The first law of thermodynamics states that change in weight equals caloric intake minus caloric output. Caloric intake is the number of calories you eat and drink each day, and caloric output is your resting metabolic rate plus any physical activity expenditure. If caloric intake exceeds caloric output, then the excess calories are deposited as fat in your body, and body weight increases. If caloric intake is less than caloric output, then your body fat stores supply the necessary calories and weight loss ensues. Reducing caloric intake has been shown to be more efficient than just simply increasing exercise to induce weight loss.
Simply handing a patient a 1,200 or 1,500 calorie diet seldom works. We acknowledge that dietary choices are based on a variety of factors, such as religious and cultural beliefs, a person's socioeconomic status, and the health of the individual, all of which are taken into account during the meal planning process. Conferences with the physician and dietitian help each patient finalize their individual choice of diet program/prescription based on their personal goals and preferences. Diet prescriptions are written to offer a safe rate of weight loss and assurance that the majority of weight loss will come from fat stores and not from muscle mass. Patients are required to attend the clinic weekly; therefore, individualized diet regimens can be modified in response to adherence, rate of weight loss, etc. Since protein has the advantage of being the most satiating macronutrient, most of the individual diets are high in protein, low in fat, and moderate to low in carbohydrate.
As an added measure to assist patients in compliance and adherence to the diet, dietitians and the behavioral program are available for education, advice and to answer questions. If a patient thinks that they are adhering to the diet and losing insufficient weight, then the patient is given an individual food diary to keep track of food intake for one or two weeks. This food diary is analyzed and discussed with the dietitian, who can often see a food pattern, which is not apparent to the patient. If a patient is adhering to the prescribed diet and does not lose the anticipated weight (rarely due to a genetically low metabolic rate), the caloric intake may then be lowered accordingly and/or the physician may prescribe low doses of triiodothyronine, a thyroid drug, to boost the patient's metabolic rate.
In the RFO Program, the dietitians, therapists, and physicians work closely with each patient on a weekly basis to assure patient success.