Evolving dietary strategies in the management of obesity: a narrative review

Purpose: This article reviews recent dietary strategies for obesity management, with particular attention to low-calorie diets (LCDs), low-carbohydrate diets, intermittent fasting (IF), and structured dietary patterns.Current Concepts: Dietary intervention remains a cornerstone of non-pharmacological obesity treatment. A LCD, defined as a daily caloric reduction of 500 to 1,000 kcal from baseline, typically produces weight loss of approximately 0.5 to 1.0 kg per week and is considered both safe and practical. IF has demonstrated comparable weight loss efficacy to LCDs and may be an option depending on individual characteristics and medical status. However, evidence is still limited, and because of the risk of hypoglycemia, IF is generally not recommended for patients with type 2 diabetes. Additional approaches, such as low-carbohydrate diets and Mediterranean-style dietary patterns, have shown variable metabolic benefits. Meta-analyses suggest that the degree of carbohydrate restriction alone does not yield additional cardiovascular benefits, with outcomes depending largely on the quality of macronutrient substitutions.Discussion and Conclusion: Ultimately, rather than promoting any single dietary strategy, reducing overall caloric intake remains the fundamental principle of obesity treatment. Within traditional Korean diets, a modest reduction in carbohydrate intake may also enhance metabolic outcomes.