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A very-low calorie diet is likely to help you lose weight fast, but maintaining that weight loss is a challenge
THE adverse health effects associated with being overweight or obese need no further mention, because we now know the conditions are linked to almost every ailment, both physical and psychological. From heart disease to osteoarthritis and some cancers, and from body-image issues to low self-esteem and depression.
“The general environment makes it more difficult for people to be physically active, and the development of labour saving machines – devices for the household, motorcars, motorised cycles and so on – enable people to do things that 50 years ago would have required much more energy,” he adds.
Tipping the energy balance so that our energy intake from food is less than what we expend through physical activity is the key to any diet plan. A very-low calorie diet is one of the ways to create this deficit, says Leeds.
While other weight loss diets, including low-calorie diets (LCD), recommend a person eat 800 to 1,500 calories a day, very-low calorie diets (VLCDs) recommend an energy intake of only 450 to 800 calories a day, he says.
“These are fortified liquid meals that provide all vitamins, minerals, trace elements, and essential fatty acids that are required on a daily basis.”
He explains that if a diet of ordinary foods that contains 450 to 800 calories is chosen, it is not possible to get all the micronutrients that are needed.
“In this programme, the individual does not eat other foods, but after the diet, they have to be gradually re-educated before the re-introduction of food.”
But how long can a person manage on such a low calorie intake?
Leeds says that although there are a number of trials that lasted for 16 weeks, the formal guidelines of the United Kingdom recommend VLCDs for no more than 12 weeks as a general rule.
“Once they pass through that period, the energy intake has to be brought back up. And then they have to go onto a maintenance diet because it is not possible, and certainly not appropriate, for people to stay at that low level beyond the length of time of that we suggest,” he explains.
On criticisms that people usually regain their weight after going off VLCDs, Leeds explains that it is just because they do not go onto or follow the appropriate maintenance diet.
The amount of calories a person should take on a maintenance diet depends on the amount of weight loss achieved within those 12 weeks.
For each kilogram of weight lost during the programme, you need to reduce your regular energy intake (your normal calories inkate before the diet) by 25 calories.
That means, if you lose 10kgs on a VLCD, you would have to take 250 calories less than what you were eating before the diet to maintain the weight loss.
This is because for each kilogram of weight lost, there is some metabolically active lean tissue lost with it, Leeds says. “That is why the energy requirement of the body goes down.”
There are, however, some side effects in this diet, which are associated with the weight loss. Constipation and an increased risk of gout and gallstones are sometimes seen in people going on VLCDs.
Some people will also have cold hands and feet, and develop bad breath when they are on the diet due to the body’s physiological response to produce and conserve energy
But this knowledge does not seem to have slowed down the overweight and obesity epidemic.
There are some specific medical causes of obesity (e.g. thyroid problems), but in large populations, obesity is generally due to an imbalance of the energy going into the body compared to energy being utilised by the body, says obesity researcher and medical director of the UK Cambridge Health and Weight Plan Prof Anthony R. Leeds.
As modern conveniences cause us to eat more and move less, we are packing on more pounds than we can lose.
