Extreme Diets: Life on 800 Calories a Day

CNN News Wire | 12/16/2009, 9:30 p.m.
Her death made headlines around the world: Samantha Clowe, a 34-year-old British woman, died suddenly this fall from a previously ...

Her death made headlines around the world: Samantha Clowe, a 34-year-old British woman, died suddenly this fall from a previously undiagnosed heart condition. At the time of her death, Clowe was following a plan called LighterLife, a very low-calorie diet designed to help obese and severely obese patients lose weight.

She was consuming 530 calories a day.

"Samantha came to LighterLife with a BMI of 37, weighing more than 17 stone ," says a spokesperson for the company. "Although she managed to lose 3 stone , her health may have already been compromised." An inquest determined that Clowe most likely died from cardiac arrhythmia but could not determine what role, if any, Clowe's diet played in the development of her condition, only that her death "may be related to her low calorie diet and weight loss."

Very low-calorie diets have been used to help obese and severely obese patients lose weight for more than two decades. "Next to bariatric surgery, nothing is more effective for weight loss than a VLCD, including pills and other diets," says Dr. John Hernried, medical director for OTC Medical Weight Loss Group, a weight-loss clinic in California.

But the diet "is not indicated for someone who wants to lose 10 pounds." Most programs screen potential participants to ensure they are psychologically and medically stable enough to begin the process.

Gordon Heitman, 46, a California man, lost 233 pounds in just over a year on a VLCD that allowed him to eat an average of 800 calories a day.

"For the most part I wasn't hungry," says Heitman. "I was fine with what I was eating."

The diets use a process called ketosis to prompt the body to burn stored fat for energy while being fed anywhere from 500 to 800 calories a day. Patients may eat or drink only manufactured food, shakes, and snack bars especially created for and sold through specific programs. The products are designed to supply the patient with adequate nutrition without offering excess calories.

"This is a very specialized diet," says Hernried. " We are taking on full responsibility for [the patient's] nutrition."

In the United States, there are at least four certified VLCD diets, each run by a different company. Dieters enrolled in any of the programs purchase shakes, snack bars, and meal replacement foodpacks directly from the doctor or clinic supervising them. In the U.S., a day's worth of products usually has an average of 800 calories. Costs vary, but a year on a VLCD could cost between $6,000 and $10,000, if the person strictly follows the plan, which would include paying for program food and visits to the clinic to check in with the doctor.

" are very safe and effective diets only if they are done under medical supervision,"says Hernried. "Not all VLCDs are made equal."

Hernried has lectured on very low-calorie diets for more than a decade and supervises a VLCD program in his California clinic. He believes every low-calorie program must have regular involvement from a medical professional and incorporate lifestyle changes, exercise, and enough calories in order to be effective and safe for the patient.