Low Calorie Diets

Every effective diet is ultimately a reduced calorie diet. Some achieve this
through macronutrient restriction without conscious caloric reduction and others
by direct calorie counting. It is the latter sort of diet, one that focuses directly
on calorie intake that I will focus upon here.

Portion reduction predates the concept of calories. It is plainly obvious that
starvation leads to weight loss and so it is not surprising that people would
conclude that deliberate weight loss should also involve starvation be it total or
partial.

Indeed deliberate portion reduction is effective and total starvation very much
so. Unfortunately, total starvation leads to death and therefore hardly
constitutes a lifestyle change. Even used in the short term, total starvation is
extremely dangerous and causes serious loss of lean body mass including muscle
and vital organs. Total starvation plays no legitimate role in weight control
today.

Protein sparing fasts are designed to provide dieters with only the bare minimum
of daily protein in order to reduce lean tissue loss. Along with protein, these
diets generally provide electrolytes though not necessarily enough for all
patients. Protein sparing fasts are covered in more detail here. Protein sparing
fasts are the most radical of the modern approaches to weight control and they
do produice rapid weight loss, but there is no evidence that this manner of
weight reduction is any easier (and may be harder) to maintain than slower
approaches.

Classical "low calorie" diets generally provide somewhere between 800 and 1800
daily calories. Above about 1800 calories the distinction between a deliberately
"low" calorie diet and macronutrient-restricted diets begins to blur. Perhaps the
most commonly encountered calorie limit for diets is 1200 per day. Many people
have tried such diets.

People following moderately low calorie diets generally feel hungry and this
sensation grows more intense the longer people adhere to this calorie limit.
Interestingly, this sort of hunger may not accompany very low calorie diets like
protein sparing modified fasts because those radical diets induce a metabolic
condition called ketosis which reduces appetite. Unfortunately, diets above
roughly 1200 daily calories induce little ketosis and therefore leave people
increasingly ravenous and this is the principle problem with such diets. In the
end, moderately low calorie diets are effective as long as people follow them
butfollowing them becomes increasingly difficult as appetite grows.

Thus it is the essential criterion of liveability that low calorie diets fail to satisfy
and this failure has caused them to fall into deserved disfavor. The only
circumstances under which I will prescribe a low calorie diet for a patient is
when the patient has an urgent need for rapid weight loss in order say, to
undergoe bariatric surgery or because of extremely brittle type-2 diabetes and
then, in those rare circumstances, I generally prescribe a protein sparing
modified fast.

Otherwise, low calorie diets are rather barbaric and totally fail to recognize that
patients are human beings who get hungry and not robots that can simply
"dial-in" a daily calorie limit.