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Article
January 5, 1990

Responsible and Irresponsible Use of Very-Low-Calorie Diets in the Treatment of Obesity

Author Affiliations

Drs Wadden and Blackburn are consultants to the Sandoz Nutrition Co and Dr Van Itallie is a consultant to the United Weight Control Corp. Both companies offer multidisciplinary programs for the treatment of obesity that may include the use of a very-low-calorie diet (ie, providing <3.4 MJ/d).
From the University of Pennsylvania School of Medicine, Philadelphia (Dr Wadden); Columbia University College of Physicians and Surgeons at St Luke's—Roosevelt Hospital Center, New York, NY (Dr Van Itallie); and New England Deaconess Hospital and Harvard Medical School, Boston, Mass (Dr Blackburn).

Drs Wadden and Blackburn are consultants to the Sandoz Nutrition Co and Dr Van Itallie is a consultant to the United Weight Control Corp. Both companies offer multidisciplinary programs for the treatment of obesity that may include the use of a very-low-calorie diet (ie, providing <3.4 MJ/d).
From the University of Pennsylvania School of Medicine, Philadelphia (Dr Wadden); Columbia University College of Physicians and Surgeons at St Luke's—Roosevelt Hospital Center, New York, NY (Dr Van Itallie); and New England Deaconess Hospital and Harvard Medical School, Boston, Mass (Dr Blackburn).

JAMA. 1990;263(1):83-85. doi:10.1001/jama.1990.03440010081036
Abstract

AMERICA'S most celebrated weight loss was announced on November 15,1988, when Oprah Winfrey disclosed to her 18 million television viewers that she had lost 30.5 kg (67 lb) in 4 months by consuming a medically supervised very-low-calorie diet (New York Times. November 24,1988:B17). Ms Winfrey's announcement sparked a frenzy of interest among the nation's dieters, reminiscent of that which greeted the appearance of the liquid protein diets in 1976 and 19771 and the Cambridge Diet in the early 1980s.2 Sadly, consumption of these diets was inadequately supervised; at least 58 deaths were reported among users of liquid protein products1,3 and 6 deaths in persons who consumed the Cambridge Diet.2

Current very-low-calorie diets that provide essential nutrients and high-quality proteins are unquestionably safer than their liquid protein predecessors, as noted in a timely report prepared by the American Medical Association's Council on Scientific Affairs.4 But the

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