What’s To Be Lost by Trying a Formula Diet?

Dr George Bray's article "Obesity: Is There Effective Treatment?" (CONSULTANT, July 2002, page 1014) was informative and useful. However, I would like to point out an effective therapy that was not included: the protein-sparing fast. This treatment uses medically designed liquid protein formulas that contain all necessary electrolytes, fiber, vitamins, and other nutrients. We have prescribed these formulas for years and have had considerable success with them-so long as patients are properly counseled on maintenance dietary restrictions when feeding resumes.

-Andres Anacker, MD
  Richmond, Calif

In my view, "very low calorie diet" is a more appropriate term for the type of diet you describe. Diets based on food, liquid, or powder formulas had their heyday in the 1980s and may still have a role in settings in which rapid weight loss is required before surgery. However, because such diets can cause hypokalemia and cardiac arrhythmias, medical monitoring is necessary. I prefer diets based on "meal replacements," which use foods with a known caloric value, such as frozen entrees, liquid diet drinks, and dietary bars.

-George A. Bray, MD
  Boyd Professor
  Pennington Biomedical Research Center
  Louisiana State University
  Baton Rouge