Very lowenergy diets

Many of the problems associated with total starvation can be avoided by feeding a very low energy intake, commonly 1—1.5 MJ/day, in specially formulated meal replacements that provide adequate intakes of vitamins and minerals. Such regimes have shown excellent results in the treatment of severe obesity. There is very much less loss of tissue protein than in total starvation, and with this small intake people feel less hungry than those who are starved completely.

If very low-energy diets are used together with a programme of exercise, the rate of weight loss can be close to the theoretical maximum of 2—2.5 kg/week. Such diets should probably be regarded as a treatment of last resort, for people with a serious problem of obesity which does not respond to more conventional diet therapy.

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