Very low-calorie diet therapy; fast and furious!

Obesity is a serious public health issue with massive medical, social and economic consequences. The optimal management of obesity requires a combination of diet, exercise, and behavioral modification. Besides, some patients eventually require pharmacologic therapy or even surgery interventions. Very-low-calorie diets (VLCDs) are sometimes considered for the management of obesity in clinics and commercial programmes. There is a need for long-term comparison with conventional dietary interventions to assess clinical effectiveness. VLCDs are defined as hypocaloric diets that provide between 500 to 800 kcal per day and are enriched in a protein of high biological value. They must contain the full complement of vitamins, minerals, electrolytes and fatty acids. They are usually in a liquid formulation and are intended to completely replace other food intakes in a weight loss programme for a specific time. Meal replacements are portion-controlled low-calorie foods that facilitate compliance with a VLCD by simplifying food choices and allowing a structured eating pattern. The risk of overweight to the patient should be evaluated before beginning any treatment program. The selection of treatment can then be made using a risk-benefit assessment. The choice of therapy is dependent on several factors, including the degree of overweight or obesity, comorbidities, and patient preference. In this presentation, I try to explain the indications, complications and conditions that we must follow to use this emerging effective diet in obesity treatment. I also provide the last guidelines and studies regarding this relatively new diet therapy.