Very-low-calorie diets and sustained weight loss.

OBJECTIVE To review of the literature on the topic of very-low-calorie diets (VLCDs) and the long-term weight-maintenance success in the treatment of obesity. RESEARCH METHODS AND PROCEDURES A literature search of the following keywords: VLCD, long-term weight maintenance, and dietary treatment of obesity. RESULTS VLCDs and low-calorie diets with an average intake between 400 and 800 kcal do not differ in body weight loss. Nine randomized control trials, including VLCD treatment with long-term weight maintenance, show a large variation in the initial weight loss regain percentage, which ranged from -7% to 122% at the 1-year follow-up to 26% to 121% at the 5-year follow-up. There is evidence that a greater initial weight loss using VLCDs with an active follow-up weight-maintenance program, including behavior therapy, nutritional education and exercise, improves weight maintenance. CONCLUSIONS VLCD with active follow-up treatment seems to be one of the better treatment modalities related to long-term weight-maintenance success.