***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: To determine the optimal energy intake of very-low-calorie diets ( VLCDs ) , 76 obese women were r and omly assigned , in a double-blind fashion , to one of three liquid-formula diets : 1758 kJ/d ( 420 kcal/d ) , 2763 kJ/d ( 660 kcal/d ) , or 3349 kJ/d ( 800 kcal/d ) . Weight , body composition , symptoms , mood , and acceptability of the diet were assessed throughout the 6-mo study . There were no significant differences in weight losses or changes in body composition among the three dietary conditions at the end of treatment , nor were there significant differences among conditions in acceptability of the diet , symptoms , or mood . These results suggest that there is no clinical advantage to using VLCDs that provide less than 3349 kJ/d ( 800 kcal/d ) This study investigated the acceptability of two very-low-calorie diets in 16 moderately overweight persons participating in a weight reduction program . Subjects were prescribed a 1000 - 1200 kcal balanced diet the first month and asked to complete appetite and mood scales on a weekly basis . They were then r and omly assigned to either a protein-sparing-modified fast ( PSMF ) or a protein-formula-liquid diet , each of which provided about 400 kcal daily . Analysis of the appetite data showed that PSMF subjects reported significantly less hunger and preoccupation with eating than did liquid diet subjects during 2 of the 4 weeks on a very-low-calorie diet . Subjects in both conditions reported significant reductions in anxiety . Results are discussed in terms of possible advantages of PSMF Respondents may answer sensitive questions differently depending on the mode of assessment ( e.g. , question naire , interview ) . The possibility of differences in these mode effects across groups is an important assessment consideration given the implication s for test-score validity and bias . Although differences in mode effects are highly relevant to issues in clinical assessment , research is limited and generally fails to make use of psychometrically sound methods . The present research argues for greater attention to demographic differences in mode effects with regard to the assessment of psychopathology . Analyses of differences in mode effects in depression assessment are presented for gender , age , and education based on data from 440 community adults .  Depression symptom ratings from a structured clinical interview were regressed on a self-report state depression composite score ; analyses tested for differences of intercept and slope across gender , age , and education . Neither slope nor intercept differences were found for gender , but intercept differences were obtained for both age and level of education . These results indicate that younger and better educated respondents receive somewhat lower than expected ratings of depression in interviews , given their level of self-rated symptoms . These findings suggest that use of a single mode of assessment over- or underpredicts depression in certain participants . More generally , they demonstrate the value of multi method assessment of psychopathology and justify further inquiry into mode-effect differences in clinical assessment BACKGROUND & AIMS The benefits of serologic screening and early diagnosis of celiac disease in asymptomatic patients are not known . We investigated the impact of a gluten-free diet on self-perceived health and well-being in symptomatic and asymptomatic patients with celiac disease . METHODS We performed a prospect i ve study of 698 consecutive adults newly diagnosed with celiac disease because of classic ( n = 490 ) or extraintestinal ( n = 62 ) symptoms or through screening of at-risk groups ( n = 146 ; 23 were asymptomatic and analyzed separately ) . The survey included questions on health and well-being ; quality of life was evaluated by the psychological general well-being ( PGWB ) question naire . Patients were followed for 1 year of treatment ; 110 healthy subjects served as controls . RESULTS On a gluten-free diet , self-perceived health improved significantly among patients with classic symptoms and those detected by screening . Patients in all groups were equally concerned about their health before the diagnosis , but anxiety was alleviated by the gluten-free diet . At diagnosis , the quality of life reduced among all 3 groups but improved significantly among patients on the diet . Among the 23 asymptomatic patients , perception of health worsened and concern about health increased while they were on the diet . CONCLUSIONS Self-perceived health and well-being were low among patients at the time they were diagnosed with celiac disease . Most patients benefited from a gluten-free diet , so it is important to identify patients with celiac disease . Perception of health decreased among asymptomatic cases , which discourages population -based screening Very-low-calorie diets ( VLCDs ) cause rapid weight loss . However , weight regain is rapid upon discontinuing the VLCD unless lifestyle is altered . The addition of a behavioral-modification ( BMOD ) program improves the long-term outcome . The major components of a BMOD program to alter lifestyle are education about nutrition and eating habits with alteration of amount and patterns of eating , institution of an aerobic activity program design ed to increase energy expenditure , training in self-awareness and assertiveness , and training in coping techniques for long-term alteration of lifestyle . By retrospective chart review , we evaluated two VLCD programs at the same institution . One program gave 12 wk of BMOD before a 12-wk course of VLCD ( Program 1 ) , then scheduled individual visits regularly thereafter . The other program used simultaneous VLCD and BMOD in a 26-wk treatment course ( Program 2 ) , consisting of 2 wk of stabilization on 5020 kJ/d ( 1200 kcal/d ) , 12 wk of VLCD , and 12 wk of transition to a low-calorie solid food diet . Follow-up was obtained at 1 y in both groups . Maximum weight loss was similar , but subjects in Program 2 regained about one-third of the lost weight versus approximately 10 % in Program 2 . A third program of preceding BMOD followed by a low-calorie diet ( Program 3 ) gave similar weight maintenance at 1 y as Program 1 . Prospect i ve studies are needed to determine if BMOD simultaneously with or preceding VLCD promotes better long-term weight maintenance . These data confirm the benefits of long-term follow-up for maintaining weight loss OBJECTIVE Excess weight has been associated with numerous psychological problems , including depression and anxiety . This study examined the impact of intentional weight loss on the psychological well-being of adults participating in three clinical weight loss interventions . METHODS This population consisted of 588 overweight or obese individuals r and omized into one of three weight loss interventions of incremental intensity for 12 months . Psychological well-being was measured at baseline and 6 , and 12 months using the Psychological Well-Being Index . RESULTS Mean weight loss was 5.0 pounds at 12 months . Weight change at 12 months was associated with higher overall psychological well-being ( r = -.20 , p < .001 ) , lower levels of anxiety ( r = -.16 , p = .001 ) and depression ( r = -.13 , p = .004 ) , and higher positive well-being ( r = -.19 , p < .001 ) , self-control ( r = -.13 , p = .004 ) , and vitality ( r = -.22 , p < .001 ) . Vitality was found to be the best predictor of weight change at 12 months ( p < .001 ) . CONCLUSIONS Weight loss was associated with positive changes in psychological well-being . Increased vitality contributed the largest percentage of variance to this change Rationale Cigarette smokers weigh less than nonsmokers , and smokers often gain weight when they quit . This is a major barrier to smoking cessation , especially among women . However , strict dieting is not recommended during smoking cessation out of concern that it might promote relapse . This concern derives , in part , from the observation that calorie restriction increases self-administration of drugs of abuse in animals . This relationship has never been experimentally demonstrated in humans . Objectives To evaluate whether calorie restriction increases cigarette smoking in humans . Methods Seventeen ( nine males , eight females ) healthy , normal-weight smokers not attempting to quit were cycled in partially counterbalanced order , double-blind , through four diets — normal calorie ( 2,000–2,800 kcal/day ) , low calorie ( 700 kcal/day deficit ) , low-carbohydrate (CHO)/normal-calorie , and low-CHO/low-calorie — for 6 days per diet in an inpatient research ward . Smoking was assessed by cigarette counts , breath carbon monoxide ( CO ) levels , and cigarette craving . Results Compared with the normal-calorie diet , while on the low-calorie diet , subjects smoked 8 % more cigarettes ( P<0.02 ) and had 11 % higher breath CO levels ( P<0.01 ) . The low-CHO/normal-calorie diet showed no significant effect on either variable , but there was a 15 % increase in breath CO levels ( P<0.05 ) on the low-CHO/low-calorie diet . There were no changes in self-reported cigarette craving or mood . Conclusions Consistent with animal studies , moderate calorie restriction was associated with a small but statistically significant increase in cigarette smoking , with no independent effect of CHO deprivation . These findings suggest that dieting may increase smoking behavior and could impede smoking-cessation attempts OBJECTIVE Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery . The role of mental health providers in this population is not well defined , and the selection of c and i date s is often the result of clinical judgment alone . The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric b and ing ( LAGB )  by ( 1 ) examining changes in depressive symptoms and quality of life in the year following surgery ; ( 2 ) evaluating the interaction between patterns of change in depression , quality of life , and weight postsurgery ; and ( 3 ) identifying presurgical psychological predictors of initial weight change . METHOD Participants were 101 severely obese adolescents aged 14 to 18 years receiving LAGB at the Center for Adolescent Bariatric Surgery at the Morgan Stanley Children 's Hospital of New York Presbyterian/Columbia University Medical Center between August 2006 and December 2009 . Measures of height , weight , depressive symptoms , and quality of life were obtained in the first year following surgery . Changes in the Beck Depression Inventory ( BDI ) , Pediatric Quality of Life Inventory ( PedsQL ) , and body mass index were analyzed using latent growth curve modeling . RESULTS Short-term changes in psychiatric symptoms and weight were analyzed using latent growth curve modeling . Significant changes in total BDI ( βslope = -0.885 , SE = 0.279 , P < .01 ; βquadratic = 0.054 , SE = 0.021 , P < .001 ) and PedsQL ( βslope = -0.885 , SE = 0.279 , P < .001 ) scores were observed following LAGB , and comparable postoperative changes between psychosocial variables and body mass index were also noted ( BDI : covariance [ COV ] = 0.21 , SE = 0.06 , P < .001 ; PedsQL : COV = -0.41 , SE = 0.10 , P < .01 ) . Two variables ( family conflict/loss of control eating ) were found to be significant predictors of weight change over the year following surgery ( P < .05 ) . CONCLUSIONS Adolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB , and measures of preoperative binge eating and family conflict affected postsurgery body mass index among youth . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01045499 This study compared the  weight losses of 49 obese women r and omly assigned to a 52-week behavioral program combined with either moderate or severe caloric restriction . Subjects in the balanced deficit diet ( BDD ) condition were prescribed a 1,200-kcal/day diet throughout treatment , and those in the very-low-calorie diet ( VLCD ) condition were given a 420-kcal/day liquid diet for 16 weeks and a 1,200-kcal/day diet thereafter . The VLCD subjects lost significantly more weight than the BDD subjects at all periods through Week 26 , at which time mean losses were 21.45 and 11.86 kg , respectively . VLCD subjects , however , regained weight during the next 26 weeks of weekly therapy and during a 26-week weight maintenance program that provided biweekly meetings . Mean weight losses at the end of the maintenance program were 10.94 and 12.18 kg , respectively . Reports of binge eating declined in both groups , and no relationship was observed between binge eating and weight loss or attrition Objective : Although it has been hypothesized that the depression – obesity relation is bidirectional , few studies have addressed this hypothesis in a prospect i ve setting . We aim ed to examine the bidirectional relationship in middle-aged and elderly women . Subjects : A total of 65 955 women aged 54–79 years in the Nurses ’ Health Study were prospect ively followed from 1996 to 2006 with up date d information on body weight , depression status and various covariates every 2 years . Depression was defined as self-report of physician-diagnosed depression and /or antidepressant use . Obesity was defined as a 
    Output:
    
There are conflicting findings regarding the effect  very low calorie diets ( VLCDs )  have on  self-reported depressive symptoms and anxiety levels .