Robard (fasting VLCD plan)

(medical weight loss modified fasting program)

Type of Counseling: Provided by a physician, nurse, RD, or behaviorist

Typical Cost: 800-2,000, for 12 weeks

Type Program: Medically supervised, modified fasting

Type of Foods Used: Company liquid supplements plus grocery store food

At-Home or Direct Mail Plan Available? No

Headquarters

Robard Corp.

821 East Gate Drive

Mt. Laurel, NJ 08054

609-778-9200 or 800-222-9201

Website: www.foodsciences.com

Summary

Food Sciences Corp. has been in business for 25 years, serving U.S. corporations, and thousands of medical professionals by manufacturing a variety of products, in the following areas:

• General health & wellness
• Women’s health
• Personal care
• Weight management
• General fitness
• Physical rehabilitation
• Specialty health issues (diabetes, cancer, renal disease).

It is not just a weight loss company. However, its weight management products and programs are provided to hospitals, medical professionals, clinics and fitness centers. It does NOT sell its weight management products directly to the public. You must be referred to a medical professional.

The Robard Program

Robard has a roster of more than 60 products, in categories such as: meal replacements, nutrition bars, puddings, fruit drinks, hot drinks, soups, shakes, breakfast items, entrees, fiber drinks and gelatins, and weight loss capsules. It has a private label program, wherein a doctor, health club or others may use the Robard-made products and attach their own brand name to it.

A glimpse of the company’s website and discussions with management shows that this organization now has four programs or brand names. They differ slightly in the products used and the end-user group each is targeted at. The Nutrimed plan is aimed primarily at physicians. The New Direction program is mainly a hospital-based program. Weight & Inches is mostly for fitness centers and health clubs, and Advanced Health Systems is aimed at clinics.

Robard does not have any direct-to-consumer operations or mail order catalogs. Consequently, it does not have any phone support or Internet-based support systems or services, unlike several of the other major VLCD programs. It does not sell any company brand foods or entrees—just the fasting supplement.

The basic modified fasting program has not really changed since the early 1990s. Following is a description of each of the four plans offered:

Nutrimed

This is a VLCD program for those with a BMI over 30. A physician,, nurse or RD administers the program in four phases: adaptation, weight loss, refeeding, and maintenance. Nutrimed 420 and 500 are used, in the form of meal replacement shakes, puddings, adding up to 420 or 800 calories/day. This is an independent MD program. Participants can expect to lose an average of 3 pounds per week.

New Direction

This is a hospital-based plan for people with major health risks, patients with a BMI of 30+. Those with less weight to lose or who prefer not to have a total fast can use the LCD (low calorie diet) Outlook option. Patients typically lose 3 lbs/week on this plan, 2 lbs./week on Outlook. This program utilizes educational modules concerning nutrition, exercise, and behavior modification. The products used are: Nutrimed Plus (the sole source of nutrition), or Nutrimed Excel (for the Outlook plan), which also uses a beverage replacement for two meals/day.

The Outlook program is for people who have less weight to lose or who prefer not to follow a total fast. This is a low calorie diet (LCD), as compared with a very low calorie diet (VLCD).

The program has not changed since 1993. This plan combines nutritional supplements, shakes, drinks, soups, and real food with practical behavior modification techniques (Lifestyle Skills education modules) and individualized exercises. Nutrimed products are pudding shakes in chocolate, vanilla, strawberry, and banana flavors. The former Biomed line (comprised of: low-calorie, high protein soups, Jello, fruit drinks, and an orange cream drink) has been replaced with a new Advanced Health Systems line (shakes, hot soups, bars, hot drinks, entrees and breakfast items). The meals plus plan uses regular food2-3 shakes a day plus a regular meal)to wean a dieter back to real food gradually.

After successfully meeting entry criteria, patients begin the Reducing Phase of the program. They attend weekly clinics consisting of routine medical evaluations, followed by group sessions combining the principles of counseling and education. Each weekly session covers topics in behavior modification, exercise, and nutrition. Regular attendance is required of all patients. The sole nutrient intake during the period of weight loss is provided by the NEW DIRECTION Nutritional Beverage. Rapid weight loss (an average of 4-7 pounds the first few weeks, tapering thereafter to an average of 3 pounds per week) is produced by the VLCD.

• Adapting & Sustaining Phases As patients in the NEW DIRECTION program approach their goal weight, lean meats, vegetables, fruits, breads and cereals, and dairy products are gradually reintroduced into their diet.
• Sustaining Phase
 During this final phase of the program, patients work with the dietitian to develop a personalized diet, generally between 1200 kcal and 1800 kcal, to promote permanent weight maintenance. With the help of the healthcare team, especially that of the behaviorist, patients identify danger signals for weight regain and develop behavioral strategies to deal with them. Program counseling with a behaviorist emphasizes lifelong adherence to the principles of the NEW DIRECTION System and the need for periodic reinforcement.

The average length of this program is about 17 weeks. Patients try to get within 10% of their goal weight during this time. The supplement is not sold alone, unsupervised, to patients beyond the fasting phase. They must be actively involved in educational or group programs, and be monitored.

Program Costs:

Costs have been held in check since 1991. The average cost will vary by patient and by hospital, but a general rule is about 100 per week during the reducing phase (17 weeks), 70/week during the adapting phase (5 weeks), and 24/week during the sustaining phase (26 weeks)or about 2,675 for a full-year program encompassing all three phases. About 50% of this cost is for the supplement itself. Therefore, the total cost to the patient for a 12-week program would be in the range of 600-1,500, and 800-2,000 for a 16-week program.

Robard also has videotapes, workbooks, and recipe books. Each patient must have a complete medical exam before starting the program, including an EKG, blood work-up, etc.). Some participating doctors offer support groups or rap sessions as well.

Weight & Inches

This is a 7-day kit, a short-term plan with no physician supervision. It typically is used for a jump start to obtain some quick results, when a dieter reaches a plateau, or for vacations. This plan is geared to health clubs and fitness centers, and contains high protein meal replacements, bars, dietary supplements and meal planning tools. Weight & Inches is claimed to be ideal for any dieter or fitness center member with moderate weight loss goals and who exercises at least 3 days a week. It’s also effective for persons who want to break through a weight loss plateau or to jump start a longer-term diet program. Consumers follow a daily regimen of 1200 or more calories. Participants in this plan can expect to lose 1-3 pounds per week.

Advanced Health Systems This plan, geared to clinics, uses supplement as well and is a low-calorie, modified fasting plan. AHS is said to be ideal for people that are mildly overweight to morbidly obese. This program is based on a daily intake of 1000 or more calories, using a combination of supplement and foods. The average weight loss is 2-3 pounds per week.

Comment

The company’s website is little more than a superficial brochure describing the company’s major businesses, with no detail about how the weight management programs work, what they typically cost, or how to find a program or physician in your area that offers it. When you call the company’s 800 number, you can’t always get a live person. To obtain a referral to a program in your area, you have to leave a message (with your name, phone, city and state) and wait for them to call back. This, in the opinion of BestDietForMe.com analysts, is operating in the dark ages, compared to some of the other diet websites and customer service departments set up to give you information. The website has a long way to go compared to others, since it does not offer any interactive tools for the dieter, no nutrition or exercise information, etc.

Summary of Modified Fasting Programs By Hospitals, Clinics, MD’s

Approximately 550 hospitals and clinics nationwide are now using a modified fasting VLCD programs.

Hospitals pay for the VLCD supplement product, but they get free staff trainings and program literature. Staff typically used includes dietitians, nurses, ex-patients, and psychologists. These people provide the patient counseling.

Strong recommendations have come from the NIH and others that the diet medications be used only with strictly supervised medical programs that provide behavioral components. There is a high dropout rate when the medications are used alone, and one usually sees only small amounts of weight loss.

Marketdata estimates that fully 30% and perhaps more of the total patients in a modified fasting program are re-enrollees (clients that were on the program before), rather than new patients. We believe that many people that were on the diet drugs came back to these fasting plans.

The rise in popularity of the diet medications is bringing more dieters into the realm of medically supervised programs. This can only help boost enrollments in VLCD plans, as some will be found to be unsuitable candidates for the medications.

The increase in the number of bariatric surgeries has benefited VLCD programs and the demand for fasting supplements. Many patients are put on the supplement to lose weight PRIOR to the surgery, to make the operation go smoother, and many patients also use the supplement AFTER the surgery, to assist in the long-term weight maintenance phase.

Most VLCD programs have made their programs more flexible, adding intermediate level (more moderate) programs, food entrees, nutrition bars, and higher calorie levels.

Insurers are reimbursing more often for the behavior modification/counseling portion of fasting programs, a good sign.

Although liquid protein diets have been available to American consumers since the mid-late 1970s, many of todays competitors did not exist until the early-mid 1980s. For example, OPTIFAST® (Novartis Nutrition) has been around the longest, since 1976 in the United States. Medifast was introduced in 1980 and the HMR program in 1983. Most of the other companies, however, did not appear until much later Ross Labs New Direction (now part of Robard) – 1988, Ultrafast – 1987 (now out of business), Baylor Fast (now not operating) – 1985.

Typically, about 70-80% of those on medically monitored fasting programs are women. Their average age is 43 years. Medicare and insurance firms will reimburse patients for the cost of the physical exam and any tests related to obesity conditions, but they generally do NOT reimburse for the supplement formula.

Strictly from a cost/benefit approach, a VLCD program, if successful in maintaining weight loss over the long term, will eliminate future need for ongoing medication, surgeries and other, more costly procedures. Consequently, the VLCD can be viewed as a preventive measure.

Obesity research expert Thomas Wadden pointed out to Marketdata that VLCD programs are actually more powerful or effective in losing weight than are the diet medications. He says that it’s probably a waste of money for a dieter to use BOTH a VLCD program and the medications. With a VLCD program, one can expect to lose up to 20% of body weight.

A specific diagnosis is always required for a VLCD patients insurer to reimburse them for part of the total program. The cost of the supplement is not covered (which may represent as much as 50% of the total bill). On average, the VLCD supplement alone accounts for 47% of the total cost of the program, and is not reimbursed by health insurance.

Personnel at various VLCD companies say that the most common diagnoses pertaining to patients includeobesity, Type 2 diabetes, hyperlipidemia, hypercholesterol, hypertension, hypertriglycerdemia, degenerative joint disease, hyperglycemia, arthritis, and sleep apnea.

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