Outcomes and Predictors of Success for Very Low Calorie Diets in an Australian Publicly Funded Bariatric Medicine Service.

OBJECTIVE: Enablers of successful completion and outcomes from Very Low Calorie Diets (VLCD) conducted in real-life clinical settings are poorly understood. This study explored weight and metabolic changes following VLCD and identified baseline factors associated with VLCD completion, weight-loss, and weight-loss maintenance. METHODS: A retrospective chart review was conducted for patients beginning VLCD between February 1, 2018 and October 31, 2020 at an Australian bariatric medicine service. Univariate analyses assessed weight, glycemic control, blood pressure, and cholesterol changes following 6 and 12 weeks of VLCD. Multivariate analyses explored factors predicting clinically significant weight-loss (CWL), VLCD completion and weight-loss maintenance. RESULTS: The 90 patients who completed VLCD had statistically significant improvements in mean weight and percentage weight lost, blood pressure, glycemic and cholesterol control at 6 (all p < 0.0001) and 12 weeks (all p < 0.0001). Obstructive sleep apnea (OSA) and depression symptoms were negative predictors of CWL (all p < 0.05). Weight lost by week 6 positively predicted VLCD completion (p = 0.01); weight-promoting medications negatively predicted this (p = 0.02). CONCLUSIONS: Weight promoting medications may hinder VLCD completion. OSA and depression have the potential to impede weight-loss from VLCD. Addressing these factors before starting VLCD may enable better adherence and outcomes.