Lancet Regional Health trial: 800–900 kcal diet gave 54% remission, 86% reported side effects
In a 12-week trial of 96 adults with obesity and prior type 2 diabetes, a diet of 800–900 kcal a day produced remission in 54%, but most participants reported side effects.
A study in The Lancet Regional Health examined a very low-calorie diet in 96 participants aged 18 to 45 with obesity and earlier type 2 diabetes who did not use insulin, ad-hoc-news.de reports. After 24 weeks, 27 of 50 participants in the intervention group (54%) were in remission, compared with two people (4%) in the control group ad-hoc-news.de
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Trial design and results
The intervention group followed a diet of 800 to 900 kcal per day for twelve weeks, split into about 30% protein, 50% carbohydrate and 20% fat. It was combined with two supervised sessions of aerobic and strength training and one independent session per week, followed by a twelve-week weight-maintenance phase. Average weight loss was 18.5 pounds in the intervention group against 2.6 pounds in the control group.
However, 86% of the intervention group reported side effects, including constipation, headache, dizziness and sensitivity to cold. The report concludes that such a strong calorie restriction should not be undertaken without close medical supervision.
Nutrition expert Aline Pamsl says that below roughly 1,000 kcal a day the body switches to an emergency program: water is lost first, while basal metabolic rate falls, and weight usually rises again soon after a crash diet ends. According to her, people who diet four, five or six times a year build up more body fat in the long run ad-hoc-news.de
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What clinicians recommend for weight loss
Specialists quoted in the report say weight loss should reduce fat tissue while protecting muscle. They advise avoiding ultra-processed foods and, in steatosis, alcohol. Evening carbohydrates are not forbidden; total energy balance and combining carbohydrates with fibre and high-quality protein matter more. GLP-1-based injections should be used only under a physician's care, as nausea, vomiting and constipation may occur.
At a cardiology training event in Bad Wörishofen attended by 130 physicians, participants stressed lasting lifestyle change. An extra 500 to 1,000 steps a day is described as life-prolonging, and a 5 to 10% weight reduction within six to twelve months as a realistic goal. Drugs such as Wegovy or Mounjaro allow up to 20% weight loss and bariatric surgery up to 35%, but without strength training lean mass may be lost, and weight may return after stopping medication. The physicians also suggest a one-time lipoprotein(a) test; values above 50 mg/dl indicate raised cardiovascular risk.
