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We are excited to offer the Optifast medically supervised diet and behavior modification program, for patients seeking to lose 40 pounds or more in a more aggressive, expeditious manner, but in a safe, supportive medically supervised setting.

While most patients see us on a once-monthly basis to focus on steady, persistent weight loss (see "
Our Services"), some patients are better served by a more aggressive, intensive, very low calorie weekly program that focuses on behavior modification and accountability and uses nutritionally balanced, low calorie meal replacements.  This is called a very low calorie diet (VLCD) or "medically supervised diet" and is yet another effective tool specifically for patients who are looking to lose 40 pounds or more in a more expeditious but safe manner.

Medically Supervised Diet:  Very Low Calorie Diet (VLCD) Meal Replacement and Behavior Modification Program

We enthusiastically offer the OPTIFAST weight management program for patients in whom traditional commercial weight loss, medical weight loss, or surgical weight loss programs have not obtained the desired results.  Developed in 1974 to treat obesity in a healthy and effective way,  OPTIFAST is an intensive medical weight loss program that focuses on lifestyle modification with medical monitoring while using nutritionally balanced, low calorie meal replacements.  See for further details.

OPTIFAST has a long history of success and has been used by more than one 1 million patients over it's 35 year history.   With more than 80 peer-reviewed studies and a clinical database of over 80,000 participants, these studies have clinically proven the effectiveness of the OPTIFAST program. One study of 20,000 patients completing 22 weeks of OPTIFAST treatment showed the following results:

52 pounds average weight loss over 22 weeks
15% average decrease in cholesterol
29% average decrease in average blood sugar
10% average decrease in blood pressure

This study of more than 20,000 participants showed that five years after completing the program, the majority kept enough weight off to improve their health long term.

If you are specifically interested in the Optifast Program please review the Consent and Cost forms at the end of this web page.

What is Optifast?

A Very Low Calorie Diet (VLCD) is a medically supervised diet program where patients consume 800 - 1000 calories per day. 
Intake of less than 1000 calories per day is not recommended without close medical supervision and monitoring. 

Low calorie but balanced meal replacements (such as bars, shakes, or soups) are provided to replace all meals during the active weight loss phase (typically 12 weeks) during which time patients have rapid weight loss.  The provided Optifast meal replacements must be used during this low calorie phase to ensure that the very low calories (800 calories) still provide to your body the adequate amounts of protein, carbohydrate, fat, minerals, and vitamins. 

Who is it for?

A VLCD diet program is an aggressive weight management program designed for severely overweight people or for people who are looking to lose a large amount of weight quickly and safely.  Most patients who enroll in a VLCD program have attempted other diets.  You might consider this program if:

you are seeking to lose more than 40 pounds,
you are looking to lose weight in a fast, effective, and safe manner,
    •  your weight is causing significant health problems (diabetes, blood pressure, cholesterol, joint problems, other)
    •  previous attempts of diet and weight loss have not been effective, or
    •  you are considering bariatric surgery but undecided, or your insurance does not cover surgery, 
you have previously had bariatric surgery but have regained your weight

How much weight loss can be expected?

Using a VLCD program, you can expect 3-5 pounds of weight loss per week.  In a typical 18 week program, weight loss of 50 - 100 pounds (average 52 lbs) can be achieved (usually depending on your baseline weight).  If more (or less) weight loss is required, the length and duration of the active weight loss phase of the program may be extended (or reduced).

What are the components of the OPTIFAST program?

The OPTIFAST program intensively offers the following 4 components that lead to successful long term weight loss

  Full meal replacement diet
      Medical monitoring (evaluated on a weekly basis on Wednesday evenings at 4 pm until class time)
    •  Behavior modification (weekly small group behavior modification classes on Wednesday evenings at 5 pm)

Nutrition and exercise education (small group education classes on Wednesday evenings at 5 pm)


How does the full meal replacement program work?

The OPTIFAST meal replacement plan, behavior modification, and nutrition education program works in 3 stages:

   Active Weight Loss The active weight loss phase typically lasts for 12 weeks but the duraction can be adjusted by you 
        and your healthcare provider.  During this aggressive phase of weight loss, all calorie intake is taken through well balanced 
        meal replacements including 5 bars, shakes, or soups per day to drop your calorie intake to 800 calories per day.  Meal 
        replacements are required to still obtain adequate nutrition at such a low calorie level.  If needed, appetite suppressants 
        can be used to help reduce hunger and cravings during this active weight loss phase.  Initially you will be seen weekly in the
        physician office and expected to attend a weekly small group class focusing on behavior modification, stress management,
        exercise, and various other subjects.

      Transition:  After the 12 weeks of active weight loss, you will enter a transition phase for 6 weeks where you will start to use
        fewer meal replacements while incorporating regular into your diet, initially 1 regular meal per day, then 2 regular meals per
        day.  During this time, you are expected to attend a weekly small group class (led by a dietician) focusing on sound nutrition 
        concepts and training.  At the end of this 6 weeks of transition, you will be back to regular food.

      Ongoing Weight Control / Maintenance:  Upon completing the 18 weeks of full and partial meal replacements, you will
        have lost a significant amount of weight (52 lb average weight loss).  However, the most important and most difficult part of
        the process begins here.  Some people say "losing weight is easy ... it's keeping it off that is the hard part" ... we know that
        BOTH "losing weight" AND "keeping it off" are both very difficult.  For ongoing weight control and maintenance, we would
        arrange your follow up in our more traditional non-VLCD regular clinic practice which is typically a once a month visit with 
        Dr. Sicat initially, and then spaced out further based on how you are doing.

Why use meal replacements?

Consistently reducing to less than 1000 calories per day can be dangerous and should be done under the care of a physician or healthcare provider, especially if you have any conditions such as diabetes or blood pressure, or if take any medications.  It is very difficult to achieve the proper balance of nutrients when taking such low calorie levels, and an imbalance of nutrients can lead to complications and side effects.

Meal replacements are usually used during a VLCD (very low calorie diet) because by taking the exact 800 calories prescribed through these specific food products, the nutritional needs are supplied and balanced.  

A very limited variety of bars, shakes, and soups are used with very "plain" flavors such as chocolate, vanilla, and strawberry. 
Keeping the available options limited and simple helps reduce cravings by a concept of "stimuli narrowing" and reduces the need to make food choices. 

The concept of "stimuli narrowing" is that the less involvement and fewer available choices with food... the better.  This can help break some people's unhealthy relationship with food.  When fewer and simpler options are available, commonly there is less craving or yearning for more (i.e. the opposite of an all-you-can-eat buffet).  Some describe this as a "vacation from food"

The Optifast meal replacement products use precise portion control, stimuli narrowing, and high protein, low carbohydrate formulas to help you lose fat while conserving muscle mass and avoiding cravings and hunger.

When are the small group classes?

The weekly small group classes are held on Wednesday evenings at 5:15 pm and last approximately 1 hour.  The weekly medical evaluation/check-in will be during the 60 minutes prior to class (starting at 4 pm on Wednesdays).

While the Optifast program has many advantages, many factors need to be considered in deciding on this program:

Pros Cons
 Rapid, definitive weight loss  Significant time commitment 
 Average 52 lbs over 18 weeks  18 week program (12 weeks active weight loss, 6 weeks transition)
 Highest medical monitoring with weekly evaluations Weekly medical visits (just prior to class)
 Highest support and weekly small group classes  Weekly small group class is required
 Use of well balanced meal replacements  Use of only meal replacements exclusively
 No need to make food choices (vacation from food) Vacation from food 
Likely improvement in medical conditions  Significant financial cost (up to $144-$234/week initially)
Likely to reduce other medications  The average weekly cost is about $188 (with weekly class)
or $148 without class
during the active weight loss period and reduces over time.

This cost may be higher based on your baseline weight.
 For example baseline BMI > 55 ~ $234/week

The majority of this cost is food costs.
This includes all food, medical visits, and classes
(the cost reduces as you use fewer meal replacements) 

How much does the Optifast Program cost?

We want to ensure that you have all the you need to make your decision on whether the Optifast program is right for you.  The cost may be a limiting factor for many and thus it is important to know this information in advance of making your decision.  Listed below are the detailed weekly and total program cost breakdowns.  Note that the cost of the program increases based on your baseline BMI due to starting at a higher calorie level and using more meal replacements (otherwise all other costs are the same).  If you are starting at a higher calorie level, this may potentially be reduced as the program continues depending on the speed of your weight loss.

 Cost and Financial Outline for the full Optifast Program (example based on baseline weight < 250 lbs  
 If possible please review before your first visit

Please note that the difference in cost between Optifast enrollees is based on the difference in food costs ($3.25/serving) and whether or not you choose to attend the weekly class ($30/class per week).  Participants with a higher Body Mass Index (BMI) will initially start at a higher calorie level which accounts for the difference in cost.  Note that this cost can potentially reduce as the program continues as on occasion the calorie level can be adjusted based on the rate of weight loss.

Can I afford the Optifast program? Other factors to consider?

We understand the significant cost of the Optifast program.  When reviewing the cost of the Optifast program, it is important to note that the cost of all your food is included in the initial 12 week active weight loss phase, as well as most of your food during the ensuing 6 weeks of the transition phase.  More than 50% of the program cost is for food/meal replacements.  When budgeting for the program, some people actually find that the actually spend LESS on food than what would have when considering the costs they may have been spending eating out at restaurants or fast food, or purchasing food at the grocery store.

Another benefit that is not immediately apparent is the improvement of medical conditions associated with weight gain.  With significant weight loss, many diseases associated with weight gain may lessen and even disappear.  Many people will be able to reduce medications, medication costs, and may require fewer visits to their healthcare providers as a result. 

Does my insurance cover the cost of the Optifast program?

The insurance industry is complex and Insurance traditionally does not cover medical weight loss services and thus our practice does not submit claims to your insurance company.  However, some insurances may reimburse you for the costs of the medical visits and group classes if you submit your clinic receipts to them.  It is unlikely that your insurance will cover the costs of the food or meal replacements.  Upon request, we are happy to give you receipts and billing codes that you may submit to your insurance company for possible reimbursement directly to you.

Do I have to complete the entire 18 week program or can I choose to do a shorter program?

We understand that this is a major commitment from a time and financial perspective.  While we encourage most patients to complete the entire 18 week program, in some scenarios, some people may be considered for an abbreviated program as short as 6 weeks in duration (see Fast Track which is as short as 6 weeks and no class).  This should be discussed in detail with Dr. Sicat.

Who should NOT do the Optifast Program (Contraindications and Relative Contraindications)?

Contraindications:  You are NOT eligible to enter the Optifast Program if:  you are pregnant, you have had a heart attack with the last 6 months, if you have ever had a stroke, if you have diabetes with a history of "ketoacidosis," if you chronically use steroids more than 20 mg per day, if you have a recent history of a bleeding peptic ulcer, or if you have active "thrombophlebitis" or any condition where decreased blood volume could put your health at risk.

Relative Contraindications:  Patients with the following conditions may be appropriate for the Optifast Program based on the  physician's judgement:  if you have a history of a transient ischemic attack (TIA), if you have a history of thrombophlebitis (but not currently active thrombophlebitis), if you are on a medication called "lithium," if  you have a history of kidney or liver disease, if you take any medications that have severe gastrointestinal side effects, or if you have an occupation where you must be 100% alert at all times (i.e. pilot, surgeon, truck driver, bus driver, window washer).

Consent Forms:  Please review these Consent Forms Prior to your First Optifast Visit:

If you know you are specifically interested in enrolling in the Optifast Program, please download, print, and bring these forms with you to your first appointment along with the new patient forms.  Please read them prior to your appointment and we will also review these information and consent forms in detail with you as well at your first appointment.

Click HERE to download the overall Program Information                          
as well as detailed CONSENT FORMS for the Optifast Program                 
Please make sure to review these forms prior to your first appointment 



Thank you for reading about the Optifast program.  For additional helpful information, please also visit

If you are intersted in the Optifast program, when calling our office, please let the receptionist know and we will expedite your medical evaluation and enrollment into the group classes.

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