Protein Sparing Modified Fasts
These Diets Eliminate Both Carbohydrate and Fat But Supply the Protein Needed to Prevent Loss of Lean Body Tissue
Protein sparing modified fasts
(PSMF) are the most rapid yet safe
weight control diets. Known by
names like Optifast and Medifast,
these usually take the form of five
liquid "meals" daily-usually prepared
by mixing a dry powder with water.
These liquid diets usually provide
about 500 calories of protein daily
along with some minerals and
electrolytes. They contain virtually
zero carbohydrate and therefore
these diets are strongly ketogenic
within a day or two of starting.
Because ketosis suppresses
hunger, many patients find these
diets surprisingly painless. Because
ketosis causes large shifts in fluids
and electrolytes in the body,
patients need close medical
monitoring during their time on the
fasts. They also usually require
additional prescription electrolyte
replacement.

PSMF's typically produce very rapid
weight loss. Some studies show
that obese patients placed on
PSMF's lost about thirty pounds of
body fat in six weeks. One
particularly famous patient was
Oprah Winfrey whose first major
public weight loss occured in the
late 1980's using a PSMF.
Unfortunately, Ms. Winfrey's
success after stopping the fast
was rather typical for patients:
rapid weight regain accompanied
by irrepressible hunger. Indeed,
largely because of Winfrey's public
re-grain, PSMF's fell into
widespread public disfavor by the
early 1990s.

Today, PSMF's have a limited but
important role in medical weight
control. These diets are generally
reserved for patients who have an
urgent need for weight loss, often
an upcoming surgical proceedure
(including bariatric surgery) or very
serious weight related medical
problems. Used appropriately,
these diets can produce results
that no other diet can match.
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