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Randomized Controlled Trial
. 2024 Sep 16;16(18):3125.
doi: 10.3390/nu16183125.

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

Megan L Gow  1 , Hiba Jebeile  1   2 , Eve T House  1   2 , Shirley Alexander  3 , Louise A Baur  1   3 , Justin Brown  4   5 , Clare E Collins  6   7 , Chris T Cowell  1   8 , Kaitlin Day  9   10 , Sarah P Garnett  1   8 , Alicia Grunseit  11 , Mary-Kate Inkster  4   10 , Cathy Kwok  1   3 , Sarah Lang  10 , Susan J Paxton  12 , Helen Truby  13   14 , Krista A Varady  15 , Natalie B Lister  1   2
Affiliations
Randomized Controlled Trial

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

Megan L Gow et al. Nutrients. .

Abstract

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 (p < 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, p = 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.

Keywords: acceptability; adolescent; dietary intervention; obesity; safety; very-low-energy diet.

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Conflict of interest statement

LAB has received honoraria for speaking in forums organized by Novo Nordisk in relation to the management of adolescent obesity and the ACTION-Teens study, which is sponsored by Novo Nordisk. ACTION-Teens is a multi-country on-line study of attitudes towards and perceptions of obesity held by adolescents living with obesity, their parents and health care professionals and LAB is the Australian lead of the study. KV has received author fees from Hachette Book Group for the book, The Every Other Day Diet. The funders of this study had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Individual participant changes in weight (kg) and BMI expressed as a percentage of the 95th percentile (BMIp95) during the 4-week very-low-energy diet phase.
Figure 2
Figure 2
Number of participants experiencing at least one side-effect and total number of side-effects reported at each time point during the very-low-energy diet phase. Participants with side-effect data at each time point were: day 3–4, n = 111; week-1, n = 129; week-2, n = 129; week-3, n = 122; week-4, n = 130. Note: some participants reported more than one side-effect at certain time points.
See this image and copyright information in PMC

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