HEALTH LIFE IN THE FASTING LANE

On the BaylorFast diet, you can never be too rich or too thin.

It’s Wednesday night at Baylor Univer-sity Medical Center and a woman who has eaten virtually nothing for six weeks is about to see her doctor. In-! stead of hunger, she’s feeling pangs of guilt over half a can of tuna she ate the weekend before. In the waiting area, “before” and “after” Palaroids of onetime heavies hang on the wall; they seem to be shaking their fingers at the backslider.

She goes into the doctor’s office for her weekly checkup and confesses her sin. They discuss her feelings (failure) and why she ate the tuna (hunger). She gets weighed, then comes out smiling. “I lost 3.4 pounds,” she tells her friend, who is also starving herself. ’And I didn’t turn off ketosis.’”

Welcome to the world of BaylorFast, Baylor hospital’s take-it-off-fast fast in which words like “cheat” are never used (in spite of the fact that about half the dieters do), in which ketosis (the chemical reaction that signals that the body is burning fat stores for energy) is the watchword, and food, even water-packed tuna, is against the rules. Sustenance comes by way of a liquid protein supplement called BaylorFast. Patients live on 450 to 800 calories of the mixture daily and meet weekly for medical checkups, weigh-ins, and group support sessions until they reach their goal.

For these people, BaylorFast is a last-ditch effort to end a lifetime of seesawing on the scales. For doctors, it’s a largely successful means of treating the obese. Early figures substantiate their claim: some 2,000 patients have lost an average of seventy-two pounds on BaylorFast since its inception three years ago; another 1,400 are currently slimming down at the hospital’s fasting centers in Mes-quite. Grapevine, North Dallas. Las Col-inas. and at the hospital on Gaston. (Two more locations are set to open this month in Denton and Arlington.) Seventy percent of those who completed the program and attended maintenance have kept most of the weight off for eighteen months, according to BaylorFast. Conventional diets, say the experts, produce such results only 1 percent to 5 percent of the time.

Because it’s actually a protein-sparing modified fast, the program has more to do with “fast” weight loss (an average of three to five pounds a week) than a true fast, which means a regimen of water and vitamins only. BaylorFast is a four-phase program (enrollment, fast, refeeding, and lifelong maintenance) designed for people at least thirty-five pounds overweight-the point at which obesity becomes a risk factor. In the Dallas area, an estimated 100,000 adults fall into this group.

After an enrollment fee of $610 (to cover the initial physical and all lab work), patients pay $i20 each week for checkups and rations of BaylorFast. It’s Baylor’s sign-up price that distinguishes it as the most expensive in the city. At Garland Memorial, St. Paul. Dallas Diagnostic Association, and The Weight Management Center, for instance, the initial cost is about one-third Baylor’s price. Insurance sometimes covers the initial cost, but only for the morbidly obese (those at least 100 pounds overweight). For the average patient with eighty-three pounds to lose, the cost comes to about $3,000.

Dieters who have an all-or-nothing mentality tend to succeed on BaylorFast, if only because it’s decision-free. The diet has worked for alumnae like Channel 8 sports-caster Dale Hansen, who lost fifty pounds in nine weeks; public relations maven Martha Tiller, who discarded ninety-five pounds in six months; and cheerleading equipment magnate Lawrence Herkimer, who saw fifty-two pounds vanish in eleven weeks.

Baylor’s is the oldest hospital-backed fasting program in Dallas and is believed to be the largest one of its kind in the U.S. But competition mounts as others discover the demand. In the last year and a half alone, St. Paul Medical Center and Memorial Hospital of Garland have devised fasting programs, and this month, Presbyterian Hospital unveils its own version. Besides Baylor-Fasters, there are hundreds of Dallasites fasting on similar programs designed by physicians in private practice (most notably, Dallas Diagnostic Association and The Weight Management Center), while countless others are taking the do-it-yourself approach and getting their doctors to prescribe the formula for them. In a word. liquid protein-in spite of its checkered past-is a hot commodity.

Liquid protein diets were responsible for a number of deaths in the late Seventies. “The early supplements were made out of collagen, like horses’ hooves and tendons, very low-quality protein,” says Charles Walker. M.D., medical director of Baylor-Fast. ’They had none of the things you need for your body and your heart to work appropriately, such as potassium, manganese, and magnesium. They were put together cheaply and were sold unethically.”

The new formulas are made of vitamins, minerals, electrolytes, and egg-white and milk proteins that are more easily assimilated by the body. In the early Eighties, a study was done to determine the safety of the new supplements versus the old. Opti-fast (the supplement now used at Presbyterian Hospital) was given to one group of women, and one of the original liquid proteins to another. After three weeks, the latter group began to develop heart irregularities, while the women on Opti-fast continued for twelve more weeks without any problems.

Even so, there are possible side effects with the new formulas, ranging from the ex- pected (bad breath, constipation) to the alarming, such as hair loss and sudden numbing in the legs. Dieters are warned that “binge” eating could trigger gallbladder attacks or pancreatitis.

“The first week they enter the fast we warn them about lightheadedness, headaches, fatigue, and intolerance to the cold,” says Dr. John Pippen, attending physician in internal medicine at Baylor. “Some of the long-term side effects are dry skin, brittle nails, and hair loss, which is usually worse in women.”

Those warnings didn’t scare Jean Burns, a secretary at Wilshire Baptist Church, until she lost the feeling in her lower right leg midway through the fast. Walker says that such sensations can be caused by rapid weight loss or gain. “The nerve is probably feeling trapped by the change in fat deposited in that part of the leg,” he says. Burns says the feeling in her leg came back after a few months.

And for those who break the fast? “If they eat a lot of carbohydrates, the body will release insulin, which stops the breakdown of fat [ketosis],” says Becky Chase, director of training for the BaylorFast program. “They can have all these shifts by eating very little food. It makes it difficult to get back on the fast, and it’s defeating emotionally.”

During the fast and for at least six months afterward, group sessions provide support for the participants. They learn about nutrition, exercise and behavior modification, and how to deal with temptations. Feelings of inadequacy are shared, early eating patterns are explored (Mom most often gets the blame here), and the group gets lots of coddling.

Learning how to keep the weight off is thegoal of maintenance. Participants continueto attend sessions for twelve weeks and thenhave the option to attend for the rest of theirlives. Lawrence Herkimer. president ofCheerleader Supply Co., first thought ofmaintenance as a “Mickey Mouse deal,” buteventually changed his mind. Herkimer andwife Dorothy celebrated the end of his fastwith a gastronomic tour of London. “I feelI passed the supreme test. We went to the tenbest restaurants in London and when we gotback. I got on the scales and I hadn’t gaineda pound. That’s what the fast does. It helpsget the weight off fast and then helps you appreciate food.”

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