Liquid-diet regimen might trim need for bariatric surgery

By Russell Rian

ctoexclusive

Sherri Rudeen joined UT Southwestern’s supervised diet program as part of requirements for a planned bariatric surgery. But the 44-year-old mother of twins has since succeeded in losing enough weight — more than 65 pounds in all — that she no longer needs the surgery.

The bariatric program recently developed the medically supervised regimen, featuring a specially designed liquid protein diet, for people who are looking to lose weight with or without surgery. The weight-loss program, available to those seeking to lose anywhere from 10 pounds to more than 100 pounds safely, is based on a severe calorie-restricted diet and monitored by physicians and registered dietitians.

“It’s not safe to go on a diet like this by yourself. It could be very dangerous,” said Rosemary Son, a registered dietitian and faculty associate with UT Southwestern’s Clinical Center for the Surgical Management of Obesity. “It’s absolutely essential that you get enough protein and enough vitamins, which is not necessarily what all protein shakes on the grocery shelf provide.”

liquid-diet
Sherri Rudeen (left) discussed the liquid protein diet with dietitian Rosemary Son at the Clinical Center for the Surgical Management of Obesity.

A vow to enjoy family

Ms. Rudeen, of Flower Mound, found motivation in her twin 3-year-old daughters, Sydney and Jordyn. She had begun gaining weight after her metabolism spiraled downward during a difficult pregnancy that included nine months of bed rest and the stress of infant twins afterward. But she vowed to take the weight off in order to be enjoy play time with her children.

“The first week is really tough. There’s so much you’re changing. You miss food,” she said. “But after the first four or five days, it’s OK. I lost about 8-and-a-half pounds in the first week, so that’s pretty motivating.”

She lost about 25 pounds on a supervised diet plan, then another 40 since last October using the stricter liquid diet.

Ms. Rudeen said she typically loses about 3 to 4 pounds a month while going on and off the diet, and about 8 to 10 pounds a month following the strict diet, she said. She goes on and off at different times to factor in events such as Thanksgiving and Christmas, but also eats more sensibly in between bouts on the liquid diet so as not to gain weight when off the diet.

Ms. Rudeen, who had tried multiple diets previously, said she believes this diet worked in part because of the supervision by physicians and dieticians.

“It holds you accountable. But the doctors have been very positive, very reassuring. Often with other doctors, you get someone telling you that you’re overweight and you really need to do something about your weight with no real assistance or positive reinforcement.”

The ease of following the liquid protein diet was also a factor in her success, she said, because as a working mother, she didn’t need the added stress of reading labels, counting calories, or trying to juggle meal plans.

Her goal is to lose another 45 pounds or so on the diet and hopes to hit that number around the upcoming wedding for her niece.

Initially, 800-calorie intake

The medically supervised diet contains about 800 calories per day — the equivalent of about four slices of pizza — and consists of a specially designed protein powder that dissolves in water, milk, tea, yogurt and similar products. No other food is consumed initially, although after a certain period some vegetables and other foods can be added.

“Physician supervision is essential due to the drastic calorie restrictions,” Ms. Son said. “If patients stay on it long enough, their appetite is suppressed. It’s pretty hard for about a week. Once they get through the wash-out period, they’re very motivated.”

The Food and Drug Administration in March expanded medical alerts covering more than 70 over-the-counter products marketed for weight loss that contained undeclared, active pharmaceutical ingredients it said could put consumers’ health at risk. The various products contained controlled substances, a drug not approved for marketing in the U.S., anti-seizure medication and a suspected cancer-causing agent, according to the FDA’s alert.

“Studies continue to show that successful, long-term weight loss is difficult to achieve,” said Dr. Edward Livingston, chief of GI/endocrine surgery and director of the bariatric program, the Clinical Center for the Surgical Management of Obesity. “A medically supervised program can help ensure you accomplish your goals safely and effectively, whether you are considering surgery or hoping to avoid it.”

Bi-weekly monitoring

Participants in UT Southwestern’s liquid diet program are seen by a dietitian or physician on alternating weeks to help monitor their health. Weight measurements are taken weekly and measurements including fat distribution are taken with a special body composition analyzer and reviewed at regular intervals. In addition, support groups are offered weekly and dieticians provide individualized counseling to educate participants and help them adopt a more sensible eating plan after the desired weight loss is attained.

“How it should work is that you go to the extreme at the beginning, and then you get back to real food where you’re learning how to behave, have a good diet, how to make sensible meals and so on,” Ms. Son said.

The bariatric surgeons developed the program because bariatric surgery candidates often are required by insurance to follow a dietary plan for at least six months before surgery. In addition, research by UT Southwestern bariatric surgeons shows that losing pounds before weight-loss surgery can help reduce the time spent in the operating room.

UT Southwestern offers free monthly 90-minute education sessions for potential bariatric surgery patients every other Thursday of each month. Those interested in the diet program or bariatric surgery can call 214-645-2900 for information.

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