A Proven Medical Weight Loss Program
Prior to beginning the protein-sparing modified fast all participants will undergo a complete history and physical examination with routine laboratory work and an EKG. These can be done either are at IHM or by the primary care physician. In this way a complete medical assessment of safety and medical issues for each participant in the program can be made. Individuals who have special medical needs are identified to make sure that they are capable of fasting safely. We have supervised the weight loss of patients with a variety of medical conditions including cardiac arrhythmias, emphysema, asthma, kidney disease, diabetes, hypertension, fatty liver, gout, sleep apnea, psoriasis, and osteoarthritis. IHM will assume responsibility for scaling back on diabetes and blood pressure medications as weight loss is achieved. There are some medical risks of very low-calorie dieting including constipation, low blood pressure, exacerbation of gallstones, and gout. These risks will be reviewed and monitored at the weekly IHM medical visit.
The Modified Fast
The modified fast, hereafter referred to as “the fast”, is perhaps the most important service provided by IHM. After each individual has had his or her history, physical exam, laboratory studies, an EKG reviewed, they begin the fasting phase at IHM. During this time they will abstain from all calorie-containing foods and consume only the meal replacements are supplements provided by IHM. These supplements have a very high protein content and a low carbohydrate and fat content. Supplements contain 100 cal each. They are fortified with essential vitamins and minerals so that, with the exception of potassium, additional multivitamins or minerals are not required during the fast.
The supplements used at IHM have proven to be safe for over 30 years of practice. They come in a variety of flavors. Due to changing dietary sensibilities in Northern California IHM has begun to offer new supplements containing clean ingredients from non-genetically modified (non-GMO) sources. No artificial coloring or flavoring is included, but each individual can flavor their supplements as desired.
Individuals are asked to space out the supplements at 2.5 to 3 are intervals throughout the day. Most participants require potassium supplementation, which is provided by prescription. Potassium is the major intracellular salt and is lost into the urine as fat cell mass is reduced. Most patients need added fiber to maintain normal bowel movements. Patients who are on anti-hypertensives or diabetes medications usually need these to be reduced in a stepwise manner, which is done by the medical staff.
Larger individuals tend to lose weight faster than smaller individuals. In general women lose 2-3 pounds per week and men lose 3-5 pounds per week. However, the 1st 2 weeks of the fast there is exaggerated loss of saltwater. During the 1st 2 weeks individuals may lose 5 to 10 pounds. When we eat, our digestive system dilutes the nutrients to a concentration acceptable for absorbing into the bloodstream. When we fast the salt water used to accomplish this is lost through the urine. This accounts for the exaggerated weight loss during the 1st 2 weeks of the fast.
The fast can continue indefinitely as tolerated by each individual. Most participants want to lose over 20 pounds. It is not uncommon for our participants to lose over 100 pounds. During the fast participants may take a 1 to 3 week break for vacation, family events, or a variety of medical issues. These are all anticipated and coordinated by the IHM medical staff.
A key component of IHM is to eat teach each participant how to modify their behavior to achieve lifelong weight control. To the extent that the ability to diet successfully and exercise and a healthy way is within the control of each participant, we provide you with the tools needed to accomplish a healthy lifestyle. At each weekly visit there is also a group behavioral / nutritional meeting led by either IHM behaviorist Dr. Marc Klein, PhD or IHM dietitian, Ms. Ginny Irwin, RD. Although these meetings occur in a group both Dr. Klein and Ms. Irwin are available for one-on-one discussions as well. Dr. Klein has over 25 years of experience in counseling patients about food-related behaviors. Ms. Irwin has over 10 years of experience in nutritional counseling.
When you have completed the protein-sparing modified fast, you will undergo what is called re-alimentation. The alimentary tract or digestive tract becomes somewhat quiescent during the fasting phase. Re-introduction of normal food is referred to is re-alimentation. During this phase you will decrease the number of supplements to 3-4 per day and begin eating one small meal consisting of 5 to 6 ounces of lean meat, one cup of steamed vegetables, and a piece of soft fruit. After one week the number of supplements will be decreased to 2-3 and a salad will be added to the small meal. On the 3rd week of re-alimentation you will be allowed to add a small serving of carbohydrate-rich food. During this phase you are potassium supplements will be decreased.
After completing the fast, you will have a choice of undergoing complete re-alimentation back to regular food and no supplements or periodic maintenance with medical visits at regular intervals and continued use of 2-4 supplements a day to provide an easy, convenient way to get through difficult times of each day while eating one small meal and a salad daily. This option we call Monthly Maintenance. Group behavior meetings are provided for each medical visit.