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January 5, 1994

Very Low-Calorie Diets for Obesity-Reply

Author Affiliations

National Institutes of Health Bethesda, Md

JAMA. 1994;271(1):25. doi:10.1001/jama.1994.03510250040021

In Reply.  —We thank Drs Kaplan and Stifler for their comments regarding our article on VLCDs. We agree, as we stated in our article, that VLCDs are clearly effective in promoting short-term weight loss. Unfortunately, no short-term nonsurgical intervention for obesity has been shown to provide long-term maintenance of lost weight for the majority of patients. Obesity is a chronic condition, and as such, any treatments developed need to be continued indefinitely in order to maintain their effectiveness. Without ongoing support or intervention, lifetime changes in diet, behaviors, and— perhaps most important—physical activity are difficult if not impossible for most individuals to sustain.Health care professionals play an important role in determining which patients will benefit medically from weight loss, as well as identifying psychological and social factors that may impact on the type and intensity of any treatment provided. Adjunctive treatments, including anorectic medications1 or surgical treatment in