The role of very-low-calorie diets in obesity

The popularity of very-low-calorie diets (VLCDs) is enormous, but questions persist about their safety and their long-term efficacy. This article addresses the following questions: who should be placed on a VLCD? when should a patient go on a VLCD? how much should an individual lose? where should a VLCD program be carried out and by whom? It stresses the importance of evaluating VLCD programs by their long-term goals and long-term results. Also, a few of the unanswered questions in VLCD treatment are addressed. Finally, worrisome financial-ethical questions of the business of VLCDs is discussed.