In the Kaiser program, this is a month of adjusting from all Optifast product meal replacement, to mostly or all “real food,” as well as an adjustment (increase) in calories. For those who have been at 800 or 900 (or anywhere lower than 1,200) there is an increase to 1,200 calories. (There is at least one in our group who is on 10 products a day, so he will be going off product but not reducing to 1,200 calories. Some need one-on-one counseling about their transition schedule.)
Part of the reason they want us to increase our calories is that after this month there is no official medical supervision, no more lab tests, no more blood pressure monitoring even, I think. That supervision is needed for a very low calorie diet, but once at 1,200 calories you are no longer considered to need medical monitoring. (And we no longer pay the “big bucks” monthly since we aren’t paying for doctors, lab work, etc.)
Each week of transition you have one less product, and you substitute in the specified real food replacement. The schedule we are given is as follows (although our group leader has given us permission to not follow this too rigidly – unless that is what works best for us):
Week 17 – lose one Optifast product, swap in 4 oz lean protein and 1/2 cup cooked veg (chicken and broccoli, salmon and asparagus, shrimp and green beans, etc.)
Week 18 – lose another product, swap in 2 more oz lean protein, 1 serving fruit, and 8 oz non/low-fat dairy (yeah blueberries and yogurt for breakfast!)
Week 19 – lose another product, swap in 1 cup raw veggies, 1 serving fruit, 1 serving fat (spinach salad with strawberries?)
Week 20 – lose another product, swap in 1 more cup raw veggies, 8 more oz dairy, 1 tsp oil, and 1/2 cup cooked grains or 1 oz slice bread (carbs! but not many…)
If you follow this plan, then the calories are gradually raised over the month so that calories are at 1200 by the end. The remaining (one to three) products can be kept in the food plan, as high-protein snacks, for example, for quite some time, if desired. (That will be a bar, for me – I won’t miss the shakes one bit!) You can continue to buy Optifast products from Kaiser as long as you weigh-in and go to group meetings twice a month.
At the end of the transition phase, the plan is to have our metabolism checked so that we know how many calories we need to maintain our weight at that point. For those who want to continue losing, they would need to eat less than that. For those who are told, based on the test, that they need more than 1,200 calories to maintain, if they choose to stay at 1,200 they should continue to lose weight.
For those who want to eat more than the calories they need to maintain, they need to focus on weight training, since lean muscle mass boosts metabolism. For those who slacked off on ANY exercise or resistance training during phase 1, the results of the metabolism test will be where it comes back to bite you in the (flabby) butt. One of the doctors told us a story of a couple who both lost the same pounds during phase 1 but one had exercised enough to maintain their lean muscle and one hadn’t. One was told they could only eat 1,200 calories to maintain, the other could eat 1,600 calories to maintain. More is better! (I won’t get the test for a few weeks yet – but am worried. I look at my body and see no evidence of muscles!)
Other options for those who want to continue to lose are to join another Optifast 16-week meal-replacement phase 1 group at some point (ugh), or to do some other kind of weight-loss program, such as Weight Watchers, now that they’ve had their weight loss “kick started” by the more rapid results of the Optifast program. Success is motivating, so I’m sure most or all of those in the program not at their goal will continue to pursue some sort of weight-loss plan. And since our group should still be meeting together for months, I hope to see everyone reach their goal at some point!