posted Aug-11-2006 04:35 PM            

Haven't seen anything about this diet on this forum, and with the recent advertising, I thought we could discuss it.

Medifast is a Low Calorie, ketosis-based diet. It's been around for 15 or so years and was pioneered at John Hopkins Univ. Traditionally they have not advertised to the consumer, and have relied on doctors to reccomend it. It was mainly given to very obese patients who had tried other diets and failed. Patients were typically put on a program of 5 packages shakes a day and nothing else, giving them approximately 550 calories, halfway split between carbs and protein, with very little fat.

The program today is modified in order to fit a wider range of people rather than just the extremely obese. The supplements have changed from being just shakes, to a large array of foods: hot drinks, oatmeals, soups, bars, puddings as well as the classic shakes. In addition the plan has added one meal of lean protein (7oz chicken for example) and 2 cups of green vegetables. This plan (often referred to as the 5+1 plan) gives you around 800-1000 calories, with 80-85 grams of carbs and protein, and still has very little fat.

Some doctors still put patients on the classic plan but the majority of Medifasters are on the 5+1 plan.

As of very recently Medifast has been advertising on the web (I saw an add on coolrunning once I think) and on TV. And as of the last two years or so you can buy Medifast products directly rather than having to go through a doctor. Due to this many people are able to go on this program without being under doctor supervision. I kind of have mixed feelings about this, because while I think it's good that the information about this program is getting out there, it is a very extreme plan and should be done only under doctor supervision, and many people aren't doing it that way.

Medifast works by giving you more carbs than a standard low-carb diet like Atkins, but still restricts them enough to put you in Ketosis. What this achieves is suppression of the "hunger" response and the bodies requirement for glucose. The liver converts fat into ketone bodies, which are a servicable substitute for glucose for every part of the body except for the brain, which still requires glucose. Thus to get energy the body will burn fat in a very rapid state to create ketone bodies, and excess ketone bodies will be disposed of in the urine.

Now the calories are much lower than most other diet programs reccomend, except for similar programs to medifast, and always cause some skepticism or controversy. The idea is that 80 carbs per day is enough to feed the brain with glucose while the rest of the body is feeding off ketone bodies, and 80 grams of protein per day is enough to stop you from losing muscle mass. One would assume that on 800 calories per day, you would be malnourished but this is not the case when you are getting so much of your energy from your own fat. The metabolism drops very little.

Exercise is encouraged on the diet. Unlike Atkins or similar low-carb programs, you have enough carbs that you won't "bonk" immediately. Dieters are encouraged to keep exercising like they did before they went on the diet, and if sedentary, to wait three weeks after starting and to build up exercise slowly.

Now for my personal story. I'm a 6'4" 23 year old male and had tried pretty much everything and, under the consultation of my doctor, started Medifast on 6-1-06 at 425lbs, as a last-ditch before bariatric surgery. I took tests and my blood sugar was diagnosed as pre-diabetic, however my cholesterol and BP were outstanding.

I weighed in this morning at 350lbs, which is a 75 lb loss in the 2 months and 10 days that I've been on the diet. I have not taken a glucose tolerance test as that would kick me out of ketosis but my blood sugar waking and throughout the day is a perfect 75-100, even right after I eat. My cholesterol and BP are still fine, as of my last labs. I have lost no muscle mass according to a caliper test.

My initial exercise was yoga and cycling and I started training myself to run (modified C25K) in mid July, and now run a 5K for exercise in a two days on, one day off routine (5k, 5k, rest, repeat). Running has made my weight loss go a whole lot faster, and I haven't bonked or ran out of energy yet.

I feel know that I have what I need to continue living healthy for the rest of my life. One would think that a regimented diet wouldn't help to engineer a lifestyle change, but honestly, what I crave right now is things like oatmeal and yogurt. The thought of pizza or hamburger disgusts me. I'm totally obsessed with nutrition now, and will be for the rest of my life. I think that if I went off Medifast right now, I would still be able to lose weight just fine, simply watching calories and the foods that I eat. In fact, it's something that I've been thinking about a lot lately since I'm no longer in the "danger zone" and don't have a reason to hurry to get the weight off.

As for the dreaded "keeping the weight off" thing, it's something that haunts me every day, and probably what's driven my obsession with nutrition that I mentioned earlier. I know that the hardest part about this is going to be the end game, after I get off the program. But I think that I can man up and handle it.

One would think that my opinions of Medifast are all rosey but that's not the case at all. First of all, I can't criticise the program itself: I'm living proof that it works, and works pretty well. But I think that the company does a few things which are morally reprehensible. I think the recent advertising is a prime case: this is not a program that someone should be on unless they are under direct doctor supervision, and the company is catering to the consumer instead of catering to the doctors now, making it more and more friendly towards those who don't have doctor supervision. Second Medifast offers support through their "nutritionists" which are basically tech support for dieters. They tend to offer conflicting and nonsensical information at times, and I worry about people who take what they say as gospel.

So I have mixed feelings, but it's what works for me and a whole bunch of people that I know, so I can't knock it too much.

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posted Aug-11-2006 05:45 PM            

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posted Aug-11-2006 06:36 PM            

Second, I am guessing that Flyweight did not fully read your well written post and so I wouldn't be too worried about his/her response. You will likely get other similar responses telling you that diets aren't needed and a life style change is all it takes. That may be true when one has 10lbs to shed but in your case it sounds like a dramatic step was needed. And I am happy that it was Medifast verses a potentially dangerous surgery.

Third, I'm not quite sure what you want from this post. You sound confident and happy, while open minded to critique. This is great, but I wasn't sure if you had a specific question. The only one I sense was "Am I ready to go it alone, without the diet yet, or should I continue a bit longer". That is a question your doctor may be able to help with but here are my thoughts ...

You wrote: "I know that the hardest part about this is going to be the end game, after I get off the program. But I think that I can man up and handle it."

This worries me. I don't know what man up means but unless it involves a support group, a very well thought out plan, and some well set up goals, I think it might be a hard road for you.

What I would do is take a few more weeks on the diet while you carefully plan what the coming off phase will look like and also think about how you want to live in your late 20s and 30s and on from there. (For example, if you really want to take off with this running thing, you'll need to learn to eat like a runner ... something I'm still learning after 10 years of the sport.)

Changing behavior is very powerful and maybe that is all you needed to take back your life and body (I'm not assuming you had no life before but at least your health was in danger). But often getting to a place where you are very overweight involves factors beyond simple behavior. It may be worth thinking about what those where for you before you try to just "man up" (okay last time I'll repeat that phrase). It may be worth making a very strict food plan for when you first come off the diet and then a less strict plan that you will follow later in life (the ideal being feeding your body what it needs based on your own body's cues ... again, not easy). But whatever it is, I urge you to think ahead and let yourself seek out all types of support.

I have no doubt you will fully succeed and I think this was simply the kick in the pants you needed to start the life you desire. But everyone everyone everyone needs help in long journeys. Just don't be afraid to keep asking for more than just a diet plan from those around you.

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posted Aug-11-2006 06:48 PM            

And there's a transition plan included with the medifast literature. It's three months of slowly weaning yourself off the low calorie diet and on to real food.

And yeah, I assumed flyweight just read the topic and didn't read the post.

Edit: Oh, I plan to run a half mary in december, I wonder how I'll handle that nutritionally as I obviously wouldn't want to do it on 800 cal.

[This message has been edited by kponds (edited Aug-11-2006).]

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