Healthcare professionals Clinical treatment protocol Long-term weight management with the OPTIFAST VLCD Program

Long-term weight management with the OPTIFAST VLCD Program

Long-term weight management with the OPTIFAST VLCD Program

While the focus of the OPTIFAST VLCD Program is on weight loss, what is just as important is identifying behaviours and strategies for successful weight maintenance. Maintaining lost weight is just as important as the weight loss itself and does require ongoing monitoring by a healthcare professional.

Following weight loss, people must overcome potent physiological responses that increase hunger and encourage weight regain, as well as resisting returning to previous weight promoting lifestyle habits1.  Weight management, however, does get easier over time. Once people have maintained a weight loss for 2-5 years, the chances of longer-term success dramatically increases1.  The OPTIFAST VLCD Program is designed to assist with long-term weight management. The gradual reintroduction of food across the three Levels (Active 2, Active 1 and Maintenance), helps patients to learn about appropriate food choices and portion sizes in a controlled and supported manner. In addition, the Active 2, Active 1 and Maintenance Levels can be followed as a long-term weight-maintenance plan.

It is advised that VLEDs should not be used alone but in conjunction with cognitive and behavioural counselling for permanent lifestyle changes. This is highly recommended as research shows that weight invariably will be regained after VLEDs if used without additional measures2.

When following the OPTIFAST VLCD Program, cognitive behaviour counselling can begin during the VLED period. Topics such as increasing exercise and day to day activity levels, stimulus control, increasing consumption of low starch vegetables and limiting sedentary activities or sitting time can be advised. Then following the VLED period, cognitive behavioural sessions need to be carried out in more normal living conditions. Topics such as slowing the pace of eating, separating food from other activities, shopping for food according to a list, not using food as a reward, appropriate portion sizes and including the whole family can be discussed3.

In addition, other behaviours have also been associated with successful long-term weight maintenance. These include;

  1. Regular monitoring of weight to catch lapses before they become large-scale weight gains 
  2. Regular monitoring of food intake and maintaining a consistent eating pattern. 

While most of these strategies involve self-management, healthcare professionals play an important role in continuous monitoring to review weight and behaviours, provide continuing support, reinforce lifestyle and behavioural advice and discuss intensive interventions when needed1.

 
Long-term weight maintenance strategies:

1.    Set up three monthly regular review visits to monitor weight and continue to provide support by reinforcing lifestyle and behavioural changes.
2.    Set a weight regain limit (e.g. 3-4kg) at which reintervention is sought1.
3.    If the weight regain limit is attained, reinforce lifestyle and behaviour changes and consider an intensive intervention.
4.    The OPTIFAST VLCD Program under the supervision of a healthcare professional can successfully and effectively be used in the following ways to assist long-term weight management:
     a. Reintroduction of Intensive Level for 2-6 weeks if weight regain limit or higher is achieved4.
     b. Use Intensive Level intermittently for two weeks every three months as part of a continuous weight management program4.
     c. Use as a meal replacement for 1-2 meals per day as part of a continuous low energy weight management program5.

If you are interested in learning more about bariatric surgery and the OPTIFAST VLCD Program, here is some information .

References

1.    National Health and Medical Research Council., Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. National Health ad Medical Research Council, 2013.
2.     Mustajoki, P. and T. Pekkarinen, Very low energy diets in the treatment of obesity. Obesity Reviews, 2001. 2: p. 61-72.
3.     Gibson, A.A., et al., Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obes Rev, 2015. 16(1): p. 64-76.
4.    Lantz, H., et al., Intermittent versus on-demand use of a very low-calorie diet: a randomised 2-year clinical trial. Journal of Internal Medicine, 2003. 253: p. 463-471.
5.    Ryttig, K.R. and S. Rossner, Weight maintenance after a very low-calorie diet (VLCD) weight reduction period and the effects of VLCD supplementation. A prospective, randomised, comparative, controlled long-term trial. Journal of Internal Medicine, 1995. 238: p. 299-306.

  • Overview of Very Low Energy Diets

    Very Low Energy Diets (VLED), also known as Very Low Calorie Diets (VLCD) have been shown to be very effective in the management of obesity, with weekly weight losses averaging approximately 1.0 -2.5kg per week, providing greater initial weight loss than other forms of calorie restriction.

  • Expected rate of weight loss on Intensive Level

    During the Intensive Level of the OPTIFAST Program, weight loss averages 1.0 to 2.5kg/week with an average total loss of 20kg after 12 to 16 weeks.

  • Long term weight loss goals

    It is often mentioned in the lay press and amongst healthcare professionals that "the faster you lose weight, the quicker you regain it", yet there is little evidence to support this assumption and in fact the opposite may be true.

  • Mechanics of a VLED

    A VLED works by restricting total energy intake to approximately 800 calories (3300kJ) or less per day. Weight loss with a VLED is achieved by restriction of both carbohydrate and total energy intake. This enables the body to use its body fat stores for energy via a metabolic process called ketosis.

  • Patient suitability

    For a patient to succeed with the OPTIFAST VLCD Program, it is important to assess their readiness to undertake the necessary behaviour changes required for effective weight management.

  • Calculating ideal body weight

    Ideal body weight is calculated to help determine an appropriate weight for height or to determine a long term weight loss goal. We recommend that you use the ‘Adjusted Ideal Body Weight’ calculation.

  • Calculating protein requirements

    OPTIFAST VLCD is formulated to contain adequate high quality protein in sufficient quantities for nitrogen sparing and to preserve lean body mass.

  • Medical monitoring

    As a healthcare professional, you can tailor the program to suit your patient's specific needs.

  • Long-term weight management with the OPTIFAST VLCD Program

    Research has shown that having the support and guidance of a healthcare professional will make the program more successful for your patients.

  • Bariatric surgery and the OPTIFAST VLCD Program

    Surgical intervention by way of bariatric surgery can result in substantial weight loss that is sustained over the long term when combined with education, ongoing monitoring and patient support.

  • Diabetes and the OPTIFAST VLCD Program

    Most overweight and obese patients with Type 1 or Type 2 diabetes are eligible to use OPTIFAST VLCD as part of an overall management program that emphasises the importance of ongoing weight maintenance.

  • References