Table 2.

Key recommendations for clinicians advising patients undertaking very-low-energy diets (VLEDs)

Compliance—Continued adherence to a VLED may prove difficult for some patients who elect to trial a VLED. Frameworks that facilitate sufficient compliance with the intervention should be strongly considered prior to its implementation. This may include diet personalisation to optimise adherence, reduce hunger or provide self-monitoring [91]

Symptomology—Patients should be adequately counselled before commencing the diet with respect to the common symptoms. These may include fatigue, bloating, cold intolerance, constipation, haemorrhoid formation and dizziness. Development of these symptoms would require reporting to the responsible clinician [92]

Cholelithiasis susceptibility—Dietary composition may contribute to cholelithiasis formation [92]. This may be reduced by a proportional increase in fat content, relative to other macronutrients [93]

Mitigation of weight regain—VLEDs and LEDs are both associated with weight regain following the intervention period [92]. This may be addressed in part by counselling with respect to other lifestyle factors that contribute to weight loss maintenance [94]