To the Editor.
—I was very pleased to read the article by Kreitzman et al.1 Management of obesity and its complications using the newer very-low-calorie diets (VLCDs) should receive more attention in the literature. Experience with these formulas is distinctly different from that with the predecessor liquid protein diets that have been discussed so extensively.My interest in VLCDs, like Dr Kreitzman's (oral communication, June 1983), began with a personal experience. Using the same formula, I managed an 18-kg net weight loss that I have maintained for 1½ years. Subsequent extensive use of the formula in my practice has resulted in several observations that I must share.Though proper use of this type of formula is deemed safe, the overwhelming majority of persons using it do not do so under medical supervision. Frequent, often avoidable problems do arise. Persons seeking medical attention after long periods of unsupervised use may