Abstract
Twenty patients (16 female and 4 male) with moderate or massive obesity were treated with the very low calorie diet (VLCD), Optifast. Ten patients were hospitalized and others were outpatients. Optifast consisted of 70g of protein, 30g of carbohydrate, 2g of fat and sufficient amount of vitamines and minerals. Total calorie intake from Optifast was 420 Cal, daily. In addition, patients were instructed to drink more than 2.0 1 of water without calorie. All patients had such complications as hyperlipidemia, hyperuricemia or hypertension possibly linked with obesity. The VLCD treatment was carried out at least for 2 weeks and continued for the period as long as the patient could stand. In the hospitalized patients, body weight, blood pressure, urine volume and urinary ketone body were measured every day. Outpatients measured their body weight everyday at home and their blood pressure and urinary ketone body were examined at visiting the hospital once a week or every two weeks. Blood chemistry (liver and renal functions, serum lipids etc), the count of peripheral blood cells and plasma somatomedin C levels were measured regularly during the VLCD treatment. Although the period of VLCD treatment was different from patient to patient, a significant reduction in body weight was observed in all patients. No serious problems to discontinue the treatment were seen. All the complications possibly caused by obesity were improved with a reduction in the body weight. Plasma somatomedin C levels were not changed during the VLCD treatment which indicated that no significant changes in the nitrogen balance were present. From these results, we conclude that VLCD (Optifast) treatment has much benefit and safety to reduce body weight in obese individuals. However, the strict selection and the regular observation of the patient should be done by doctors during the VLCD treatment. It is also considered that this treatment should not be employed for the cosmetic reasons.
