Question
Do you have information on the changes in cholesterol on VLCD's and LCD's? Most of our clients have had great improvements, but there are a few that I don't understand. Some peoples LDL's and Total Cholesterol have increased. These clients have lost a significant amount of weight as well. I want to be able to give them a good explanation if there is one.
Answer
Most patients will see a big drop in their total and LDL. It is for a number of reasons, including improved insulin sensitivity.
There are a few people who will see a temporary rise in cholesterol then followed by a drop. The theory is that cholesterol is being liberated by the fat cells, though there is not much hard evidence on that. However, it is not felt to be a significant risk factor and is usually temporary.
There is a group of super-morbidly obese patients with very low cholesterol levels. As they lose a large amount of weight, their cholesterol actually rises. It is an interesting phenomenon. It usually stays elevated despite the weight loss. I usually am aggressive with treating these patients with statins. —John Hernried, MD