In Reply Dr Hall and colleagues take issue with the 3500-kcal restriction to lose 1 lb referenced in the Viewpoint. A mathematical model based on laboratory measurements for predicting individual and population weight loss was previously published,1 in which the example recommends that an individual decrease his or her daily intake from 3000 kcal/d to 1800 kcal/d to lose 44 lbs over 6 months. This clearly would be a laudable achievement. I do not wish to argue with their calculation, but do suggest that asking patients to decrease their daily intake by almost one-third is not a realistic goal.
Guth E. Reducing Calories to Lose Weight—Reply. JAMA. 2018;319(22):2337–2338. doi:10.1001/jama.2018.4265
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