To the Editor.
—We applaud the National Institutes of Health National Task Force on the Prevention and Treatment of Obesity1 for its well-balanced presentation of very low-calorie diets (VLCDs). An important point not made by the authors concerns appropriate criteria for evaluating the effectiveness of VLCDs. They were designed as a procedure for weight loss; as such, they have repeatedly been demonstrated to be effective.2 Since VLCDs are, by definition, used short term, they are not useful for maintenance of long-term weight loss. Thus, it should come as no surprise that obese patients who have been successful on a VLCD would regain weight without continued support for a change in lifestyle. Poor long-term weight control data speak to the ineffectiveness of treatment models and program content. In addition, as stated by the authors, averages can hide successful groups of individuals. A two-year follow-up of three samples of patients
Kaplan GD, Stifler LTP. Very Low-Calorie Diets for Obesity. JAMA. 1994;271(1):24. doi:10.1001/jama.1994.03510250040020
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