Very low calorie diets safe for teens with obesity when monitored by a dietitian, study finds
In recent findings set to be unveiled at the European Congress on Obesity (ECO) in 2024, researchers assert that stringent low-calorie diets, when under the vigilant oversight of seasoned dietitians, hold promise for adolescents grappling with moderate to severe obesity.
The study, originating from Australia, explored the viability and tolerance of very low energy diets (VLEDs) among teenagers, revealing an overall positive reception despite some experiencing adverse effects. VLEDs, characterised by a daily intake of 800 calories or less through specialised meal replacements like bars and shakes, aim to fulfil essential nutrient needs while offering an alternative path to weight loss. This approach is particularly geared towards young individuals who have found little success with traditional diet and exercise regimens, presenting a potential prelude to a more balanced diet without resorting to bariatric surgery.
Historically, the application of VLEDs in youth has been approached with caution due to scant data concerning potential side effects—ranging from headaches and fatigue to muscle cramps and digestive issues—and their impact on overall growth, cardiac health, and psychological well-being. This hesitancy underscores the significance of the study conducted by Dr. Megan Gow and her team at the Children’s Hospital Westmead Clinical School, affiliated with The University of Sydney, Westmead, Australia.
The research delves into the initial phase of the “Fast Track to Health” study, specifically the first four weeks during which participants engaged in a nutritionally balanced VLED to initiate weight loss. The cohort, comprising 141 adolescents aged 13 to 17 years with obesity and at least one obesity-related complication (e.g., hypertension, insulin resistance, or dyslipidemia), was divided to receive either four Optifast meal replacement products daily alongside low carbohydrate vegetables and a teaspoon of vegetable oil or a similar regimen with three meal replacements and one solid meal of lean meat and vegetables.
Support was provided through weekly consultations with a dietitian, with assessments at baseline, weekly intervals, and a comprehensive survey to gauge the diet’s acceptability, detailing aspects the participants found favourable or unfavourable.
Despite prevalent side effects, the adherence rate was notably high, with an average weight loss of 5.5kg observed across participants. The majority reported experiencing multiple side effects, including hunger, fatigue, headaches, and gastrointestinal disturbances, with the incidence peaking in the first week. Interestingly, a correlation was observed between the early onset of side effects and more substantial weight loss, hinting at higher compliance with the dietary restrictions.
Feedback on the VLED’s practicality and enjoyment yielded mixed reviews, with the structured nature and the tangible outcomes of weight loss cited as positives, whereas the restrictive diet and the palatability of meal replacements drew criticism.
The findings advocate for the short-term safety and potential acceptability of VLEDs under professional guidance for adolescents with significant obesity challenges. Dr. Gow emphasises the necessity for further research to pinpoint those who would benefit most from this approach. She advocates for the incorporation of VLEDs into clinical guidelines for managing severe obesity and related health issues in young people, positioning it as a preliminary step before considering medication or surgery.
Adolescents and their guardians are encouraged to consult healthcare professionals to explore suitable treatment avenues for obesity.
This study not only sheds light on the pragmatic aspects of implementing VLEDs among adolescents but also underscores the importance of professional oversight and the need for a broader discourse on obesity management in younger populations.
