Severe vs. Moderate Energy Restriction in Obese Postmenopausal Women

Severe energy restriction (<800 kcal/day) is effective for weight loss, but known side effects (e.g., hair loss, fatigue) have limited its use. In this trial, 100 obese postmenopausal Australian women (mean age, 58; mean body-mass index, 34 kg/m²) without osteoporosis were randomized to receive either a severe or a moderate energy–restricted diet. The moderate diet cut energy intake by 25% to 35% relative to estimated energy expenditure using a healthy food–based plan. The severe diet cut energy intake by 65% to 75% relative to estimated expenditure for the first 4 months using commercial meal-replacement products, then relaxed to a moderate diet plan for the remaining 8 months of the study.

At 12 months, the severe-diet group, compared with…