upping your intakes “refeeding”, you should be fine. Of course talk to your doctor FIRST and FOREMOST!!!

        • Claire

          Also to maintain my weight, once I am 150 lbs, I will eat about 1800-1900 cal/day for like the rest of my life. I am pretty good at portion control now even without measuring so I know how much to eat. Also, I started with a 600/day diet. This is a lifestyle change not a diet for me. I cannot believe I have come this far and I cannot wait!!!

        • Ted

          I assure you it’s not a myth. This has been researched and I’ve personally observed this with many of my clients who have been on a low-calorie diet for more than 16 weeks. Just because you haven’t experienced this does not mean it isn’t true for others.

  5. Skyler

    people just put down VLCD because it takes discipline, discipline they lack, they can barely control their own ability to not eat one more cupcake let alone a day of meals. not one did i lean out, my mental toughness is better. Anyone who says they’ve tried it and failed, are lying, under reporting calories and over reporting exercise, and eating calories they didn’t know that even had calories in them. also not adjusting there daily calorie intake to there new weight.

  6. Skyler

    All the drama around VLCD is just that drama, I’ve been on one for 9 weeks my body fat keeps dropping started at 189 lbs at 6’0ft down to 171lb on 600 calories or so. workout everyday weights and 40 minutes of cardio. I’m getting shredded, muscle and strength lost is practically none, i actually feel like I’m getting stronger my pumps are INSANE. I don’t look unhealthy and i feel great! I don’t look skinny at all I’m the new super shredded guy at the gym. my appetite is nothing close to what everyone screams that I’ll feel “starved” lies all lies and here say, and group think, everyone who told me not to is over weight and unhealthy, and here I am my fit than I was when I was in the USMC, i can run further, hike longer, and lift more.VLCD work, and just to be safe once i start to come off of it for the supposed metabolic slow down weight gain they talk of I’m going to tapper my calories back up just to be sure, and I’m going vegetarian.I am 23 and shredded, feel great, am Strong, i am the sharpest blade i have ever been. I honestly think all this stuff is to sell supplements. if VLCD had the reputation that it deserves nutritional companies would see a decline in profits guaranteed.

    • denise

      Excellent congrats to you

  7. Bill McCreary

    Thank you for your comment. I needed to hear that!!

  8. laura

    *crickets chirping*

  9. Jimbo

    I agree with Jay, I have been on a 500 calorie VLC for 7 weeks. I have lost 38 pounds. You just need to pay attention to your body. It will tell you when it needs protein or carbs. I have cut out most protein and eat plenty of fresh steamed veggies. I started at 242 pounds and BMI of 37. I am now 204 and BMI went below 30. My blood pressure is down to 112/69. I walk several times a day and keep active. I snow skiied better this last week than ever with the weight loss and still have energy. Drink 2-3 liters of water a day. A VLC can work. Just listen to what your body is asking for. My goal is 50 pounds loss then go back to a maintenance diet to maintain. A person needs to ease back to regular meals to let the body adjust.

  10. Sheryl

    Jennifer mentioned that bariatric surgery always works. No, it doesn’t.

    I took a class for six months to be approved for surgery and was a star pupil. Out of 12 people in the class, I was one of two to lose all 10% of my required weight, and lost several more pounds between the end of the class and the surgery. I then proceeded to lose 30 pounds after surgery — and came to a dead standstill.

    Everyone’s body is different. I didn’t know that before, but now I do. I assumed you “have to lose the weight” with WLS (weight loss surgery), but you don’t. My body didn’t react correctly. And what’s the worst thing about this is because you KNOW you’re supposed to be losing weight because everyone says “it’s impossible not to.”

    And when you don’t, no one believes you. That’s when the depression comes, because you’re isolated. You need help, so you beg for help by going back to your surgeon, you have tons of x-rays and tests run, you go to internal medicine doctors, two endocrinologists, a registered dietitian, and a nutritionist.

    I have done so much studying this past year that one of my endos mistakenly paid me a HUGE compliment. He saw some tests that had been run on me and assumed the other endo had ordered them. He said, “Whoever ordered these tests is an excellent endocrinologist.” Through tears I looked him in the eye and said, “My endo didn’t order those tests. I ordered those tests. If no one else cares about what’s going on with me, I’M going to figure it out.”

    Unknown to him, I’d had my primary care physician order those tests for me so I could see them for myself. My degree is in Business, not medicine. I am a wife and mother. But a board certified expert related what I’d done to one of his equals. That doesn’t happen by accident. That happens when someone who’s serious about changing their circumstances gets proactive in their health.

    The thing that never seems to occur to anyone is, think about it — do you HONESTLY think anyone in my position would WANT to tell anyone this? Imagine how embarrassing it is. Do you not know that “I” know how ridiculous it sounds to say you’re not losing weight after a GB?! Do you not realize how absolutely MORTIFYING it is to tell a doctor you’re not losing weight after a surgery like this? If anything, I’d be wanting to save face and not say anything.

    But the reason I keep going back for help is because I CAN’T lose the weight, and I WANT to! It’s not the common story, but it’s my story. I hate it, but those are the facts. Hard to believe or not, it’s still my story, and I needed help.

    It is the worst thing in the world to be so isolated in this kind of an issue. You have a real problem and you need real help, but no one will help you because no one believes you. Imagine being accused of a crime you didn’t commit. And then imagine that as you try to find a lawyer to represent you, that they all believe you’re guilty. That’s what this is like. You keep telling your story, but no one believes you — dooming you to a life in prison for something that’s out of your control. That’s my life.

    I looked at WLS as the governor’s pardon out of my self-imposed prison. But it’s as if on the day I was to walk out, I try to use the key the governor gave me, and it doesn’t work. I stand at the door staring at the key thinking, “This can’t be possible.” So I call the governor and he says, “Well, it should work. It always works.” And I turn and turn and turn, and the door never opens. You talk to others on the outside and they just shrug and say, “I dunno. It worked for me.”

    It feels like a cruel, sick joke — made worse by people on the outside you are telling you that things like that don’t happen; that the key ALWAYS works.

    For me, the issue has been losing water, but not fat. I can eat 1000 calories and I immediately start losing water, but never fat. I was running — RUNNING — 30 minutes a day 5x a week. And I’m doing this at 242 pounds. And I’m in pain with my knees and hips hurting — but ignoring it and pushing through the pain — because I want SO badly for it to work. I would do 45 minutes of step aerobics followed by another 30 minutes of weight training.

    So on the slight chance that someone’s telling the truth . . . where do they go for help if no one’s willing to believe their story? You’ve no idea the pain and emotional isolation it puts a person in when they want help, but first they have to get people to believe them. You want answers and no one can tell you why.

    In recent days I believe the issue for me has to do with the fact that WLS is a VLCD. I think, like someone above also mentioned, that it also has to do with nutritional deficiencies. I have a small pouch now, since my stomach is not in use, and it’s very hard for me to eat 1600-1800 calories in fruits & veggies because they’re more fibrous and filling — and have few calories. I’d have to eat a LOT of healthy food to get my calories up, and I can’t do that because my pouch only has so much room.

    Before surgery that was really a big key — I needed to get my calories down but needed to feel full. But now it’s the opposite issue. Very little food makes me feel full, but I really think I need more calories to lose. I can eat an apple (80-120 calories) and almost feel like I’m going to spit it up from the fullness in my pouch! And that gave me very little bang for my buck.

    I think my body didn’t handle the VLCD portion of the surgery very well. I’ve been eating at about 1400 calories, and when I eat a bit more than that, I immediately gain water — which tells me 1400 calories isn’t enough. Your body typically doesn’t respond by gaining a pound or two of water overnight unless you’ve been running low on calories and/or carbs to begin with.

    This is like trying to run a marathon while being chained to a tree. You can run your heart out and keep your goal in mind each and every day . . . but as long as you’re chained to a tree, all the heart in the world isn’t going to get you to your goal.

    So anyway . . . I understand how Jennifer could have come to such a conclusion, because I NEVER in a million years expected to have this issue. I had determined I was going to be the poster child! Instead, I live the life of a WLS patient who struggles to lose weight and feels weary of taking vitamins but got very little in return. If I struggled with being overweight before, I struggle with it even MORE now, because I’ve gone the distance.

    I allowed someone to cut me open so I could lose the weight. I didn’t care that I might have nutritional issues after surgery; losing weight was all I cared about. To me, it was worth it. But now I am sentenced to take a boatload of vitamins every day and no weight loss in the last year to show for it — with 70 pounds still to go and guessing as to how to get them off.

    • Pam 7 days ago

      Your story sounds exactly like mine, except I never lost a pound after surgery. Week after week my group would meet, and the pounds were just falling off everyone else. They were so excited and happy each week, and I just wanted to throw myself off a bridge. I was exercising more than any of them and getting about 400 calories a day, and nothing. No weight loss. Several years later here I am with suddenly high blood sugar which is keeping me at below 500 calories a day, and while it does help keep my blood sugar down, still now weight loss. Every time someone thinks they are being helpful and gives me dieting advice, not having any idea what I’ve gone through all these years, I want to push them in front of a moving train.

  11. sarah

    first of all…

    i eat very healthily. iam asian and growing up in an asian family everyone is weight conscious. if you are female and over 50 kgs or 110lbs. your family and asian friends ridicul u and call you fat which is why most asian families and asian people are skinny because its their culture to stay under a certain weight and grow up eating very healthy. growing up in asian family has taught me very healthy eating habits. we hardly had any junk food and most of our foods consists of rice, seafood and plenty of veggies anf fruit. i was eating a heap of cabbage,brocolli,cellery for dinners with seafood. thats what i eat daily however over a 4 yr period i gained 10kgs per yr. i was also excersising but gain 10 kgs per yr. i had a boyfriend and everyone in my family including my boyfriend of 5 yrs all thought it was wierd because iam a healthy person. I JUST dismissed it thinking maybe i just wasnt exercising enough..even though i was doing 3- 30 min sessions per week. 2 weeks ago i finally decided to try VLCD and it worked. in 2 weeks ive lost 10lbs and i went to the doctor 1 week ago and got diagnosed with low-thyroid. i think this was the real reason for my weight gain. my CURRENT BMI WAS 30 when i started VLCD and i intend to keep going until i lost all the weight i gained in 4 yrs because of low thryoid. low-thyroid makes your matabolism slow down veryyy slow.. so if the VLCD does slow down my matabolism it doesnt worry me as my matobilism is crap to start with.. lol iam not taking medication for low-thyroid meaning my matabolism would be better than what i started with before VLCD anyway. lol the worst is i have the same matabolism.. lol so it really doesnt bother me at all..

    with people saying u feel hungry all the time.. U DO NOT. i only feel this way for the first 2-3 days. once u get past the first few days its very easy. for me personally i never was hungry even at day 1.

    iam consuming under 800 calories per day.. iam feeling bettter than i have in the last 2 yrs.

    i quit going to the gym but instead bought professional home gym equipment so i can work out daily instead of only 2-3 times per week because it takes me 1 hour to go to and from the gym so it saves me time.

    i work out now every day for 30 minutes per day.

    iam never hungry.. i take alot of vitamins.. i take a multi + fish oil and some extra vitamins as well.

    again iam a veryhealthy person to start with.

    so people who are knocking it saying ohh u just go back to old eating habits.. THERE R PPL IN THIS WORLD WHO ARE HEALTHY AND HAVE GREAT EATING HABITS BUT GAIN WEIGHT U KNOW LIKE ME BECAUSE OF A MEDICAL CONDITION.

    this diet is great. i highly recommend it to everyone. i can even see myself doing this for the next 18 months. iam actuallly never hungry and can see myself doing/being on this diet long term. i have not had any cravings for any food.. the sight of food turns me off because i just think fat. lol
    u just have to be mentallly prepared for it.

    i hope i can lose 5lbs per week for the next 3 months as i lost 5lbs per week for the first 2 weeks so far however its highly unlikely.

    the only thing i only had a hard time giving up coffee… i had 4 cups of coffee per day before going on this and i suffered headaches for the first 5 days because of coffee withdrawals. now i feel great. i dont even think about food nor am i tempted.

    i actuallly wish its healthy long term because i want to be on it 4 a long time but i know i only can be on it for 3 months so iam abit sad i had 2 go back and eat normal food after it. 🙁

    • Claire

      I hope I am not too late to reach you but saying “the sight of food turns me off because I just think fat” Um that seems like you have an eating disorder (anorexia). Do not let it get to that stage. Go see a doctor!! And a VLCD should not be done long term. No more than 16 weeks! Be careful.

  12. GT

    The article mentions a lot of problems with VLC dieting, but very little is written about a real solution to losing weight!

  13. bob

    on another note aswell I ate lean cusines and really didn’t do any more exercise then a guy who does 9-5 at a desk. It took me looking at myself to really make the change. And until you are ready to do that it really doesn’t matter, because once your ready it will work.

  14. bob

    what a joke lol I had a BMI of over 56 when I started eating between 600-1000 cal’s a day maybe 70-140 carbs took vitams and I was losing 20 pounds a week doing nothing. Never felt bad and now 10 months later have a BMI of 29.

  15. jenn

    vlc diets work or anorexa norvosa would not be so deadly

    • lisa brown

      so true

  16. Dr. J

    True, eating fewer calories is the best way to lose weight. As I understand the warrior diet, it’s a good system for either losing or maintaining weight. Although some body builders do it, the vast majority of body builders eat several meals a day, and time their eating to their work out schedules.

  17. lou

    thank you doctor for your tip. the warrior diet is interesting but seems more suited for body builders and others who are serious about sculputing their physique than losing weight. i’m gonna take this one step at a time. the warriors seem to do an extremely hard work out. i suppose to burn the calories off from their one BIG meal. the originator of the diet said he eats once a day but the equivalent of 3 meals…i’m hoping to do that someday but i’m not holding my breath. in the end it stands for reason that unless one is pursuing extraordinary forms of athleticism, the best way to burn calories is NOT to put them in once mouth in the first place.

  18. Dr. J

    Hi lou!

    You are basically eating warrior style (look it up). Personally, I think it’s a good system, but certainly not for everyone. It doesn’t fit most people’s lifestyle, and for most, it’s too hard to maintain. It’s usually done with only eating in the evening, but if your morning style works, and you are getting good nutrition, why not. Good luck!

  19. lou conci

    unfortunately dieting has become too complex, like everything else in life, i suppose. i think i’ve found a simple solutions to all this mess. i’m 5/7 and weighed 195 in oct of 08. i decided to go an a diet after i picked up a sport magazine which gave the height and weight of all the athletes on a soccer team. i noticed that i was heavier than all of them even those a foot taller than me. i felt this was ridiculous. i realized i should be around 145-150.

    i decided to follow this simple method of dieting:
    eat more or less anything i want from the time i get up in morning until lunch. after lunch the only thing i have is a cup of coffee. in other words from 1pm til 7am the next morning i go without eating any thing at all. that’s 18 hours without eating.
    I walk/run 2 to 3 miles 4/5 times a week. i’m now 160# and expect to reach my goal of 150 in a month or so. my metabolic rate is perfectly normal. i’ve never felt better in over 25 years. my running has improved. i’m 54 and can fun faster now than 15 years ago. i expect to go faster. i dont see the great need to increase my caloric intake too much for my running for the time being. i seem to have become more “efficient” and need fewer calories to do the same amount of work. nevertheless, I will increase carb intake when i’m 150# if need be. i weigh myself every sunday morning and analyze the progress. if i lose less than a pound then i simply cut back on food intake. i’ve been losing aprox 2# per week. never had any rebound effect and dont expect to.

    my energy level is higher, so is my alertness. i dont get tired and fall asleep while reading a newpapers anylonger. losing weight feels like going back in time in a time capsule and recapture how I felt and looked in leaner years past. I was 140 in high school and would love to get there if ever possible.

    there is no doubt that a very low cal diet is great for you on every level of your well being. losing weight and getting healther can easily be achieved by simply eating just two healthy meals a day and avoid dinner altogether. i never slept better than when i started to go to bed on an empty stomach. in fact i seem to need fewer hours of sleep from my usual 8/9 to about 6.
    and of course, i dont have to tell you how much money i’m saving in food expenses.

  20. fatcow

    i want to loose at least 50kg. My BMI is 38. I’ve lost 12 kg in 14 weeks. No one will let me go on a vlcd, maybe because of my history of eds. I am desparat and hate myself

  21. Lori

    Thnaks for your time in posting, it was just what i was looking for…. Here to a new way of eating and goodbye to the aches, pains, swelling, rolling off bed putting socks on, old me. Again, Thanks

  22. Dr Lomar

    If you go read what is on the internet you will most likely get very confused about this VLCD subject.

    Here is how it works. I am sure you all have heard about your (minimum rec. calorie intake) this number varies depending on your height/weight. These numbers mark the amount of calories your body needs to sustain regular function as in respiration etc.

    This only means that your body will burn x amount even if your sitting on your rear all day long doing nothing.

    When I was in the army I put myself on a VLCD using slim fast a multivitamin and a couple sports drinks every day. I did fine and lost around 45 pounds in a month and a half roughly.

    The problem with these (crash) diets is that people tend to forget about actually changing they way they look at food. So when you have lost all that think you can go out and eat an entire pizza every day for a week. Well folks..if you do that..your going to see the weight come back.

    Now as to the last poster asking if they where going to gain weight once they reach a 1700 cap. The answer just depends on what you are doing to keep your weight in check. If you are exercising and eating the right foods then you will be fine.

    Lastly…these VLCD diets are usually physician monitored and incorporate the right foods to keep your body right. So if you are trying one..dont eat up your 800 calories in snickers bars. 800 calories can account for ALOT of healthy food. You could probably eat your body weight in vegetables before reaching 800 calories.

    The reason this whole “diets dont work” craze is because thats how these companies have decided to sell their products. Diets do work and have worked for a very long time. The word you have to remember is DEDICATION. If you can stay dedicated to your diet no matter what it is (except for the snickers diet) you will do well.

  23. Niki

    After reading all of your comments, being very mixed I must say. I am still a little confused myself!

    I am currently on a 1100 calorie a day diet, but every 2 weeks I am planning on adding an extra 100 calories to my diet until I reach my 1700 a day limit.

    I am currently at a BMI of 29.7 and I need to loose around 2 stone(28 pounds) to get myself down to about a BMI of 22-23.

    I am just over 5 feet tall so any extra weight shows a lot more on someone of my size, I do around 2 hours of exercise a week which includes 45-60 mins of aerobics and 60 mins of netball per week.

    I currently eat lots of veg, brown rice and chicken along with porridge in the morning and a varied meal of no more then about 400 calories for dinner.

    I also take multi vitamins and minerals as an extra precaution

    Do you think that I will start to gain weight again once I reach my 1700 calorie a day diet which is good balanced long term diet for someone of my height?

  24. exona

    Actually after about 3 days the body gets very used to the amount of calories and feels great. Strange, but true.

  25. exona

    Actually after about 3 days the body gets very used to the amount of calories and feels great. Strange, but true.

  26. Carol

    never do this. spend the money and go to a nutritionist if you want to lose weight.

  27. jts

    it’s absolutely impossible to eat in a caloric defacit and gain fat weight. Your body is using something for fuel, the food you put in your face then stored energy. That stored energy is not coming from thin air. It’s coming form somewhere in your body. The weight you’re gaining can only be attributed to the weight of the food you’re putting into your body and water gain.

  28. Cheetie

    I totally agree with Jenifer- VLCD work. I honestly don’t feel hungry and manage less than 1K Calories per day. I choose ‘nutrient dense’ foods such as skinless chicken breast, tuna in water (from tins) and fresh raw tuna if its available. I supplement with a small amount of nuts, avocado, and lots of veggies (raw or minimally cooked). If I want some carbs, I eat a few pretzels. Sometimes I take a multivitamin, but only a couple times per week.

    I’ve been doing this for just over seven weeks and have lost about 35 lbs. My starting BMI was 33.2 (245 lbs). My borderline high blood pressure is now back down to normal, my resting pulse rate has decreased significantly, and my cholesterol has dropped from 230 to the 170’s.

    For some reason, I haven’t seen all the side effects that everyone keeps mentioning. I’m still able to work, think, and function as I always did. I could sustain this indefinately I think. I make soups with beans, lentils, veggies, and lean chicken. I drink lots of water and coffee. I really don’t find it all that bad. When I reach my goal weight, I plan to modestly increase my calories, continue to cut out the junk and alcohol, and begin a serious weight training and aerobic exercise program.

    One thing that keeps me going is that I now notice the fat people everywhere I go. I look at them and it validates my decision to take control of this situation and manage it.

  29. Jay

    I’ve been on a VLCD for 2 and half months. It’s actually easy to follow. The ketosis induced by the diet has a central nervous system effect that suppresses appetite. I am **never** hungry. That’s not to say that the sight or smell of good food doesn’t make my mouth water, but I now recognize it for what it is: not hunger, but mere desire.

    I lift three times a week, and do cardio four times a week. If I’m losing much muscle mass, it’s news to me, as I’m lifting heavier weights with better form every week.

    To be sure, I’ll have to keep that up, and do even more once I begin eating again, but this will be a permanent solution to a 15-year problem for me.

    Maintenance of weight loss is hard, regardless of how you lose it. VLCDs are no better at long-term weight loss than other methods, but they’re no worse, either. It takes an acceptance of the fact that weight will always be something that requires work to control, and a real commitment to doing that work, and making wise choices, day in and day out. It’s not too different from AA, except that total abstinence is impossible.

    If your hospital weight management clinic/physician offers a VLCD, don’t be scared away by the stories of slowing metabolism, lean body mass loss, and weight/fat regain/rebound.

    Oh yeah… In 9 weeks on the diet, I’ve lost about 55 pounds, almost 25% of my pre-diet weight, and almost under the threshold for obesity for the first time in 15 years.

  30. Brad

    I’ve read a bit of the research that Mike mentioned above on the 800 calorie diets… and from that, plus much of the other research that I’ve seen regarding heavy-moderately heavy resistance training…

    … the #1 key to muscle loss is DISUSE… especially in a low calorie environment.

    If you’re ever broken a bone and had it cast for weeks on end, you can see how you not using the arm/leg atrophies the muscle… even though your calorie levels haven’t changed.

    This is the true power of resistance training while attempting any type of fat loss goal… the preservation of muscle mass (as shown in the above study)… and the increase of the amount of body fat per lb of weight loss over the cardio only (aerobic) group.

    As an aside, I heard a trainer on TV tell a client that if she missed breakfast… that her entire next meal would automatically turn to fat!

    And you could tell that she wholeheartedly BELIEVED IT.

    Shear craziness.

  31. cari

    I’m with you Liam – and there is plenty evidence that VLCD have a rapid (not just weight regain) but fat rebound… so you gain fat disproportionately fast and it’s fat gain (not weight gain) that is problematic from a health point of view.

    And we haven’t even begun to talk about the psychological effects of continually going on a diet only to feel like you’re the failure when you can’t stick to it. Doing that year in and out (and I did for 20 years) is increadibly confidence-eroding.

  32. jennifer

    Use common sense here–if “starvation mode” caused a SIGNIFICANT reduction in BMR then bariatric surgery wouldn’t work. It always works. And at least 75% of those undergoing it find a permanent solution to co-morbid obesity.

    What is most significant about a VLCD is that it be comprised almost solely of fat and protein. Heavy on the protein. Most of the side effects of so-called “starvation” diets are from sacropenia (muscle wasting) and inadequate protein intake.

    Hey we hate to hear it because most people LOVE to eat but we really don’t need a lot to survive.

    • Pam 6 days ago

      No, it doesn’t always work. I didn’t lose a single pound, not in the weeks of clear liquid diet leading up to the surgery or in the years after. The surgeon finally gave up. I now keep to under 500 calories per day and am still obese.

  33. cari

    I’ve also seen research that says that a drop of only 2-3% in water also slows metabolism

  34. Never teh Bride

    Metabolism slowing down is the adaptation!

    During periods of scarcity, it slows to prevent starvation. During times of plenty, it goes back to a normal level.

  35. jessiem

    VLCD works fine for a short period of time. But the moment you are off, you return to your old eating habits. I think it’s a matter of eating sensibly and with a purpose for any weight loss to work.

  36. Quito

    I’ve been plowing through what Regina and Mike has posted here, and also what I’ve found on the effect of bariatric surgery and thermogenesis. It’s interesting material. Hypothyroidism is one of the control mechanisms, as Heather has experienced. Only a fraction of people experience it with bariatric surgery, and exercise can counter the effect.

  37. Spectra

    You CAN increase your BMR, like Dr. J said, by building muscle mass. A pound of muscle burns 50 calories/gram while a pound of fat burns close to 5 calories/gram. Have you had your body fat levels checked? It’s possible that you are not simply overweight but overfat from years of dieting. If you add in physical activity, especially weight training, you will increase your muscle mass and possibly increase your BMR quite significantly.

  38. Spectra

    Oh, I totally agree…you CAN be overfed yet undernourished. If you simply eat macronutrients (as in, carbs/protein/fat) with not enough vitamins, minerals, cofactors, etc., you will store the energy as fat and won’t be very efficient at turning the fat into energy. Similarly, there are a lot of people who eat diets that are low in calories and VERY high in nutrition. In fact, if you are going to cut calories, you really do need to make sure the ones you’re getting count toward meeting your daily intake of calcium, vitamins, minerals, etc. That’s why if you are going on any sort of low calorie diet, you need to be working under the supervision of a doctor or nutritionist.

    Incidentally, this is why I think one of my friends can’t seem to lose weight on Weight Watchers. Instead of getting her calories from fruits/veggies, etc., she eats around a bag or so of gummi bears per day (as many as her Points range allows her to).