Hello I just came about this thread through noticing people visiting one of my pages from this thread on the risks of very low calorie diets. I read through the whole thread phew and just wanted to say a good on you to Macnoodle.
I see a lot of people jumping on her but consider this, here is a doctor whom has actually weighed the pros and cons, decided that in her opinion it is not safe and rather then make money due to people making regular appointments with her just to sign a form she has decided to recommend against it instead?
One of the biggest problems with doctors these days is they don't sit back and look at the research themselves before forming an opinion or recommendation. Rather, choosing to simply take the opinion of the drug companies or simply dogma (e.g. the food pyramid!) at face value or let the $$$ incentives sway their decision instead.
It takes integrity to do what she is so good for her, lets just hope shes the same with other things such as drugs like statins and anti-depressants
Now on to VLCD stuff, first of all, I want to say that the last thing I would ever think of a person on such a diet, is that they are a moron. Being obese downright sucks and there's many reasons why a person becomes obese, NO-ONE WANTS TO BE OBESE and comming out of the other side is DAMN HARD. Some obese people don't even eat all that much in the first place! WEIGHT LOSS IS NOT EASY and if you find that it is then YOU ARE LUCKY. I don't know the answer to getting from that position and having everything click into place (this is probably the biggest issue for various reasons) so I don't think badly of a person following a VLCD but that doesn't change how I feel about VLCD's. Whom I think badly of is the people behind such diets whom probably know better, the weight loss industry is a huge money spinner.
I see a lot of talk about emotional eating and being obsessed with food as a reason why LL should be recommended, its great these people have lost the weight and maintained it and it is great if they have overcome these issues but have you ever considered that it was not the result of the diet itself but rather the support? And if you agree that it was the support then would it be so bad for a doctor to rather recommend someone begin their weight loss journey through something with less risks and rather get support somewhere else?
There was actually a research study not too long ago that found a support network to be a vital factor in maintaining weight loss BUT it is important to realise that a person does not need to pay for a VLCD or even pay for anything to achieve that. You guys could easily start up a support network right here on your forum, you will have just as much experience as those so called counselors if not more through your own journeys and shared experiences.
Also, in regards to the comment regarding obsession with food. If you are getting this under control for good through a VLCD then you are one of the lucky ones. The reason I say this is that it is very common for very low calorie diets to cause eating disorders and obsession with food. This is probably one of the most common risks (and can even be a risk on a more milder diet just not to the same degree) and to be honest personally, I would not want to be worked through coming of a very low calorie diet and entering a refeeding stage by someone whom really may have very little experience.
Obviously, one size does not fit all and there is no easy answer. But personally I don't think VLCD's are the answer. Obviously there may be situations where someone has to do that as they need to lose weight quickly in a short space of time for a major operation etc so perhaps for them the benefits may outweigh the risks.
If someone was to do a VLCD though I would at least tell them to ensure they have fat with each meal, say 15g to help minimise their risks for gallstones as well as to ensure they absorb their vitamins and minerals. You can have all the vitamins you like in your shake but remember they are not very well absorbed and some are fat soluble and thus require fat to be absorbed. Also, to only stay on for a maximum of say 8-12 weeks at a time. 12 weeks is the furthest they have been studied and even by then your thyroid may already be impaired and may not return to it's baseline (another common reason for the yo-yo effect).
This is another important factor why a VLCD may be a bad idea as thyroid disease is very common and may be why you are obese in the first place and thus dieting to hard may just make it worse! You may think its emotional eating but it may not be the whole truth. Hypothyroidism doesn't just slow your metabolism down, it makes you feel like shit, it will cause lack of energy, cravings, depression you name it! Unfortunately, it is commonly undiagnosed with patients being chucked on an anti-depressant instead (another common cause for weight issues, emotional eating and probably diabetes 2) to make things worse it is not always picked up in blood tests which are very controversial.
To the person I think wannabe? thank you for sharing that information regarding the counselors, that is a very important factor to consider and I don't understand why she is being knocked for it. You know here in Australia my partner and my son joined a karate club several years ago that knock on your door. They had yellow belts as karate instructors but people wouldn't know as these instructors would wear a black and white striped belt! How would you feel about paying money for your kid to be trained by someone whom may have only been doing karate for a month or two? What if they were injured? It is not any different to what Wannabe showed...