Jaggu wrote:What would you consider as a very low calorie level? .
It would depend on the person, their height, weight, activity levels, etc etc, but remember I am not recommending calorie levels or calorie counting. Therefore, the best marker would be how quickly the weight is being lost. Most professionals in the field recommend no more than 1/2-2# per week and that is why the weight loss in the above study is considered "rapid", though I am not sure I agree. Studies have shown that people who lose more than 3 pounds per week may have a greater risk of developing gallstones than those who lose weight at slower rates and that is probably one of the places where the above recommendations of no more than 2#/week comes from.
However, again, we have to put this in perspective. Often these results are from studies using a very low-calorie diet (VLCD) which by traditional definition, provides about 800 calories per day in food and/or liquid form. Studies on these diets have shown that 10 to 25 percent of people on a VLCD developed gallstones. These gallstones are usually what are called "silent" which means they did not produce any symptoms. However, about one-third of the dieters who developed gallstones, did have symptoms. So, 1/3 of 10-25 is 3-8% had symptoms and this is on a 800 calorie diet. But, no one here is recommending such a regime so the results may not (and most likely do not) apply here to you or to anyone following the MWL which encourages you to eat whenever hungry till comfortably full. Those VLCD diets are also very low in fiber which is another contributing factor to this issue. The MWL is very high in fiber, so again, these results may not apply.
Also remember, that in spite of all the cautions, there is really little evidence for serious side effects of rapid weight loss, if it is done in a healthy way, and for many, the risk of the excess weight and the benefit of getting the weight off quickly, may outweigh any potential risks. As the study in my above post showed, there were few if any problems and those subjects lost a very substantial amount of weight in a short period.
Jaggu wrote:3 lbs and over per week is considered as rapid weight loss but what about continuous weight loss let's say on an average 2-2 1/2 lbs per week for few weeks initially and then 1 lb a week and then 0.5 lbs per week till reaching the final weight with a total weight loss of 50-55 lbs over a period of year. Would you consider that as a rapid weight loss?.
Again, there is no single answer. All these questions and their answers depend on the specific situation and the specific person. The answer would be very different for someone trying to lose weight weighing 300 lbs and someone trying to lose weight weighing 145 lbs. Another recommendation you often hear is 1% of body weight per week. For a 300 lbs person this would be 3#/wk and for a 145 pound person this would be 1.45/wk. That makes more sense to me as this is relative to the person and their weight and not just a random absolute number. But again, remember, most all recommendations are "general" recommendation and again, I am not sure I always agree with them or if they always apply here and to anyone's specific situation here.
The real irony is that the risk for gallstones increases as BMI increases. Studies have shown that the risk may triple in women who have a BMI greater than 32 compared to those with a BMI of 24 to 25. The risk may be seven times higher in women with a BMI above 45 than in those with a BMI below 24. A BMI of 45 is very high and related to many serious health problems and not just gallstones. So in this case, both the current weight, and the need to get it off quickly both could increase risk for gallstones. Yet for someone with a BMI Of 45, which is around 300# for someone around 5'8, losing 2#/week is not very much at all and would take them over 50 weeks just to get to a BMI of 30 where they are still at risk for weight related issue and gallstones. Would you recommend they lose 2# or less per week or more?
This is why there is never a simple answer or a single answer that always applies to every individuals specific situation.
The problem here today is that when you hear a risk like say, 1 in 10,000, you figure maybe it is not a serious risk or issue. But, when you are the one, (as you are here) it is suddenly a serious issue.
Jaggu wrote:Can the gallstones form in matter of say six months ...?.
Yes.
Jaggu wrote:You said, GB issue can be dealt with if it develops. How do you deal with it? Is there a way to deal with it without surgery or removing it? .
There are both surgical and not surgical (drug, sound waves) methods that are commonly used. However, I am not sure it applies in the situation of someone who experiences them from rapid weight loss if they are done with the rapid weight loss. My recommendation would be to discuss this with your MD and/or email Dr McDougall to see what they say. My guess is, that if the problem was from rapid weight loss and the weight has stabilized, this may no longer be a problem.
BTW, the traditional dietary treatment recommended for issues surrounding gallstones (prevention, treatment, etc) is to follow a low fat (especiallylow animal fat) healthy diet based on fresh fruits, veggies, whole grains, etc and to lose excess weight if necessary and to maintain an active lifestyle.
Jaggu wrote:Thanks for your timely post. Appreciate it.
You are welcome,
In Health
Jeff