Managing Appetite on a Very Low Energy Diet (VLED)
This information is general in nature and does not replace personalised professional advice. Please contact your healthcare team if you have any questions or concerns.
Why Does Appetite Increase on a VLED?
If you are following a VLED, it is very common to notice changes in appetite, especially during the transition into the diet (the first few days up to around 1 to 2 weeks). During this time, your body is adjusting to a much lower energy intake and shifting how it fuels itself [1]. Temporary increases in hunger are normal and expected. It is not a sign you are failing or doing anything wrong.
What to expect?
First week
During the first week, hunger can be very strong and at times hard to manage. This often is the most difficult in the first few days before your body adjusts to its new situation.
You may experience:
Increased hunger or frequent thoughts about food, especially early on [2]
Stronger cravings for carbohydrate-rich foods, particularly foods that were previously eaten regularly [3]
Feeling unsettled around eating routines or mealtimes [2]
This happens because:
Hunger hormones temporarily increase when energy intake drops [1,4]
The body has not yet fully adapted to using body stores (of fat primarily) as its main fuel source [2,4]
Usual eating habits, portion sizes and food textures have changed [3]
Second week and beyond
For many people, appetite becomes more manageable after the first week.
You may experience:
Physical hunger decreases compared with the first week [1]
Cravings become less frequent or less intense [3,5]
Appetite feels more stable across the day [6,7]
This happens because:
The body becomes more efficient at using fat stores for energy [4]
As body stores are used for fuel, ketones (which results from this process) act to reduce the excessive physical hunger seen with less intensive calorie restrictions [4,8]
Blood glucose fluctuations are reduced [5,8]
It is still common for non-physical hunger (emotional or head hunger) to continue, even when physical hunger improves [9,10].
The Three Types of Hunger
Hunger is not one single sensation. It can help to think about hunger as having three main forms: stomach (physical) hunger, heart (emotional) hunger, and head (psychological) hunger.
1. Stomach (Physical) Hunger
Physical hunger is driven by the body’s biological need for energy. It is often felt as stomach growling, low energy, or a sense of emptiness. The sense of discomfort or emptiness is felt specifically in the gastro-intestinal tract (ie. your stomach or gut) [10].
Why it happens on a VLED:
Reduced energy intake [1,2]
Hormonal shifts during early weight loss [1,4]
Adjustment period before appetite regulation settles [1,4]
Strategies to help:
Spread VLED products evenly across the day [11]
Maintain adequate fluid intake (water, mineral water, herbal teas) [12]
Use warm fluids (broth, tea) to increase fullness [12]
Include non-starchy vegetables (if permitted in your plan), such as leafy greens, zucchini, cucumber, capsicum, mushrooms, cauliflower and broccoli to increase fibre, which helps with fullness [12]
Give yourself some grace... and time... Physical hunger often improves as the body adapts [1,4,13]
Have some extra lean protein foods (eg. boiled eggs, lean chicken breast, lean deli meats (such as lean leg ham with no fat), tinned tuna in brine or spring water). These lean protein foods can help you feel fuller while adding very few extra calories [11,12]
2. Heart (Emotional) Hunger
Emotional hunger is linked to feelings rather than physical need. Stress, boredom, anxiety, fatigue or low mood can increase the urge to eat, particularly if food has been a source of comfort in the past [14].
Why it may increase on a VLED:
Food restriction removes a familiar coping strategy [14,15]
Increased stress around change or weight loss goals [14,15]
Heightened emotional awareness when eating patterns change [15]
Heightened emotional state if the VLED is being undertaken prior to a surgery, due to the anxiety surrounding this procedure [16,17]
Strategies to help:
Noticing patterns between emotions and hunger can reduce guilt and increase self-awareness [18]
Use alternative non-food based coping strategies (movement, breathing, massage, sip cup of herbal tea and relax to some music, take a warm bath, connecting with friends or family – even a quick phone call can help) [15]
Use of non-caloric food or fluids (eg. herbal tea, diet jellies or no-added-sugar ice poles for a sweet hit) [12]
Have some self-compassion, emotional hunger is not a lack of willpower. It reflects learned coping mechanisms and human needs. If you do end up eating something outside the VLED protocol, use it as an opportunity to reflect on the trigger and think about an alternative for next time [18]
Seek professional support if emotions around food feel overwhelming and you would like some assistance to investigate this [16,17]
3. Head (Psychological) Hunger
Head hunger is driven by thoughts, habits and environmental cues rather than physical need. Examples include eating because it is a usual mealtime, seeing others eat, habits such as eating while watching a move, fear of getting hungry later or cravings for specific foods [19].
Why it may increase on a VLED:
Food restriction increases food awareness [15]
Old eating habits can still be triggered, even if you are trying to eat differently [20]
You can still be influenced by the people and the environment around you [20]
Strategies to help:
Eating meals and snacks at regular times can help reduce mental fatigue [21]
Having a menu plan helps to reduce likelihood that you will eat outside of this [22]
Use mindful pauses to identify what is driving the head hunger (eg. ask yourself, “What am I actually needing right now?”) [18]
Redirect attention with non-food activities (eg. walking, reading) [15]
Reminding yourself that the VLED is temporary and part of a broader plan [23]
How to manage your diabetes on a VLED?
If you have diabetes and take medications to lower blood sugar, it is important to speak with your doctor or diabetes educator about how to manage your diabetes while on a VLED. Some diabetes medications can increase the risk of low blood sugar levels (hypos) on a VLED. You should manage these hypos as you normally would, but ideally with advice from your doctor or diabetes educator to adjust medications where needed to help prevent them [13,14].
For more information on treating hypos please go to: https://baker.edu.au/-/media/documents/fact-sheets/baker-institute-factsheet-hypoglycaemia.pdf
Contact your healthcare team if you are having frequent or severe hypos [13].
When to reach out for extra support
Call 000 immediately if:
You cannot treat a hypo yourself [25]
You become confused, drowsy, or lose consciousness [25,26]
Symptoms do not improve after treatment [25,26]
Contact your dietitian or healthcare team if:
Hunger or ‘food noise’ feels unmanageable past the first 2 weeks and is affecting sleep, daily function, mood or mental health [27]
You are transitioning off VLED and hunger spikes, so you can a structure plan for introducing a variety of foods (this is a known time when appetite can rise) [1]
You have symptoms that worry you (eg. dizziness or fainting) [25,26]
References
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