Frequently Asked Medical Weight Loss Questions

1. Can I eat while on this program?

We have several different programs that you can read about on our weight loss programs page, but the typical full-meal replacement program does not include regular food. A key component of the program is a specially formulated full-meal replacement diet (generally 800-1120 calories/day), followed by a gradual transition to regular foods at the completion of the active weight loss phase. The OPTIFAST products used in the program provide high quality protein and 100% of the Daily Value for 24 vitamins and minerals in the recommended number of servings. So if you choose this meal replacement program, you will be getting all the nutrition you need. Some of our patients feel relief from not having to count calories and have described the OPTIFAST program as a temporary vacation from food.

2. I read that as soon as you start eating regular foods, all your weight comes back. Is this true?

While patients transition from their liquid and bar diet to conventional foods, they generally continue to lose weight but at a slower rate. Some people may experience a slight transient weight regain during this time while they iron out how to incorporate regular food into their diets again. Those patients who do gain some weight typically experience no more than a 2 pound regain and it tends to happen when they add starchy carbohydrates back into their diets. This small weight regain is due to two factors:

  • Solid food simply weighs more while it is being digested in the intestine than liquid and bar diet products and
  • Digesting carbohydrates and sodium simply requires the body to retain more water.

3. Will strict dieting ruin my metabolism?

Research by Wadden and associates demonstrates that dieting does decrease resting metabolic rate (RMR). The more strict the diet, the more it depressed the RMR. This is the body’s natural response to a food shortage. The study went on to find that RMR increases as calorie intake increases. At six months after OPTIFAST Program participation, there was no difference in the RMR of people who lost weight using the 420 calorie/day OPTIFAST liquid diet* and those who lost weight using a 1200 calorie/day reduced-calorie diet of conventional foods.

If you lose a significant amount of weight, you will have a slightly lower RMR than you did before dieting because you will lose some lean body tissue in addition to losing weight. As you gain weight, you gain lean body tissue to help carry the extra pounds. When you lose fat, you lose some of the associated lean tissue too. To help ease the transition to regular foods, the OPTIFAST Program includes a gradual return to higher calorie levels. This helps give your metabolism time to increase. Developing a regular exercise program can also help maintain and increase your RMR while dieting and in maintenance.

*The standard OPTIFAST diet now provides a minimum of 800 calories/day.

4. Can I lose weight and keep it off if I don’t use an exercise program?

It is possible to lose weight and keep it off without following an exercise program, but it is much harder to do and rarely successful in the long term. According to the data provided by the National Weight Control Registry (NWCR), people who don’t begin an exercise program while trying to lose weight and/or stop exercising after losing weight, almost always regain the weight. The NWCR has determined that individuals who have successfully maintained long-term weight loss report high levels of regular physical activity. We also strongly recommend developing and following a routine exercise program not only because it is a key component of successful weight loss and weight management, but because physical activity provides a variety of long-term health benefits such as preventing illness, injury and disease.

5. Why should I attend classes?

Your short and long term weight loss will be greatly enhanced by your attendance in classes featuring Keep It Off U™, a class series taught by behavioral psychologists, dieticians and certified trainers. You will have the opportunity to learn about nutrition, exercise, and how eating and food affect our emotional and psychological being. The classes take a whole person approach and provide you with the tools that will help ensure that you maintain your weight loss. Studies have shown that 54% more attendees were able to keep their weight off when attending classes.

6. Who teaches the classes?

We have several very reputable psychologists who specialize in weight loss as well as Registered Dieticians and exercise specialists.

7. How long are classes?

Classes are one hour in length.

8. How often should I come into the office?

This depends on your individualized plan, although it is often recommended that you come in once a week.

9. How often do I see the doctor?

All of our plans are individualized and your doctor will make a recommendation that is right for you.

10. What is the cost of the program?

The average cost of a visit with your physician is $60.00, and food costs typically average less than what you would spend at the grocery store or eating out.

11. Do you accept insurance?

We do not directly process any insurance in our office. On request, we can provide you with the proper documentation to submit claims to your insurance company. Unfortunately, most insurance companies do not cover weight loss services. We, therefore, recommend that you call your specific insurance company for more information. On the other hand, many people are able to use flexible spending plans to pay for their weight loss services pre-tax.

12. What is your maintenance program?

After you have reached your goal, we have an active maintenance program that incorporates metabolic testing, ongoing education, and continued physician supervised care. Just as weight loss requires a plan, so does maintenance. We will provide a specific plan to keep your weight steady, and to deal with the normal fluctuations in your weight. Your long-term care is of great importance to us and we feel that once you are a patient, you are always a patient.

13. Can I still do the program if I have lost weight elsewhere but need help keeping it off?

We have an active maintenance program that will meet all of your needs and help you be more confident in your ability to maintain your weight loss. Many patients come to us because they have been unsuccessful in keeping off the pounds they have lost elsewhere. We provide the tools to be a successful long-term weight manager. These tools include ongoing support, continued physician follow-up, and an intervention plan to deal with weight fluctuations. If you have lost weight and have reached a plateau, we can help you lose more weight, while gaining the tools to prevent weight regain.

14. How much should I expect to lose per week/month?

The average weight loss per week is 2-7 pounds with the first month loss being approximately 12-14 pounds*.

15. How long does the program last?

Our programs are all very individualized. You are never obligated to a particular program for a pre-determined time frame. You make the decisions that best meet your personal needs and time constraints.

16. I have several health problems, high blood pressure and Type II Diabetes.  Is this program safe for me?

Since overweight and obesity are highly related to diseases such as hypertension and type II diabetes, we have treated numerous patients in your same position. In fact, our patients are able to reduce their blood pressure and diabetes medications by 50%*. Drs. Ziltzer and Primack are board certified in Bariatrics, Internal Medicine and Pediatrics. As a result, they are specifically trained in the management of these diseases.


Saris, W. H.M. (2001), Very-Low-Calorie Diets and Sustained Weight Loss. Obesity Research, 9: 295S–301S. doi: 10.1038/oby.2001.134
Very Low Calorie Diets – National Institute of Diabetes and Digestive and Kidney Disorders