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—Dr Locke's thoughtful comments confirming the safe and uncomplicated use of VLCDs in healthy subjects are welcome. His experience with VLCDs in reducing hypertension adds impressively to the mounting conviction that an important potential therapy may have been uncovered. Clearly, loss of weight, when necessary for persons with various medical problems, is not without risk. It is, therefore, important for anyone contemplating dieting to have a thorough physical examination prior to beginning the diet.It is on the issue of continuous medical monitoring of healthy individuals that I feel our data do not justify either the financial burden to the patient or the consumption of professional resources. Any of the conditions that would require insulin or β-blocker therapy will be identified in the prediet physical and would certainly be monitored by the physician. Some of the symptoms that Dr Locke attributes to unsupervised use of the diets, such