Efficacy, Safety and Acceptability of a Very-Low-Energy Diet in Adolescents with Obesity: A Fast Track to Health Sub-Study

• Published in: Nutrients 2024-09, Vol.16 (18), p.3125
• Main Authors: Gow, Megan L, Jebeile, Hiba, House, Eve T, Alexander, Shirley, Baur, Louise A, Brown, Justin, Collins, Clare E, Cowell, Chris T, Day, Kaitlin, Garnett, Sarah P, Grunseit, Alicia, Inkster, Mary-Kate, Kwok, Cathy, Lang, Sarah, Paxton, Susan J, Truby, Helen, Varady, Krista A, Lister, Natalie B
• Format: Article
• Language: English
• Subjects: Adolescent; adverse effects; Body composition; Caloric Restriction - methods; Carbohydrates; Children; Clinical medicine; constipation; COVID-19; Diabetes; Diet; Diet, Reducing - methods; Dietitians; Energy; Exercise; Families & family life; Female; headache; Health aspects; Humans; hunger; Intervention; Ketosis; Male; males; Metabolism; nausea; Nutrition research; Obesity; Obesity in adolescence; Patient Acceptance of Health Care; Pediatric Obesity - diet therapy; Pediatrics; randomized clinical trials; surveys; taste; Teenagers; Treatment Outcome; Type 2 diabetes; very low calorie diet; Weight control; Weight Loss; World health; Youth
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16183125

The aim of this study was to determine the efficacy, safety and acceptability of a 4-week very-low-energy diet (VLED) program for adolescents with obesity. Adolescents (13-17 years) with obesity and ≥1 obesity-related complication were Fast Track to Health 52-week randomized controlled trial participants. Adolescents undertook a 4-week micronutrient-complete VLED (800 kcal/day), with weekly dietitian support. Anthropometric data were recorded at baseline and week-4 and side-effects at day 3-4, week-1, -2, -3 and -4. Adolescents completed an acceptability survey at week-4. A total of 134 adolescents (14.9 ± 1.2 years, 50% male) had a 5.5 ± 2.9 kg ( < 0.001) mean weight loss at week-4: 95% experienced ≥1 and 70% experienced ≥3 side-effects during the VLED program, especially during the first week. Hunger, fatigue, headache, irritability, loose stools, constipation and nausea were most common. Reporting more side-effects at day 3-4 correlated with greater weight loss at week-4 (r = -0.188, = 0.03). Adolescents reported 'losing weight' (34%) and 'prescriptive structure' (28%) as the most positive aspects of VLED, while 'restrictive nature' (45%) and 'meal replacement taste' (20%) were least liked. A dietitian-monitored short-term VLED can be implemented safely and is acceptable for many adolescents seeking weight loss, despite frequent side-effects. Investigating predictors of acceptability and effectiveness could determine adolescents most suited to VLED programs.