Adherence

While VLEDs produce rapid initial weight loss, long-term maintenance (1-2 years) is variable and often incomplete, with average losses ranging from 0 to 13.1 kg, suggesting that VLEDs alone are insufficient for sustained weight loss without adjunct therapies.

Don't expect a VLED to be a one-time fix. You will lose weight fast, but you will likely regain some of it over the next year or two. To keep the weight off, you must use the VLED as a starting point and immediately engage in behavioral changes or medical support to maintain the loss.