very low-calorie diet (VLCD)

Introduction

800 kcals/day

Generally full complement of vitamins & minerals.

High quality protein.

Indications

• treatment of morbid obesity

Contraindications

• children
• pregnancy, lactation
• infections
• malignancy associated with weight loss
• cardiac disease, cardiac conduction abnormalities
• severe renal disease
• muscle wasting, myopathy
• frail elderly

Adverse effects

• fatigue
• dizziness
• nausea
• constipation
• edema
• cold intolerance, hypothermia
• precipitation of cholecystitis
• precipitation of gout
• cardiac arrhythmia
  • prolongation of QT interval
  • sudden cardiac death

Laboratory

• chemistry panel, electrolytes, LFTs
• complete blood count

Diagnostic procedures

• electrocardiogram: look for QT prolongation

Notes

Optifast

• non-fat dry milk fructose, calcium caseinate, canola oil ...

New Direction

• whey protein, corn oil ...

Best results when used in case management model.

With exercise, education.

More general terms

• weight loss diet

Additional terms

• calorie restriction; dietary restriction; food restriction