Our 8-year experience strongly suggests that the VLCD approach using high quality protein supplement and multi-disciplinary counselling provides a reasonable success rate for achieving and maintaining weight loss in the morbidity obese population. (Kirschner et al, 1988)

The short-term use of a VLCD is very effective in rapidly improving glycaemic control and promoting substantial weight loss in obese patients with Type 2 diabetes. Moreover, a VLCD increases insulin secretion and reduces substrate for gluconeogenesis. Thus VLCD treatment may improve glycaemic control by factors more than caloric restriction alone. (Capstick et al, 1997)

A VLCD program is suitable for preoperative weight reduction in morbid obesity and seems not to compromise the immune system. (Pekkarinen & Mustajoki, 1997)

Substantial weight loss and improvement in cardiovascular risk factors could be maintained for 1 year in Type 2 diabetic patients by the use of a very low calorie diet. (Paisley et al, 1998)

VLEDs are a proven success in achieving significant short-term reduction in body weight. There is evidence to suggest that meal replacements may make a contribution to the maintenance of weight loss in some individuals. (Jebb & Goldberg, 1998)

This weight loss programme with a VLCD enabled obese subjects to lose weight and decrease cardiovascular risks. Despite some regain in weight during follow-up, the beneficial effects were overall maintained over the year. (Pekkarinen et al, 1998)

This four-compartment analysis of changes in body composition provides no evidence of any significant loss of protein in this treatment programme. However if two-compartment models are used to assess changes in body composition during acute weight loss the very significant loss of water will appear as losses of lean tissue. (Jebb et al, 1998)

VLCD was most efficacious if combined with behaviour modification and active follow-up. The literature on long-term follow-up of dietary treatment of obesity points to an overall median success rate of 15% and a possible adjuvant effect of group therapy, behaviour modification and active follow-up. (Ayyad & Andersen, 2000)

Greater initial weight loss as the first step of weight management may result in improved weight maintenance. (Astrup & Rossner, 2000)

VLEDs accomplish maximum initial loss and can be conducted safely in patients with obesity associated diseases – diabetes, hypertension, or other chronic diseases. (Mustajoki & Pekkarinen, 2001)

VLCD with active follow-up treatment seems to be one of the better treatment modalities related to long term weight maintenance success. (Saris, 2001)

Five years after completing structured weight-loss programme, the average individual maintained a weight loss of >3kg and a reduced weight of >3% of initial body weight. After VLEDs, or weight loss of >20kg, individuals maintained significantly more weight loss than after HBDs* or weight losses of <10kg. (Anderson et al, 2001)