Novartis Nutrition claims to have the largest database of its kind--the source of clinical data from nearly 80,000 obese patients. Data tracked and published in over 82 clinical studies includes: significant improvements in blood pressure, cholesterol and glucose levels among OPTIFAST^® patients. Novartis was the first to publish 5-year outcome data with OPTIFAST^®.

A study at the Kaiser Permanente Medical Center in San Diego tracked 2,200 patients completing the program. When studied after 18 months, 60% of patients sampled kept off an average of two-thirds of their loss. At 30 months, patients studied had kept off an average of 60% of their weight loss. Results of this study were published in The American Journal of Public Health.

OPTIFAST^® is now being used to induce weight loss as needed before bariatric surgery in several bariatric surgery facilities. Novartis Nutrition has also introduced a brand new line of products, OPTISOURCE™, to help patients meet their special nutritional needs after bariatric surgery. Most of these patients require lifelong protein and vitamin/mineral supplementation after the surgical procedure. OPTISOURCE™ nutritional products are available in several OPTIFAST^® clinics, bariatric surgery facilities, and online through the Walgreen’s Home Delivery program.

OPTIFAST^® runs a solid weight loss program, with well-trained, quality staff. They have been operating for 28 years and have a very good track record, with clinical research data to prove it. Their modified fasting program ranks in the top two in the nation, according to BestDietForMe.com’s research. We cannot determine whether HMR or OPTIFAST^® is #1 (in terms of revenues, number of patients enrolled, or number of sites offering the program) in the nation, and this is a subjective call anyway. Suffice it to say, OPTIFAST^® is one of the leaders in this area. Counselors are high-level professionals.

Approximately 550 hospitals and clinics nationwide are now using a modified fasting VLCD programs.

Hospitals pay for the VLCD supplement product, but they get free staff trainings and program literature. Staff typically used includes dietitians, nurses, ex-patients, and psychologists. These people provide the patient counseling.

Strong recommendations have come from the NIH and others that the diet medications be used only with strictly supervised medical programs that provide behavioral components. There is a high dropout rate when the medications are used alone, and one usually sees only small amounts of weight loss.

Marketdata estimates that fully 30% and perhaps more of the total patients in a modified fasting program are re-enrollees (clients that were on the program before), rather than new patients. We believe that many people that were on the diet drugs came back to these fasting plans.

The rise in popularity of the diet medications is bringing more dieters into the realm of medically supervised programs. This can only help boost enrollments in VLCD plans, as some will be found to be unsuitable candidates for the medications.

The increase in the number of bariatric surgeries has benefited VLCD programs and the demand for fasting supplements. Many patients are put on the supplement to lose weight PRIOR to the surgery, to make the operation go smoother, and many patients also use the supplement AFTER the surgery, to assist in the long-term weight maintenance phase.

Most VLCD programs have made their programs more flexible, adding "intermediate" level (more moderate) programs, food entrees, nutrition bars, and higher calorie levels.

Insurers are reimbursing more often for the behavior modification/counseling portion of fasting programs, a good sign.

Although liquid protein diets have been available to American consumers since the mid-late 1970s, many of today's competitors did not exist until the early-mid 1980s. For example, OPTIFAST^® (Novartis Nutrition) has been around the longest, since 1976 in the United States. Medifast was introduced in 1980 and the HMR program in 1983. Most of the other companies, however, did not appear until much later... Ross Labs' New Direction (now part of Robard) - 1988, Ultrafast – 1987 (now out of business), Baylor Fast (now not operating) – 1985.

Typically, about 70-80% of those on medically monitored fasting programs are women. Their average age is 43 years. Medicare and insurance firms will reimburse patients for the cost of the physical exam and any tests related to obesity conditions, but they generally do NOT reimburse for the supplement formula.

Strictly from a cost/benefit approach, a VLCD program, if successful in maintaining weight loss over the long term, will eliminate future need for ongoing medication, surgeries and other, more costly procedures. Consequently, the VLCD can be viewed as a preventive measure.

Obesity research expert Thomas Wadden pointed out to Marketdata that VLCD programs are actually more powerful or effective in losing weight than are the diet medications. He says that it’s probably a waste of money for a dieter to use BOTH a VLCD program and the medications. With a VLCD program, one can expect to lose up to 20% of body weight.

A specific diagnosis is always required for a VLCD patient's insurer to reimburse them for part of the total program. The cost of the supplement is not covered (which may represent as much as 50% of the total bill). On average, the VLCD supplement alone accounts for 47% of the total cost of the program, and is not reimbursed by health insurance.

Personnel at various VLCD companies say that the most common diagnoses pertaining to patients include...obesity, Type 2 diabetes, hyperlipidemia, hypercholesterol, hypertension, hypertriglycerdemia, degenerative joint disease, hyperglycemia, arthritis, and sleep apnea.