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Doctor Hilary Jones Answers More Questions about Very Low Calorie Diets

November 25, 2011 - Dr Hilary Jones, Health & Nutrition

Want to hear more from our live web chat with Dr Hilary Jones?

We asked for your weightloss questions on our LighterLife Facebook and LighterLife Twitter streams and Dr. Hilary was live online to provide his answers. Here are some of the questions that came up…

I’ve lost over 6 stone so far, and would like to lose another 4 stone. l am on Total but have been told l have gout which is a side effect of the diet, the doctor told me it’s because l’m not eating proper food, have you heard of this, and if so would moving to Lite help?
Make sure you are drinking enough water because gout can be precipitated by dehydration as a result of uric acid build up in the joints. Some people simply make more uric acid than others any way. Uric acid is derived from proteins called purines (from fish roe and red meats in an ordinary diet) and it’s possible that a very low calorie diet (VLCD) could contribute slightly to a pre-existing condition. If your gout is very occasional you could take an anti-inflammatory tablet to counter the symptoms, but if it’s more frequent you could ask your Doctor about uric acid lowering tablets that are taken on a daily basis to prevent gout occurring. Either way it is about benefit versus side effects. If you are losing weight and getting the benefit from that I would say that an occasional bout of gout might be a price worth paying.

I lost 4 stone on Total but about 1 stone has crept back on and I hate this. I have tried to get back into the Programme again to lose it but can’t last more than 8 days, I know it works and would only need 4 weeks to be back feeling on top of the world. Any advice would be fab as I hate myself for letting this happen.
Don’t worry, this happens. It’s always a testing time going from the Total Programme to a Programme where the calorie intake is higher. You have two options – you can either increase your level of exercise or look carefully at the foods you have re-introduced and your mental approach to them. Talk to your Counsellor who will be well versed in what you need to do. You’ve enjoyed success before and you can do it again.

Why can’t people with Bipolar Disorder join LighterLife?
With Bipolar Disorder, as you know, you will experience quite significant mood swings, which can influence your lifestyle choices and general behaviour. This makes it much harder to adhere to the guidelines which you need to follow on a VLCD and because we all want to do our upmost to make sure people’s dietary choices and mindset about food is as healthy as possible we do not recommend that a VLCD is used in this condition. Talk to your Doctor or specialist for further guidance but I see no problem with you consulting an NHS dietician with a view to embarking on a high protein, low-carbohydrate diet instead.

Is it true that your metabolic rate slows down if you do a VLCD? You read lots of articles about how the body goes into starvation mode and is therefore less effective? What are your thoughts about metabolic rate?
Your metabolic rate certainly slows down if you fast completely and eat nothing. On a VLCD, however, your metabolic rate will not significantly change, especially if you are already overweight and keeping as active as usual. If you wish you could increase the amount of exercise you take which is healthy any way, but do remember to drink to thirst to avoid dehydration.

Is there a minimum weight you need to be to do this type of diet? I think I only need to lose about 1.5 stones would this be suitable?
Anyone with a BMI over 25 can embark on a VLCD because sometimes it’s the last one and a half stone which people find the hardest to lose. Sometimes you need a dramatic solution where other methods have not worked. You could try to increase your exercise levels and start a high-protein, low glycemic index diet, which if you did religiously would certainly work. It might cost you even more than a VLCD however, and prove harder to follow. Why not try a VLCD and see how you get on? I don’t think you’ll be disappointed.