Very short duration VLCDs - still a "no no"?

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goldthistime
goldthistime Posts: 3,214 Member
in Health and Weight Loss
MFP does not advocate, and in fact deletes posts that advocate very low calorie diets. I agree with their stance, for a multitude of reasons.

But I do think that losing weight quickly for a short period of time is not such a bad thing.

I'm looking to open a discussion on this topic. If even a short period of low calorie consumption is still verboten, then so be it. Delete away.

But just in case...

In my mind, it's definitely ok to push it the first week, maybe even two weeks, and possibly even 3 or 4 weeks (depending on how "very low" is defined). The risk of VLCDs of course, is loss of LBM. Not just skeletal muscle loss but organ tissue cannibalization. Organ damage that has the potential to be permanent. No joke in my mind.

Currently my motto is "Learning to lose weight s-l-o-w-l-y". I don't have what it takes to go on a VLCD for even a day or two. I can't tolerate the reduced energy and the hunger pains that go with it. But there have been times in my life when I was happy to start off with fairly severe restriction of calories. The bonus was that I made great strides quickly, and then from there lost the remaining weight in a slow and sensible manner over the next few months.

I have heard it argued that for obese people, an initial period of a fairly low calorie restriction has the benefit of quickly improving most of their health markers. A sensible diet should be followed after that "honeymoon period". I introduced this idea in a thread here at one time and got lambasted. "Do you have any idea how difficult it is to adhere to a low calorie diet? You are setting these people up for failure!". I didn't have a chance to respond then, but I would say that it depends on how the dieter views success/failure. Would it be so bad to say "You should be eating 1600-1800 calories per day in order to lose 1-2 lbs/week, but during the first three weeks, and the first three weeks ONLY, you are allowed to eat as little as 800 calories per day".

Is the concern that someone would develop an eating disorder during those three weeks? Or that it would reduce their total time in a calorie deficit to such a short duration that proper diet/exercise habits never have a chance to get established, leading to yo-yoing?

Here is someone else who thinks short term low calorie diets are ok... http://www.bodyrecomposition.com/fat-loss/size-of-deficit-and-muscle-catabolism-qa.html/
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Replies

  • WBB55
    WBB55 Posts: 4,131 Member
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    I think it's risk vs. benefit.

    The risk of VLCD for under 12 weeks in duration are (source):
    Fatigue, constipation, nausea, diarrhea, gallstones

    The benefits are things like: lower BP, improved diabetes readings, cholesterol, 40+ lbs of loss

    Children and people over 50 are typically not indicated for VLCD.
  • goldthistime
    goldthistime Posts: 3,214 Member
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    Thanks for your reply. But I just noticed that there is a good discussion already going on here...http://community.myfitnesspal.com/en/discussion/10240808/taboo-subject/p3
  • yarwell
    yarwell Posts: 10,477 Member
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    Was. A number of national / international bodies support use of VLCDs in obesity especially with complications like diabetes.

    So adults with a BMI over 30 or maybe 35 might be prescribed a specified VLCD with a minimum protein level, essential fats and full mins & bits to be used for a 6-8 week period.

    A VLCD is not just a case of dialling 800 into MFP and nibbling celery.
  • goldthistime
    goldthistime Posts: 3,214 Member
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    Given that the thread I linked is closed for review...I want to commend @WBB55 for her short but smart post. I hadn't realized that gallstones were a frequent outcome of VLCDs. Great link too.

    @yarwell, I don't understand the "minimum protein level" comment. Can you elaborate? If you had a look at my bodyrecomposition link, Lyle thinks that it's important to make protein a priority when keeping calories very low.

    Hope this doesn't sound too kissass, but I'm grateful to MFP for making calorie counting so easy. I am just assuming that I was eating under 1000 calories a day at the beginning of past diets because I wasn't counting. I know I was resistant to the concept of IIFYM initially because I still had in my head that when keeping calories low, you had to make sure every calorie was packing a whopping of nutrients.
  • goldthistime
    goldthistime Posts: 3,214 Member
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    Duh, you didn't say "minimal protein level", you said minimum protein level. NM.
  • MysticRealm
    MysticRealm Posts: 1,264 Member
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    goldthistime wrote: »
    @yarwell, I don't understand the "minimum protein level" comment. Can you elaborate? If you had a look at my bodyrecomposition link, Lyle thinks that it's important to make protein a priority when keeping calories very low.
    MINIMUM protein level means that they are supposed to eat AT LEAST that amount of protein and no less, so they agree with what you are saying.
  • vismal
    vismal Posts: 2,463 Member
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    Can VLCD be appropriate in certain situations? Certainly! In some cases are they even more beneficial then slow and steady weight loss? Again, YES! Should they be strictly implemented under the care of a physician? I believe another resounding YES. There are inherent risks of doing vcld's that we are all aware of. A professional should be the one to discuss those risks, compare them to the possible rewards, and guide you in making the decision whether the vcld is the right choice for you. They will also be the ones responsible for monitoring you while on the diet, deciding how long it should go without a break, and whether or not the diet should continue.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
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    I think that the distinction should be made here that the restricted usage of these short term VLCDs should only be under medical supervision.

    There's a risk/benefit analysis that determines if they're appropriate, and in some cases they are. However, careful monitoring is essential.

    This definitely is not something to DIY.
  • Kalikel
    Kalikel Posts: 9,626 Member
    edited August 2015
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    I have never crash dieted in my life...well, I tried Slimfast for about 36 hours once. That's it. I did go on a low-calorie diet and was under the supervision of several - I think five - different doctors at the time. I lost a good deal of weight. I lost it safely and as healthily as possible. And I stayed full.

    The only problem I had was that when they gave me an inch, I took a mile and began eating things I shouldn't have been eating. But then I got that under control and came to a healthy and happy diet with lots more work.

    Everyone has to do what is right for them and that should be decided by them and their doctor(s).

    Most the women I know have crash dieted. Magazines, fitness gurus and online sites run silly diets all the time. I think it's silly, but I don't pretend that every woman who crash diets has an ED anymore than I pretend that everyone who lifts weights has BDD.
  • zyxst
    zyxst Posts: 9,134 Member
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    How many of these threads are going to pop-up this week?
  • dubird
    dubird Posts: 1,849 Member
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    Not if you're doing it on your own. If you are under a doctor's care and are going in weekly for check ups to make sure you're getting the nutrition you need, then I have nothing against it. Most doctors aren't going to recommend it unless you NEED it or it's preparation for a surgery, but with monitoring it can be safe for a short while. But the problem is so many people buy into the 'cleanse' and 'detox' bs and try to work out a VLCD of their own based on what random internet or magazine people said would work. That can be dangerous, which is why MFP says don't do it.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    edited August 2015
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    dubird wrote: »
    Not if you're doing it on your own. If you are under a doctor's care and are going in weekly for check ups to make sure you're getting the nutrition you need, then I have nothing against it. Most doctors aren't going to recommend it unless you NEED it or it's preparation for a surgery, but with monitoring it can be safe for a short while. But the problem is so many people buy into the 'cleanse' and 'detox' bs and try to work out a VLCD of their own based on what random internet or magazine people said would work. That can be dangerous, which is why MFP says don't do it.

    Depends on the doctor. There are weight loss clinics with doctors just waiting for suckers the desperate to cross their thresholds willing to fork over the cash. They are unscrupulous, imo, and all too easy to find.

  • dubird
    dubird Posts: 1,849 Member
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    PeachyCarol wrote: »
    dubird wrote: »
    Not if you're doing it on your own. If you are under a doctor's care and are going in weekly for check ups to make sure you're getting the nutrition you need, then I have nothing against it. Most doctors aren't going to recommend it unless you NEED it or it's preparation for a surgery, but with monitoring it can be safe for a short while. But the problem is so many people buy into the 'cleanse' and 'detox' bs and try to work out a VLCD of their own based on what random internet or magazine people said would work. That can be dangerous, which is why MFP says don't do it.

    Depends on the doctor. There are weight loss clinics with doctors just waiting for suckers the desperate to cross their thresholds willing to fork over the cash. They are unscrupulous, imo, and all too easy to find.

    True, you can always find those, which is sad. But I was thinking a person's regular doctor who doesn't have a financial stake in WLS. I know my regular doctor would regard it as a last-ditch effort to AVOID a WLS. That would be a case I wouldn't argue with, as long as the person was under strict monitoring.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    edited August 2015
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    PeachyCarol wrote: »
    I think that the distinction should be made here that the restricted usage of these short term VLCDs should only be under medical supervision.

    There's a risk/benefit analysis that determines if they're appropriate, and in some cases they are. However, careful monitoring is essential.

    This definitely is not something to DIY.

    I agree with this.

    I would add that doing something like the protein-sparing fat loss approach tends to assume you know a little something about what you are doing, which most people with a great deal to lose just starting out likely do not.

    That said, I actually do think that there's too much caution often here (from posters, not the site) about doing lower calories when you have lots to lose--and yes I'm NOT talking about VLCD now. I've seen several people doing 1200-1500 when 200+ get told that at their weight they should start slower and do a more gradual deficit and even on occasion that they should do TDEE-15% (which for the person in question likely would have been less than 1 lb/week). I know for some the shift from maintenance at 225 to 1300 would be extreme and hard to stick to, but often they are really ready for the change, aren't that hungry at first, and find it the easiest time to go low (and can make simple changes in the diet to get there sometimes).

    I did 1250 when at 200 (and likely lower pre MFP, when I was even fatter), and found it not difficult at all and the losses both motivating and helpful in getting active more quickly.

    I'm not especially an advocate of low calories either, as I couldn't do it now.
  • 999tigger
    999tigger Posts: 5,235 Member
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    Threads about VLCDs under medical supervision arent deleted. Threads promoting rather than discussing VLCDS are deleted according to their terms.
  • minties82
    minties82 Posts: 907 Member
    edited August 2015
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    I did a VLCD for a while at the start of the year. I did drop weight quickly. I had a BMI of 52 and was struggling to breath in bed, and to get up off the floor etc. My doctor said the benefits outweighed the risks.

    I would never do it long term and it was NOT fun. AT ALL. I also think I still would have lost weight quickly eating at a more normal amount. I was having about 800kcal per day and losing 3-4 pounds a week.

    I have gone from 253.5lbs to about 169.5lbs since Jan 4th and I eat twice what I did at the start.
  • jgnatca
    jgnatca Posts: 14,464 Member
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    I was on it under medical supervision for a few weeks. I'd not do it again. So unpleasant. I would also insist, beyond the cautions listed above, on access to a 24/7 help line. And not be left alone. There's risk of fainting or falling.
  • yarwell
    yarwell Posts: 10,477 Member
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    http://community.myfitnesspal.com/en/discussion/10056296/eu-guideline-for-vlcds-revised - 75 grams minimum European recommendation.
  • tomatoey
    tomatoey Posts: 5,459 Member
    edited August 2015
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    2 things
    - If a person has high or unrealistic expectations about the diet, and does not adhere (binges), they may internalize this outcome as a failure, and develop negative beliefs about their capacity to succeed (become discouraged & stop dieting altogether)
    - Various scary things are associated with successful adherence, even when done right, and agree that probably many are not "doing it right"

    So yeah, agree this should be reserved exclusively for people in imminent danger related to conditions secondary to extreme obesity & done under supervision.

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