Significant weight loss followed by regain has been suggested to decrease subsequent weight loss velocity and resting metabolic rate (RMR), as well as adversely influence blood lipids and blood pressure. We examined weight loss and metabolic changes resulting from a very low calorie diet (VLCD) in ten obese women (high previous weight loss=HWL) with a previous weight loss/regain of at least 18 kg (mean=28.6 kg) compared to eleven obese women (low previous weight loss-LWL) with a maximum prior weight loss/regain of 9 kg (mean=6.5 kg). Weight, RMR, blood pressure and blood lipids were determined before and after an 11 week dietary regimen of 420 kcal/day. Weight loss (HWL=15.1 kg; LWL=15.2 kg) and the decrease in RMR (HWL=13.1%; LWL=11.8%) were similar in both groups, respectively. There were no baseline group differences in blood pressure, serum total cholesterol, HDL-cholesterol, or triglycerides. Diet-induced changes in these variables were similar for both groups. Women with either high or low previous weight loss/regain responded in a similar manner to severe caloric restriction.