Research

Adherence

Very low carbohydrate diets (VLCDs) are less effective for weight loss than less restrictive LCDs, but this is explained by lower adherence rather than the diet itself.

If you try a very strict low carb diet (under 50g carbs/day) and find it too hard to maintain, you might lose less weight. This isn't because the diet doesn't work, but because it's harder to stick to. If you can't maintain the strict version, a less restrictive low carb diet (under 130g/day) is a viable alternative that still offers significant benefits for diabetes remission and weight loss.

ModerateQualifiesMEDIUM confidence
VLCDs were less effective than less restrictive LCDs for weight loss at six months. However, this effect was explained by diet adherence. That is, among highly adherent patients on VLCDs, a clinically important reduction in weight was seen compared with studies with less adherent patients on VLCDs.
Joshua Z. Goldenberg et al. · BMJ · 2021

Why this rating

Moderate certainty evidence for weight loss, with subgroup analysis providing context.

Source

Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data

Joshua Z. Goldenberg et al. · BMJ · 2021

DOI 10.1136/bmj.m4743

Meta-analysis · 23 studiesCited 420×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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