ABSTRACT There are conflicting findings regarding the effect very low calorie diets (VLCDs) have on self-reported depressive symptoms and anxiety levels. Some studies have reported decreased

subjective depressive symptoms and anxiety post-diet, whereas other studies have not. Further complicating matters, the protocol for VLCDs vary substantially across studies, which could

account for the mixed findings. The primary goal of this meta-analysis and systematic review was to determine the effect VLCDs have on subjective depressive symptoms and anxiety pre- to

post-diet. In addition, potential moderators (the presence/absence of behavioral therapy, duration of diet, inclusion/exclusion of low intensity exercise, and amount of weight lost) were

significantly decreased pre- to post-diet when behavioral therapy was implemented during the diet, the duration of the diet was relatively long (8–16 weeks), low intensity exercise was

included, and the dieters lost 14.1 kg or more post-diet. However, no difference in depressive symptoms were observed pre- to post-diet when behavioral therapy was not included, the diet was

shorter (1–7 weeks), no exercise was implemented and dieters lost <14 kg of weight post-diet. There was no change in anxiety pre- to post-diet. Health care providers involved in

supervising VLCDs should consider using a VLCD of at least 8 weeks that includes behavioral therapy and low intensity exercise in order to enhance the potential benefits of VLCDs on

depressive symptoms. More research is required to examine the effect of VLCDs on anxiety. Access through your institution Buy or subscribe This is a preview of subscription content, access

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AND ANXIETY Article Open access 03 July 2024 PHYSICAL EXERCISE AND MAJOR DEPRESSIVE DISORDER IN ADULTS: SYSTEMATIC REVIEW AND META-ANALYSIS Article Open access 14 August 2023 ADHERENCE TO

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AND AFFILIATIONS * Department of Psychology, Ryerson University, Toronto, Ontario, Canada Natalie Ein, Bonnie Armstrong & Kristin Vickers Authors * Natalie Ein View author publications

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permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Ein, N., Armstrong, B. & Vickers, K. The effect of a very low calorie diet on subjective depressive symptoms and anxiety: meta-analysis

and systematic review. _Int J Obes_ 43, 1444–1455 (2019). https://doi.org/10.1038/s41366-018-0245-4 Download citation * Received: 12 April 2018 * Revised: 22 August 2018 * Accepted: 16

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