Huge deficit

kimny72 wrote: »

suziecue25 wrote: »

aokoye wrote: »

andysport1 wrote: »

kshama2001 wrote: »

andysport1 wrote: »

So the NHS in England are promoting these 800 calorie diets.

Is the NHS promoting 800 calorie diets for everyone, or people with specific medical conditions who are under strict medical supervision?

While click-baity headlines may imply the former, the truth is probably the latter.

https://www.england.nhs.uk/2018/11/very-low-calorie-diets-part-of-nhs-action-to-tackle-growing-obesity-and-type-2-diabetes-epidemic/

I read it was anyone with a BMI over 30

Here's some more reading for you - https://www.bbc.com/news/health-46363869

I've just looked at this article and there is a section in it that asks that you see if the 800 cal diet is suitable for you. It told me that my BMI is 33.4 [which I know] and that I could see my doctor with a view to going on the diet. It also said if I was already on a weight reduction plan to stay with it. However, it did not ask me whether I was either pre -diabetic or diabetic. In fact I am neither and will carry on with MFP.

To be fair, the calculator is from the BBC, not the NHS. And the calculator does say you should only do the diet for 12 weeks or once you reach a BMI of 25, whichever comes sooner.

I think it also bears mentioning this 800 cal diet is not just someone eating 800 cals. It is obtaining a liquid meal replacement diet program. I would assume this is to make sure there is proper nutrition included in that 800 cals.

Regardless, anything I'm seeing that is direct from the NHS is saying, their data "seems" promising and they think it's worth it for obese folks with diabetes to consult a doctor regarding the program. It is media outlets that seem to be directing it toward anyone with a specific BMI.

Also, because the diet is totally liquid the NHS provides people with dieticians when they come off it so they can learn how to eat sustainably on solid food.

suziecue25 wrote: »

aokoye wrote: »

andysport1 wrote: »

kshama2001 wrote: »

andysport1 wrote: »

So the NHS in England are promoting these 800 calorie diets.

Is the NHS promoting 800 calorie diets for everyone, or people with specific medical conditions who are under strict medical supervision?

While click-baity headlines may imply the former, the truth is probably the latter.

https://www.england.nhs.uk/2018/11/very-low-calorie-diets-part-of-nhs-action-to-tackle-growing-obesity-and-type-2-diabetes-epidemic/

I read it was anyone with a BMI over 30

Here's some more reading for you - https://www.bbc.com/news/health-46363869

I've just looked at this article and there is a section in it that asks that you see if the 800 cal diet is suitable for you. It told me that my BMI is 33.4 [which I know] and that I could see my doctor with a view to going on the diet. It also said if I was already on a weight reduction plan to stay with it. However, it did not ask me whether I was either pre -diabetic or diabetic. In fact I am neither and will carry on with MFP.

I think the bolded is the important bit. They are not suggesting people self-diagnose as diabetic or pre-diabetic and put themselves on 800 calories a day, they are recommending people over a BMI of 30 see if their doctor feels there is a sugnificent immediate health issue that requires rapid weight loss.

eta Presumably there are guidelines for doctors that recommend under what circumstances a medically supervised VLCD would be appropriate.

VLCD diets (of around 800 calories per day) ensure all nutrients are covered between their products (shakes, bars, soups, etc) and the 2+ cups of low-calorie/non-starchy vegetables that are eaten in addition to the products, & may also include a little oil (to prevent gallstones). Will also tell you to drink 2 litres of water a day.

VLCD diets are only intended for people who are obese, under doctor supervision, and for no longer than 12 weeks. A doctor may modify the diet based on their patient's needs; a larger patient may be advised to eat more than the base 800 cals to satisfy their protein needs, so it may not end up being an 800 calorie diet but a 950 cal diet (etc) once an extra product or lean meat is added. Having enough protein protects existing muscle mass.

It's quite common for obese people to be put on a VLCD prior and after procedures like lap band surgery.

If a person were only just obese at the commencement of the VCLD (e.g. BMI 31), it would not likely be recommended to stay on the VLCD for the full 12 weeks but rather only until they are no longer obese, which might be just a few weeks. Perhaps they would not even recommend that - start you on a less intense phase with more calories, or suggest something else.

A VCLD diet will have several phases, with only the first phase technically being "Very Low Calorie Diet". After the most intensive phase, the calories will increase, fewer products are consumed and the amount of normal food increases, over several phases until the person is no longer eating any products and is eating a normal balanced diet.

During the VCLD the extra calories the body needs are drawn from fat stores in the obese person rather than from diet. VCLD's are often ketogenic, putting the body into ketosis, so it draws down on fat for energy. Like other ketogenic diets, there can be some side-effects, particularly when first starting (when the body is not used to it), but nothing serious.

People on a VCLD are highly unlikely to be exercising as much as your suggestion of 1800 calories in walking, cycling & jogging per day. A 600lb person, for example, may struggle to walk 1000 steps let alone 10,000. The point of the VCLD is to lose weight by eating fewer calories, rather than through exercise.

VCLD's are not designed with highly active people in mind. Someone who is doing lots of exercise will have different nutritional needs to someone who is largely sedentary.

In summary, VCLD's are suitable for some people under specific conditions, but not for all people. Best to talk to your doctor about it and see what they recommend for you. If your existing efforts to lose weight are already working, then no need for something as extreme as a VCLD. If you are struggling to lose weight, seeing a doctor is always a good idea, they may do some blood tests and pick up on something you wouldn't have otherwise known.

The NHS does not promote 800kcal diets to 'normal' overweight/obese people. There is a 12 week NHS diet plan which recommends 1400kcal a day for women and 1900kcal for men and gives you nutrition/exercise goals each week which a GP will direct you to. It suggests alongside the plan to start cardio and strength training mainly through C25K and it's own at home bodyweight strength training video. If you are morbidly obese and your area has the funding you may get some form of free sessions to learn about nutrition/health etc. 800kcal diets are only for those who need immediate intervention or those about to undergo bariatric surgery. To start with the NHS simply hasn't got the resources to put 25% of the population that are obese on an 800kcal diet!

GottaBurnEmAll wrote: »

The NHS is promoting a clinically supervised 800 calorie diet as an emergency intervention for Type 2 Diabetes. This is different than what you outlined in your first post.

Medically supervised VLC diets are undertaken as emergency temporary measures only and since they're supervised and monitored by physicians for signs of side effects, they're fine.

Doing it on one's own like following Michael Mosley's book? No.

Yup they are clinically supervised diets. I think the recipients of the diet have to check in every 2 or 3 days because they were taken off blood pressure medication and diabetic medication plus these diets do not include any exercise.

The intent of the trials was to see if type 2 diabetes could be reversed, even in patients (with a high BMI) that had had it for over 2 years. They found that losing roughly 30lbs in 3 months was an effective way to help reverse type 2 diabetes.

I actually tried the diet (more around 1025 calories versus their 800 calories) for 7 days and lost 10 lbs. The only exercise I did was about an hour of "water walking" 6 days a week and absolutely no other exercise (sedentary).