Weight loss is quick, motivating patients to continue. A key component to any diet’s success.- As only a 5-7% weight loss is recognized for improving cardiovascular and metabolic parameters (blood pressure, blood lipids, waist circumference, blood sugar, etc.) VLCD meet and exceed this loss rapidly. A loss of 15-20% over 12-16 weeks is typical.
- Some studies correlate long-term maintenance with greater initial weight losses. The initial weight losses are high in a ketogenic VLCD.
- Weight regain, if it occurs, is not accompanied by a return to baseline of metabolic parameters; a patient may regain some weight, but does not regain the hypertension, dyslipidemia, and glycemia present before the VLCD.
- Quick reduction in waist circumference and corresponding ventral adiposity.
- Fast and impressive changes in glycemic control. Hemoglobin A1c improve and often normalize in only weeks. Post prandial (after meal) blood sugar excursions do not occur.
- Glycemic improvement occurs quickly necessitating reduction and/or elimination of pharmacologic agents. This begins within days of starting the VLCD.
- Blood pressure improvements begin even before appreciable weight losses.
- Diabetic, lipid lowering & blood pressure medications are typically greatly reduced or eliminated, by the prescribing physician.
- Insulin sensitivity improves without exercise. Increased sensitivity occurs in peripheral tissues and liver.
- Serum (blood) levels of fasting insulin are reduced.
- Liver volume decreases significantly, and liver enzymes improve.
- Pancreatic insulin (endogenous, or the patient’s own insulin) secretion is enhanced
- Hepatic (liver) glucose output is reduced.
- Triglycerides drop drastically if elevated, and this occurs early in the diet. HDL-C (good cholesterol) increases, but this is over a longer period of time. LDL-C (bad cholesterol) may or may not improve in by total LDL-C measures.
However, the LDL-C ratio of apoB (bad, dense component of LDL) and apoA (better, less atherogenic component of LDL) improves.
- Protein has protective effects on kidney function in healthy patients.
- Lack of hunger aids in diet compliance. Protein has the most satiating properties among macronutrients.
- Trend towards better weight maintenance. Weight gain occurrences tend to be gains of lean body mass, where as regain after low protein diets tends to be more fat mass.
- Thermal effect of food is enhanced with protein.
- Weight loss from fat is greater while loss of lean body mass is minimized with adequate protein.
- Reduced waist circumference and ventral adiposity.
- Meal replacement in weight loss strategy enforces portion control and has demonstrated significantly greater weight losses than a prescribed diet of self- selected conventional food.
- For type 2 diabetics, meal replacement and weekly sessions in a medically supervised setting are found very effective for weight loss.
- Can be used for as first line treatment before, after, or as adjunct to other weight loss therapies. These include short and long term pharmacologic agents and surgery.
