Study Shows Meal-Replacement Program Produces Greater Sustained Weight Loss Than Reduced-Calorie, Food-Based Plan
LISLE, Ill., Dec. 31, 2018
LISLE, Ill., Dec. 31, 2018 /PRNewswire/ -- A medically supervised meal-replacement program offered by AMITA Health produces twice as much weight loss and higher rates of sustained weight loss than a reduced-calorie, food-based approach, according to a new study.
The yearlong OPTI-WIN clinical trial occurred at the AMITA Health Center for Bariatrics & Weight Loss and at eight other sites across the nation. The study was the largest randomized control trial of total meal replacement ever conducted in the United States. Anthony Auriemma, M.D., J.D., medical director of the AMITA Health center, served as a principal investigator for the study of more than 300 obese adults between the ages of 18 and 70.
Study participants were divided into two groups. One group consumed only OPTIFAST® meal replacements, such as soups, nutrition bars and shakes, for 12 weeks. The group then transitioned gradually to a combination of meal replacements and conventional food before entering a maintenance phase during which the group ate mostly conventional food and was encouraged to consume one or two meal replacements a day. The other group adhered for 26 weeks to a reduced-calorie, food-based diet based on a modified diabetes prevention program. The group then entered a maintenance phase that included increased caloric intake calibrated to maintain weight loss.
Both groups were instructed to participate in moderate to vigorous exercise for 150 to 180 minutes a week. The groups also received weekly nutritional and behavioral education, as well as individual counseling, and were required to weigh in each week.
Although the average weight loss achieved by the OPTIFAST group doubled the other group's average, the fact that the OPTIFAST group maintained its average weight loss at a high level was even more important, Auriemma said. "One concern that patients always have with the more rapid weight loss associated with meal replacements is whether they're going to keep it off, and we showed at one year they still were keeping it off," he said. "Also, people sometimes think a meal-replacement approach is dangerous, and we saw no appreciable difference in safety between the meal-replacement and food-based groups."
In addition, the study found a greater reduction in fat mass in the OPTIFAST group than in the food-based group. At the same time, the OPTIFAST group preserved lean muscle mass. These findings should allay a common concern among patients that rapid weight loss through meal replacements will affect muscle more than fat, Auriemma said. The study also found improvements in chronic health conditions such as high blood pressure and diabetes in the OPTIFAST group, he said. The study was sponsored by Nestlé Health Science, a wholly owned subsidiary of Nestlé that offers a variety of nutritional therapies, including OPTIFAST.
The study's findings mirrored AMITA Health's experience through the years using meal replacements as a strategy for weight-loss patients, said Ruth Davis, R.N., vice president of the AMITA Health Digestive Health Institute. "We have found that patients using meal replacements can take weight off faster and keep it off for a longer period of time," she said. "We often find that using meal replacements gives patients a way to take a mental break from food and meal preparation and allows them to focus on changing their behaviors."
Health improvements are common among AMITA Health patients using meal replacements, Davis said. "The most dramatic results we see involve the impact of meal replacements on type 2 diabetes," she said. "We find that patients taking oral medications for diabetes dramatically lessen their need for medications, and 40 percent of patients on insulin get off insulin during the first year of the program."
AMITA Health's medically supervised weight-loss solutions program, which attracts about 450 new patients a year, is based on the belief that obesity is a chronic disease and must be treated accordingly, with ongoing management, support and accountability. The program requires a two-year commitment from participants, and AMITA Health encourages them to renew their commitment every two years. "We seek to have lifetime commitments from our patients because we know there will be ups and downs in life that contribute to regaining weight," Davis said.
Patients entering the program can choose from a variety of strategies, such as a full OPTIFAST meal-replacement option, a partial meal-replacement plan combining OPTIFAST meal replacements with one regular food-based meal each day, a low-carbohydrate meal plan without meal replacements, and a low-carbohydrate meal plan with meal replacements added after a certain amount of time.
Patients are encouraged to attend weekly AMITA Health classes that focus on behavioral and nutritional changes and are taught by licensed clinical professionals, such as dietitians, exercise physiologists and clinical social workers. In keeping with the program's emphasis on accountability, patients are encouraged to weigh in privately before each class. Patients also meet regularly with physicians and dietitians who monitor their health and nutrition. Patients who have completed the medically supervised weight-loss solutions program have maintained an average weight loss of 45 lbs. after one year and an average of 39 lbs. after two years.
"We offer a structured, comprehensive weight management program where patients work with a team of healthcare professionals on nutrition, activity and behavioral changes needed to not just lose weight initially, but achieve long-term weight loss," said Mary Hayen, a registered dietitian who is the program's director.
Under the program's full meal-replacement option, a patient typically consumes five OPTIFAST meal replacements a day for a total of 800 calories. "That actually provides 100 percent of the nutrients required in a day," Davis said. The meal-replacement choices available to patients are limited to reduce any emotional connection to eating that they might have. Patients consume only meal replacements for up to 26 weeks, transition gradually to a mix of meal replacements and conventional food, and then enter a maintenance phase with a customized food-based diet.
AMITA Health patient Eugene Gamez weighed 395 lbs. when he began the full meal-replacement regimen in August 2017. He since has lost 194 lbs. Nestlé Health Science recently named Gamez as one of three winners of its ninth annual OPTIFAST "New You" contest, which asks contestants to answer the question, "What accomplishments, big or small, have you been able to achieve since starting your OPTIFAST weight-loss journey?"
"The biggest thing for me with OPTIFAST has been not only losing all the weight," said Gamez, 35, who works as a 911 police dispatcher. "OPTIFAST has helped me overcome my extremely unhealthy relationship with food. Now food for me is more of a fuel source. I'm looking at food now as 'What am I going to get out of it?' instead of just pure pleasure, as I was back in the day."
The AMITA Health program provided the education, support and accountability he needed to make important behavioral changes as he lost weight, Gamez said. For example, he now works out four or five times a week, participating in high-intensity interval training. "I have reached fitness levels I never thought in a million years I would ever be at," he said. "I've been doing exercises I never thought I was capable of."
After often feeling ashamed or embarrassed in public, Gamez now feels comfortable in his own skin. He sleeps better and wakes up refreshed and eager to start each new day. "I'm just extremely happy," he said. "With OPTIFAST and going through the AMITA Health program, I feel like I have received a second chance at life."
Another AMITA Health patient, Amy Sabel, was invited to serve as a member of the OPTIFAST Consumer Advisory Board this past October after she lost 80 lbs. by following a partial meal-replacement plan. "The biggest thing with being on the meal replacements was that it stripped all my bad habits away," said Sabel, 42, who is the mother of 13-year-old triplets and works as a regional sales director for a financial staffing firm. The program, she added, allowed her "to learn good habits to keep weight off. I'm proof that it can be kept off."
Like Gamez, Sabel has dedicated herself to exercise, working out three or four times a week, including high-intensity circuit training and running. "I can run a mile," she said. "I can run two miles. It's a lifestyle change." Her new lifestyle has improved her health. Weighing 243 lbs. when she started the program in June 2017, she was pre-diabetic and had elevated levels of liver fat. Today, she is no longer pre-diabetic, and her liver fat levels "are phenomenal," she said. "It's really amazing looking at the before and after of where my numbers lie."
Attending weekly classes with other patients, weighing in weekly and consulting with Auriemma and Hayen were key factors in her success, providing important knowledge, accountability and motivation, Sabel said. "You are not doing it on your own," she said. "You have a team, a tribe, who all want to lose weight and get healthy. If you leverage that and work together, it's so much better to know that others are doing it. You can learn from them, and they can learn from you."
For more information about AMITA Health's medically supervised weight-loss solutions program, visit www.amitahealth.org/medicalweightloss, or call Mary Hayen at 847.534.4294.
About AMITA Health
AMITA Health (www.AMITAhealth.org) is a joint operating company formed by the Adventist Health System in Altamonte Springs, Fla., and St. Louis-based Ascension. With the addition of Presence Health, AMITA Health is now among the largest health system in Illinois, comprising 19 hospitals and more than 230 sites of care. The newly combined health system has 900 providers in its medical groups, more than 26,000 associates and 7,000 physician partners, and now serves over 4.3 million residents in the greater Chicagoland area.
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SOURCE AMITA Health