Very Low Energy Diets (VLED)

Last updated 25.08.13

 

Index

 

 

Definition

-    Diet with <3350 kJ/day (<800kcal/day)

 

Features

-    Replaces all meals with specific meal replacement formula

-     Additional food can be added carefully

-     High protein, low carbohydrate

-    Should be conducted under GP or Dietician guideance

-     Induce fat burning & mild ketosis causing improved satiety & reduced hunger

-    Usually used for 8-12 weeks

-    May induce rapid weight loss

-    Average weight loss 18-20% with improved sustained weight reduction

-    Improves BSL control in DM2

-    Improved BP in HTN

-    Reduces total cholesterol

 

Indications

-    Obesity with BMI >30 or >27 with co-morbidities

 

Contraindications

-    Pregnancy

-    Breast feeding

-    Porphyria

-    Recent AMI

-    Unstable Angina

-    Infants, children, adolescents (<18yrs), elderly (>65yrs)

-    EtOH dependence

-    Drug abuse

-    Caution in psychological disturbance

 

Side Effects

-    Sensitivity to cold

-    Dry skin

-    Rash (temporary)

-    Hair loss (temporary)

-    Postural hypotension, dizziness, fatigue

-    Diarrhoea, constipation

-    Muscle cramps

-    Haliotosis

-    Irritability

-    Menstrual disturbance

-    Cholelithiasis

-    Gout

-    Electrolyte disturbance (Na, K+)

-    LFT derangement (temporary)

-    Reduced BMD

 

Monitoring

-    GP or dietician review every 4 weeks

-    Baseline

-     BMI & waist circumference

-     BP, HR

-     FBE, Iron studies, U&E, LFT, Lipids

-     Urinalysis (with ketones, pH & microalbuminuria)

-     +/- ECG if other indication

-    +/- Repeat at 6 weeks

-     FBE, U&E, LFT

-     Urinalysis (with ketones, pH & microalbuminuria)

-    Repeat at 3 months if planning to continue

-     FBE, U&E, LFT

-     Urinalysis (with ketones, pH & microalbuminuria)

 

 

 

References

 

Obesity: Recommendations for management in General Practice and Beyond; AFP, Vol 42 No 8 August 2013