I do not advocate doing SS below BMI 25 but I do think that we get into a lot of scare-mongering on the matter of VLCDs.
Basically when we get into ketosis we are in a state of 'managed starvation' and that is how we lose weight fast.
But look at all of the people who live with 'unmanaged starvation' and go on for years and years and years e.g. POWs in WWII, hostages, famine stricken countries - they are starved and recover. Indeed research would indicate that periods or starvation can be beneficial - the development of the JUDD Diet is evidence of this.
My point is that we are resiliant and getting our panties (or boxers) into a twist about wasted heart muscle is not helpful.
Look at all of those who live with anorexia for years and then go on to recover (I know that people die too) - so let's all be careful and follow the rules but let's not frighten ourselves and eachother - so many of us are just waiting for any excuse to pack it in - don't let an anecdotal health scare provide us with yet another reason.