The RFO Program was one of the first programs in the world to employ a very low calorie diet (VLCD).

• A VLCD is defined medically as a diet of 800 calories per day or less.
• A VLCD is primarily for severely or morbidly obese individuals who must lose or wish to lose large amounts of weight as rapidly as possible in a safe manner.
• The average weight loss on the VLCD program is in the range of 3 to 5 pounds per week.

When an individual consumes 1,000 calories per day or less, it has the same effect physiologically as total starvation, i.e., after four to five days the patient's appetite has diminished and is (in most cases) no longer hungry. These initial four or five days may be the most difficult for some patients until the appetite suppression kicks in. The dietitian will discuss strategies to help make this transition easier for the patient during the orientation process.

At the center, patients are prescribed a VLCD diet plan of 400 to 1000 calories per day, consisting of a special nutritional product (RFO formula) made to our specifications, which contains 15 grams of high quality protein and a full compliment of vitamins and minerals. Available in five flavors, each satisfying 100 calorie packet is easily mixed with cold water and is immediately ready to drink. The majority of VLCD patients will also require a potassium supplement in addition to their RFO formula. If patients need a salty alternative or something to chew on, they can discuss the available options with the dietitian, ranging from selected bullions, to RFO soups and RFO nutritional bars. Patients participating in the VLCD program are carefully monitored. They have their weight status recorded weekly, blood pressure and pulse rate taken every 4 weeks (or more if necessary), they see a physician at least every 2 weeks, have blood chemistries done every two weeks, and EKG's and BIA's performed every eight to twelve weeks. Close medical monitoring is required because of the drastic caloric restriction and the necessity of potassium supplements.

Research results from the RFO program have been published in the medical literature and have documented weight loss ranging from 50 to 250 pounds, depending upon the patients' initial weight. Eighty five percent of patients successfully achieved their weight loss goals, and three years later sixty percent of them had maintained all or most of their lost weight. Accompanying this weight loss, there were marked reductions in blood pressure, improvement of diabetes control, improvement of serum cholesterol and lipid levels, and greater psychological well-being.

For those who wish to modify their VLCD diet plan by incorporating a low calorie healthy meal, as well as for those patients who have already lost an appreciable amount of weight on the VLCD program, we offer the MVLCD and the LCD programs.

The MVLCD diet plan consists of three to four RFO nutritional products per day plus one portion controlled meal that the patient and the dietitian decide upon together.

This program has a caloric range of 500 to 1000 calories per day and in most cases also requires a potassium supplement. The success of this program depends largely on pre-planning of specific meals rather than "choices of anything of four hundred calories or less". In this program, as in the VLCD program, selected patients may require small amounts of appetite-suppressant medication.

Like the VLCD program, patients in the MVLCD program are also closely monitored:

• Weight status is recorded weekly
• Blood pressure and pulse rate taken every 4 weeks (or more if necessary)
• They see a physician and dietitian at least every 2 to 3 weeks
• Have laboratory chemistries performed every two weeks
• EKG's and BIA's performed every eight to twelve weeks.

Close medical monitoring is required because of the drastic caloric restriction and the necessity of potassium supplements.