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Twelve trials met the study criteria, with a total of 36, 397 patients

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It has been shown previously that 14% weight loss due to a very-low-energy diet (VLED) resulted in counter-regulatory changes in appetite-regulating hormones, including a significant increase in fasting levels of ghrelin and significant reductions in the fasting levels of leptin, GLP-1, peptide YY (PYY), cholecystokinin (CCK) and amylin 48