Background: The OPTIFAST® program at UPMC is a medically supervised program using very low calorie diet from Nestle products. It focuses on nutrition and lifestyle counseling, and transitioning to a low glycemic load diet to sustain glycemic benefits of weight loss. We evaluated the impact of our program on weight reduction in a 3-year period at UPMC clinics, and secondary parameters defining cardiovascular risk factors.
Methods: Patients were divided into Completer (C) and Non-Completer (NC) cohorts. For the C-group, HBA1C for diabetics, lipid profiles and systolic blood pressure (SBP) were compared at baseline and at >5 months. Adjusting for weight loss, effect of DM, BP and lipid-lowering drugs on HBA1C, SBP and lipid profile, respectively, was also evaluated.
Results: A total of 215 patients (mean age=49.63, 69% female) had mean baseline and end weights of 263.7 and 222.8 pounds respectively, with mean 14.04% weight loss (p<0.0001). 59% completed the program with mean 19.52% weight loss (p<0.0001). For the NC-group, weight difference from baseline was not significant.
Among diabetics, there was decrease in HBA1C (7.8% to 6%, p<0.0001), with a decrease in the no. of insulin units/day (71.4 to 34.6 units, p=0.015), but no significant decrease in the no. of noninsulin drugs from baseline to >5 months. There was a decrease in mean baseline to end SBP (139.3 to 122.5 mmHg, p=0.0325), and no. of BP meds (1.9 to 1.2, p<0.0001). There was a decrease in mean baseline to end values of: total cholesterol (TC) (192.4 to 140.7 mg/dl, p<0.0001), LDL (104.3 to 84.59 mg/dl, p=0.02) and triglycerides (TG) (209.2 to 111.9 mg/dl, p<0.0001). The increase in baseline to end HDL and difference in lipid lowering drugs were not significant. Adjusting for weight loss, medications had no significant association on trends of HBA1C, SBP and lipid profile.
Conclusions: Among completers, the medically supervised VLCD program at UPMC promotes significant weight loss, glycemic and SBP improvement, and lowering of TC, LDL and TG for over >5 months.
K.B. Detoya: None. K. Han: None. B.R. Register: None. D.A. Rometo: None.