Optifast

Have you tried losing weight by carefully measuring your food portions and noticed that the scale still doesn't move? Many people find it difficult to accurately determine portion sizes and eat consistent amounts of food day after day. In fact, studies show that most people actually consume about 50% more calories than they actually think they do. This is not because they are in denial about what they eat. They simply do not have the skills to accurately track what they are eating.

Clinical studies also show that when people are given very few food choices, or even no food choices, it is easier to decrease the amount of calories they consume each day. By taking away the selection and preparation of foods, and reducing the vast array of available foods, people lose weight. This is the concept called “"stimuli narrowing".” By using a portion-controlled formula diet, such as OPTIFAST, all the nutrition needed each day is included. The benefits of this type of diet are in the reduced calories, complete nutrition, and perhaps most importantly, in the ability to stick with the diet because no food choices are made.

Imagine taking a break from food. While your body loses weight and your health improves, you will use the time to learn about good nutrition and healthy eating habits so that when you are again eating food, you are better equipped to manage it.

OPTIFAST weight management products offer:

· High quality, complete nutrition.

· Pre-portioned and calorie-controlled servings.

· Quick and simple preparation.

OPTIFAST has been used for over 25 years—hardly a fad diet.

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The OPTIFAST Formula has all the nutrients that are required for good health. This is something that nearly all fad diets do not have. In fact, the initial liquid diets that were used in the 1970's were much different – they used low quality protein with few other essential nutrients. Today, liquid diets are medically supervised to ensure safety. When was the last time you were on a diet and were being closely followed by a physician who was trained specifically to help you, and to ensure the safety of your treatment.

As far as gaining back the weight, this could happen IF a person just did the liquid formula diet and made no other changes, like the latest fad diets. Our team of professionals, including behaviorists, dietitians, and exercise specialists, provide very intensive education and support. This is necessary to help individuals successfully discover their own issues related to weight management and help guide them in changing their habits. Plus, our maintenance program provides the on-going support needed to help make these long-term changes in your lifestyle.

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The feeling of hunger and the impulsive desire to eat are real concerns. The causes of hunger, whether physical or emotional, are difficult to determine. To increase success in sticking with the diet program, controlling hunger is a primary objective. This control involves both preventing and managing hunger sensations. The Program staff will suggest various techniques to accomplish this goal. The good news is that, for most participants, hunger sensations fade within a few days to two weeks after starting the Program.

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Dealing with social eating events is one of the topics that the staff in the OPTIFAST Program will help you work through. There are a number of options to consider and strategies that people have successfully used to help them enjoy these social events and still stick to the program. Although initially apprehensive, many patients find that not eating is actually the easiest part of the program. Being successful long-term involves improving your eating habits and choices and including regular physical activity.

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Our program is not merely a "diet." This word refers to the way we feed our bodies. But the word "diet" to many people means something like this, "DIE-ett: a painful, unrewarding form of punishment involving reduced food intake." This is why we refer to the way we eat with our program as “"lifestyle nutrition".” Trivial semantics? Not really.

The InterMountain Clinical Nutrition staff has discovered that one of the biggest challenges people face when they attempt to lose unwanted body fat and improve their health is to allow themselves to believe they can and will succeed—to begin with an open and optimistic mind. However, when they think they're starting a "diet," their minds immediately begin to send negative, self-defeating messages such as, "Diets don't work... I'm going to be so hungry... I'm going to miss out on all the fun at parties, weddings, celebrations... other people can diet, but I just can't do it... after all, diets don't work." The result? They create their own reality. They fail because they decide (unconsciously) to fail.

Our program is based on scientific research as well as what works and what doesn't work in the real world. Therefore, we have to accept the fact that people (including us!) love food. We want to eat. We need to eat. The good news? Our program teaches you how to eat and helps you build the necessary skills for developing healthy eating habits.

Also, participants in our programs can continue to use limited amounts of OPTIFAST products on an ongoing basis – for convenience or to reduce the number of food choices.

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Yes! Eating for comfort or to relieve anxiety is one of the biggest challenges facing America today. Many physicians and psychiatrists often refer to food as " America 's most popular and widely abused anti-anxiety medication." When you think of it this way, you can understand more accurately the detrimental effects eating for the wrong reasons has on our bodies and lives.

Eating for emotional reasons may be a behavior learned at a very young age, even as an infant. These patterns need to be changed before anyone can achieve the long-term success they are looking for with the OPTIFAST Program. One of the keys to changing behaviors is not to just focus on eliminating the "bad ones" but to incorporate new ones into our daily habits.

For example, people who often eat late at night, especially carbohydrates, need to commit themselves to changing this behavior. We've found that one of the things that works for many participants (who, just like you, eat for comfort too!) is whenever they feel like heading for the kitchen (the refrigerator), they stop and ask themselves if they're eating to fuel their body or to feed their emotions. Then they write the answer to that question down on a notepad kept next to the refrigerator. If they find what they were about to do was eat for comfort, they immediately go to another room (i.e., home office), and write. They write about how they feel, what they're planning to achieve the next day, and they just keep writing (sometimes even cards to friends) until they feel they've released the negative energy that was trying to "come out" by eating.

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Most individuals find them pleasant and satisfying. Some may prefer one flavor over others. Remember that these products are designed to replace food entirely for a limited duration of time. This makes them much different than some commercially available nutritional formulas and products, both in taste and nutritional quality.

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When you compare costs, some commercial programs have hidden costs that aren't emphasized in their advertisements. In fact, when you consider the amount of time it will take to lose 40 pounds or more on some of these programs, they may not be less expensive. Generally they do not provide the same level of service by skilled healthcare professionals. Be sure to ask them for their average weight loss or 5 year outcomes…we think you'll be surprised at the answers! Plus, with our program you have on-going support in our Maintenance Program at no additional charge.

Because this program is physician supervised, some health insurance plans may cover a portion of the program charges.

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All OPTIFAST formulas are nutritionally complete, containing high quality biological protein and meeting 100% of the U.S. RDIs. Individuals are medically monitored to reduce the potential for side effects and to maximize improvements in weight-related health risks.

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Full formula diets provide a unique set of advantages when used by individuals in weight management programs. Many significantly overweight people have developed deeply entrenched eating behaviors that contribute to their excess body weight. Cutting back on food portions, as is done in traditional weight loss programs, has not worked for these people long-term. Replacing the usual food items in their diet, with a pre-measured, ready to serve, nutritionally balanced formula provides many advantages including:

Portion and calorie control.
Optional nutritional intake.
Decreased encounters with food cues during the day as a result of a significant reduction of time and effort required for planning and obtaining meals.

§ Prolonged opportunity to break the cycle of old eating patterns. This is important considering it takes 6 weeks to learn a new behavior.

§ Gradual reintroduction of self-prepared foods during the Transition phase of the treatment to allow new eating behaviors to be established.

(Many individuals report that it is a relief to “"take a vacation" from food” and the often angst-provoking food choices.)

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With self-prepared foods, it is not possible to achieve a balanced 800 calorie diet that meets nutritional requirements. Studies utilizing doubly labeled water to quantify the energy balance in obese subjects on prepared foods indicate that people tend to underestimate calorie intake and overestimate energy expenditure. Research comparing the use of meal replacements (MR) versus self-prepared meals, consistently shows greater weight loss with MRs than with self-prepared foods.

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Phytochemicals and nutraceuticals derived from plant based foods provide a variety of health benefits. Most experts believe, however, that the benefits attributed to these substances only occur if people consume a diet rich in plant based food for a prolonged period of time. USDA surveys of the American diet have found few people eat an adequate amount of plant based foods. The latest data examining 1998 food consumption patterns indicates that the majority of Americans eat less than half the recommended amount of produce and whole grains each week. Much of the produce they consume is in less nutritious forms, like fried potatoes, lettuce drenched in dressing, and corn smothered with butter. Given the fact that people have maintained good nutritional status after consuming a full formula diet for a decade or more, and that most people are not eating sufficient produce and whole grains, the twelve-week full formula diet is probably not long enough to impair phytochemical status. Furthermore, during the transition phase people will be taught to build a diet rich in fruits, vegetables and whole grains. Ultimately, they will end up with a diet richer in phytochemicals and fiber than the one they were consuming when they entered the program.

Remember most people do not become obese because they ate too much of a well balanced diet. In fact, the nutritional status of many individuals is improved during the full formula diet phase of the OPTIFAST program.

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When evaluating weight management approaches, it is important to remember that OPTIFAST® was designed for individuals who are significantly overweight and are at health risk because of this excess weight. Individuals who use OPTIFAST have been unsuccessful using the traditional balanced deficit diets and less intensive approached to weight management. OPTFAST is not a diet per se. It is a comprehensive health risk management system designed to address obesity and weight driven diseases. As such, the efficacy of using OPTIFAST therapy for a particular patient needs to be evaluated in the context of the health management risk benefit ratio. Many life saving medical treatments have potential side effects. As proven by the OPTIFAST Five-Year Follow-Up study, the health benefits of using an OPTIFAST program far outweigh any potential side effects such as a short-term reduction in phytochemical intake and a maintenance diet composed of a limited variety of foods. In fact, when used in accordance with the medical monitoring procedures outlined in the Reference Manual, no significant side effect have been reported.

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One of the goals of a dietitian is to teach people that there is no such thing as a “"bad food"” and thus all foods can fit into a healthy diet. This advice many work well for people who have a healthy psychological relationship with food but it can be problematic for individuals who use food as a coping mechanism. Data collected by researchers associated with the National Weight Control Registry and the University of Pennsylvania demonstrate that limiting the variety of readily available foods, and serving pre-portioned foods decreases the amount of food eaten at any once time. These observations have become so well accepted that they have been incorporated into the 2001 Dietary Guidelines for Americans which now advise eating a wide variety of fruits, vegetables and whole grains each day, but limiting the variety of other foods consumed. Extending stimuli narrowing into the transition and maintenance phases of the OPTIFAST weight loss program can give patients and added measure of control over their eating habits.

The transition phase of the OPTIFAST program makes use of the stimuli narrowing approach by slowly adding different categories of self-prepared foods back into the patient's diet. The stimuli narrowing characteristics of the transition diet can be strengthened by allowing patients to select a single food from each food group for a period of several days to a week at a time.

Several programs use an intensified Transition protocol. It allows patients to add a single 3 oz. serving of one type of low-fat meat (either chicken breast, turkey breast, or pork loin) and a 1/2 cup serving of one type of vegetable (either carrots or green beans) to their daily diet during the entire first week of transition. The same meat and vegetable combination must be eaten all week long. During week two, patients are allowed to alternate between two of the three types of meat and may choose either carrots or beans to meet their vegetable servings. They are also allowed to add one serving of a single type of fruit to their daily diet. Other food choices are added at a gradual pace, until a well balanced diet has been achieved.

Patients are encouraged to develop a maintenance diet of simply prepared foods they eat on a routine basis. The goal is to choose foods that are pleasant, but not overly appealing in terms of taste or appearance. Moderately appealing foods do not over stimulate the appetite (psychological desire for food driven eating) to the same extent that highly palatable foods do. Limiting availability of highly palatable foods can foster weight management. Favorite foods can still be eaten on special occasions provided they are worked into the meal plan.

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Some programs use an intensified stimuli narrowing process during the transition period with all patients. Others use it on an as needed basis. According to Rich Roell, LSW, an addiction therapy specialist associated with the Jewish Hospital Weight Management Program, about 40% of the people entering OPTIFAST programs have some degree of food addiction. Many of these individuals need strict guidelines, precise instructions and clear boundaries. Instead of saying “"eat a small serving of lean meat",” specify a 3.5 oz of roasted chicken breast, no sauce. Intensifying the stimuli narrowing aspects of the transition diet helps people set boundaries and avoid trigger foods.

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There is no magic combination of nutrients that produces effortless weight loss. Is it the combination of calories—those you eat and those you burn (known as your energy balance)—that matters. If you eat fewer calories than you burn, you are in negative energy balance, and you lose weight regardless of the source of those calories.

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The combination of protein, carbohydrate, and fat you consume affects your overall nutritional health, physiological functioning, and the way you feel. For example, if you consume only vegetables at a meal, you likely won't feel full very long. In contrast, eating a high fat meal can make you feel full but sluggish. Combining protein, carbohydrate, and a bit of fat each time you eat helps keep you feeling comfortably full and energized. Mixing calorie sources gives you the energy you need to get through the day.

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The May 22, 2003 , issue of the New England Journal of Medicine, contains two studies comparing weight loss results of obese individuals following an Atkins-like, very-low-calorie, moderate-carbohydrate, high-protein diet with a second group on a standard reduced-calorie, moderate-carbohydrate diet based on Food Guide pyramid guidelines. [1]- [2] Both studies found that initially people following the Atkins-like diet lost more weight (about 12-15 pounds total over 3 to 6 months) than did those following the standard reduced-calorie diet. Individuals on the standard diet lost about 4-6 pounds over 3 to 6 months in these studies.

One of the studies tracked weight loss for a full year and showed that by year-end, participants regained some for their lost weight regardless of the diet type. With this regain, there was no statistical difference in weight loss between the two diets after one year. Thus, this study did not show the Atkins-like diet to be more effective than a standard diet for long-term weight loss. In addition, about 40 percent of the patients in both studies dropped out, regardless of which of the two diets they were assigned to.

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Direct comparisons are difficult because people following an Atkins-like diet eat considerably more calories than do those following the OPTIFAST diet. Data from over 20,000 individuals reveal the typical OPTIFAST Program participant has a BMI of 39 at entry and loses an average of 52 pounds over 6 months of treatment. In addition, researchers have repeatedly documented highly significant improvements in blood sugar levels, blood pressure, and blood cholesterol levels with OPTIFAST.

People also tend to stick with OPTIFAST, with program dropout rates at about 20% or roughly half that found in the Atkins-like diet studies. Furthermore, follow-up studies conducted with over 600 individuals five years after OPTIFAST treatment show the majority who complete an OPTIFAST Program are able to keep off enough weight to improve their health long term.

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Very-low-carbohydrate, high-protein diets are often rich in animal fats and cholesterol. Many health experts are concerned that if such a diet is consumed for a long period of time, the fat and cholesterol it contains may place people at increased risk for cardiovascular diseases including stroke and heart attack.

An Atkins-like diet contains around 20 grams of carbohydrate a day. This is roughly the same amount of carbohydrate found in a single banana. The diet is so low in carbohydrate it is virtually a no-carbohydrate diet. Consuming adequate carbohydrate is important because many tissues in the human body must use glucose, a simple carbohydrate for energy. When people eat less than 100 grams of carbohydrate a day, their bodies compensate by significantly altering their metabolism. These metabolic changes generate waste products that must be removed from the blood by the kidneys.

Kidney function naturally declines as people age. Kidney function is also impaired by diabetes. Thus, many health experts fear that long-term use of very-low-carbohydrate diets, particularly by aging baby boomers (many of whom have Type II diabetes), may contribute to kidney damage.[3]

In addition to concerns about kidney function, researchers have documented an increased risk for a host of medical problems such as cancer, diverticulitis, cardiovascular disease, and osteoporosis in individuals who restrict intake of fruits, vegetables, whole grains, and dairy products long term.[4]

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During the transition and maintenance phases, OPTIFAST Program participants are taught to choose a healthy diet low in processed sugars (no more than 15 percent of daily calories from sugar) and rich in fiber, fruits, vegetables, lean meats and fat-free dairy products. In fact, the diet looks very much like that depicted in the Mayo Clinic Healthy Weight Pyramid at www.mayoclinic.org/new2000-rst/772.html.

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Researchers trying to understand diabetes and its control have noted that individual foods, even ones that are not high in refined sugar, can raise blood sugar (glucose) levels. The researchers fed people (who had fasted for at least 12 hours) a known amount of a single food and then measured the increase in their blood sugar. From this data the researchers developed the Glycemic Index (GI), a system that assigns a number to foods, particularly carbohydrate-rich foods (such as bread, pasta, and potatoes), based on their ability to increase blood glucose. The higher the GI, the greater the food’s ability to raise blood glucose levels.

Several studies have examined the effects of the GI on appetite, but to date there have been no well controlled, long-term human studies to examine the effects of GI on body weight regulation. Furthermore, there is no clear evidence that eating high GI foods leads to obesity. The GI is not a practical meal-planning tool, as it has only been established for a limited number of individual foods—not for food combinations.[5]

Overall, blood sugar response to a meal is influenced by much more than the GI of an individual food. An individual's glucose stores, hormone levels, and activity levels all play a role in glucose metabolism, as do protein and fat consumed, and the length of time since the last meal.

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Artificial sweeteners do not affect blood sugar because the body does not recognize these sweeteners as sugar. Look for detailed information about artificial sweeteners online at www.caloriecontrol.org . Once on the site, click on "Low Calorie Sweeteners".

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Many people believe fructose is a more natural sugar than sucrose because fructose is found in fruits and honey, whereas sucrose is refined from sugar beets and sugarcane. In reality, sucrose (a double sugar made of glucose and fructose bound together) also occurs naturally in fruits, honey, and grains. From a chemical standpoint, the sucrose and fructose used in cooking and baking are both refined sugars, with sucrose refined from beets and cane and fructose refined from cornstarch.

Some researchers believe high levels of sugar in the blood, which can occur when people overindulge in carbohydrates, contribute to obesity. In contrast, since fructose does not accumulate in our blood, people have reasoned that it does not promote obesity. This belief reflects and incomplete understanding of metabolism. Fructose does not build up in the blood because it does not require insulin to pass through cell membranes. Cells quickly take up any fructose in the bloodstream; they either use it to meet their immediate energy needs or convert if to fat for later use. Glucose, which is released from sucrose and complex carbohydrates during digestion, builds up in the blood until it reaches a high enough level to signal the pancreas to release insulin. Once insulin is released, cells can absorb glucose from the blood.

In summary, while fructose does not cause an increase in insulin production or blood glucose level,it contains the same number of calories per gram as sucrose and any excess not burned for energy will be stored as fat.

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The FDA specifies that the ingredient list be presented in descending order based on gram weight. This means that heavier ingredients are listed first. It is important to keep in mind that even though some ingredients weigh more than others, they do not all provide the same nutritional value for the amount used in the food. In addition, there may be one or several ingredients in a food that contribute to its total protein, carbohydrate, or fat contents.

To determine the actual gram weight of carbohydrate in a food, check the Nutrition Facts panel. The FDA requires ANY carbohydrate source that is not considered a complex carbohydrate (meaning starch or fiber) to be listed on the label as a sugar (simple carbohydrate). So, the grams of sugar reported on food labels include not only sucrose (table sugar), but also all other simple carbohydrates, including lactose (milk sugar), fructose, and honey. Maltodextrin and hydrolyzed cornstarch, two common carbohydrates used in OPTIFAST products, are also listed under "Sugars" on the Nutrition Facts label.

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The importance of the order of ingredients on a food table must be interpreted based on the total amount of each nutrient in the food. For example, even though OPTIFAST lists a carbohydrate as the first ingredient, each serving of OPTIFAST 800 provides only 20 grams of carbohydrate. A person following the standard OPTIFAST 800 diet protocol (with 800 calories per day) would consume 100 grams of carbohydrate a day. According to the National Academy of Sciences' Food and Nutrition Board, 100 grams of carbohydrate is the minimum amount needed daily to ensure normal metabolic functioning in adults.[6] Thus, the OPTIFAST 800 diet is a low-carbohydrate diet from a metabolic standpoint.

In comparison, a typical weight maintenance diet based on the Food Guide Pyramid advises a high-carbohydrate diet (50%-60% of calories from carbohydrate) to minimize health risks associated with eating too much fat and protein. Thus, a woman consuming a 1600 calorie/day diet should obtain 800-960 of her daily calories from carbohydrate. This is equivalent to consuming 200-240 grams of carbohydrate per day. The OPTIFAST 800 protocol provides less than half of the amount of carbohydrate.

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www.OPTIFAST.COM

NOVARTIS

Minneapolis , Minnesota 5540-0370

[1]Foster GD Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Egnl J Med 2003;348:2082-2090

[2] Samaha FF, lqbal N. Seshadri P, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003:348:2074-2081

[3] Carbohydrate, proteins and fat: Concepts and controversies. Food and Nutrition News. Summer 1999:3-5

[4] Position of the American Dietetic Association: Health implications of dietary fiber. JAm Diet Assoc. 2003; 102: 993-1,000.

[5] Foster-Powell K, Holt S, Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr. 2002; 76:5-56

[6] National Research Council. Recommended Dietary Allowances. 10^th ed. Washington D.C: National Academy Press; 1989.