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Medical supervision is always advised when following a VLCD program. Many patients who require weight loss will not present to you asking for assistance. A proactive approach may be required. A good way to identify patients who are suitable for a very low calorie diet is to classify them by BMI or waist circumference, distribution of body fat, morbidity of complications, age and readiness to commit.

In addition to the appropriate BMI, suitable patients may include those with:

The Intensive phase of the OPTIFAST® VLCD™ Program can be considered in individuals with a

  • BMI > 30
  • or a BMI > 27 plus risk factors, poor mobility, or a need for weight reduction prior to surgery.

Risk factors include smoking, hypertension, dyslipidaemia, hyperglycaemia, family history of heart disease, sleep apnoea, or over 45 years of age with a BMI of >27.

If your patient’s BMI is less than 30 and they have no risk factors you can still recommend the OPTIFAST® VLCD™ program however you may consider starting them at the transition or Maintenance phase.


The Transition phase (six weeks) of the OPTIFAST® VLCD™ program is suitable for those with a BMI of 25-30 or for individuals that might find intensive phase too restrictive, Transition phase also restricts calorie intake (not as much as Intensive phase) and could be combined with regular exercise for positive results. The Transition phase doesn't work by inducing ketosis as with the Intensive phase. It works purely by restricting calorie intake to less than 1000 calories per day. During the Transition phase two meals each day will be replaced with an OPTIFAST® VLCD™ product. Two cups of low starch vegetables (link to food allowed) and to drink 2 litres of low calorie fluids will also need to be consumed. The third meal should be a low calorie meal (link to recipe to be decided) of around 400 calories. One serve of fruit (approximately 70 calories) and 1 serve of dairy (approximately 100 calories) are also included bringing the total food intake, including the OPTIFAST® VLCD™ products, to approximately 800-1000 calories a day.


The Maintenance phase (four weeks) of the OPTIFAST® VLCD™ program is when one meal per day is replaced with an OPTIFAST® VLCD™ product. One OPTIFAST® VLCD™ sachet or bar is consumed in addition to two low calorie meals (link to recipes – to be decided) of approximately 400 calories each. Two cups of low starch vegetables and 2 litres of water should also be consumed as well as, 2 serves of fruit (around 70 calories each) and 1 serve of dairy (around 100 calories). This phase restricts calorie intake to between 1000 and 1200 calories per day. The Maintenance can be used as a meal replacement program for individuals with a BMI of 25-30 kg/m2 who want to lose weight but for whom the Intensive phase is not suitable. Some people may choose to stay on the Maintenance phase long term as part of a long term weight management strategy.

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