Monday 2 January 2012

31 Dec 2011 - Can't wait for the pharmacist

I had this idea that I might start with just two meal replacements with normal evening meal as a way of preparing myself for the more extreme programme with Optifast that I was going to start in the New Year.

I have to say that at this stage, my wife was not very convinced.  She is following Weight Watchers and advocates exercise and healthy eating, just as the doctor initially suggested.  However, she is not a diabetic or on medication for blood pressure which was my added motivation for the Optifast plan.

While she was out, I jumped into the car and headed to my local ASDA to see what they sold since they were mentioned in the Daily Mail article I mentioned previously.  I looked at these large tubs of meal replacement shakes.  True that they only cost £4 for nine servings but there was not much variety and I wasn't sure I wanted to buy so much of one flavour - I might have if they did a vanilla flavour but they only sold tubs of chocolate, coffee or strawberry.  I would have preferred it also if they had some soup meal replacements.

Something else caught my eye - a starter box of 5 shakes and 2 soups branded 'The Biggest Loser' which was tied in with the TV programme of the same name.  It was £19.97 for the box so I thought I would give it a go and see how I felt using these type of products.  By the way, on the way home I saw a Tescos and decided to pop in to see what they sold.  They had this same 'Biggest Loser' starter pack for £14.47.  Feeling depressed at such a large difference in price, I bought the Tesco box and returned to ADSA for a refund.

It was lunch time when I got home and tried my first shake - Cherry flavour.  It was not too bad - it did have a powdery texture though so maybe I'll use more water next time but it taste ok.  I was surprised at how full I felt and how quickly my hunger was gone and was feeling optimistic about this concept.

We were going out in a group of 12 to a pub/restaurant for New Years eve.  I was very good - I went for a vegetarian option and I didn't have any alcohol or tea/coffee.  So far so good.

I slept in late the next day and missed breakfast but used a vegetable soup meal replacement at lunch with normal dinner in the evening (turkey again!).  No biscuits or snacks at all during the day.  Will stay at this plan until I hear from the pharmacist on Tuesday, 3 Jan, as to whether he can get Optifast for me.

p.s. one of the persons that was in the group of 12 for New Year Eve that had not been part of our NYE dining group in previous years was a coach from the local gym.  Two years ago, I went to the gym on a doctors referral for 6 weeks and then I carried on for about another 6 months and this guy was my coach - so I felt suitably guilty and resolved to at least go swimming 2 or 3 times a week in the New Year.  Can only be good.   

29 Dec 2011 - Visit to Doctor - Confusion about precriptions

I visited the doctor and explained that I wanted to try this Optifast diet plan.  She was a bit cautious and said she preferred a plan that included exercise and weight loss by changing to healthy eating habits.  I explained that one of the main reasons for wanting to try this programme was because of the potential for reversing diabetes which required the rapid weight loss in order to kick start the pancreas.

She became a bit more interested at this point and I gave her the the information for doctors and the press release articles to keep as she had never heard of Optifast or this research..

She said that unfortunately she could not write out a prescription for Optifast as diet products were not prescribable in the UK which was a pity since as a diabetic I get exemption from prescription costs.  However if I did go on this diet then she would be supportive and that I should come to the surgery after a week or two and get some blood tests.

I was encouraged but disappointed that I couldn't get the product on prescription.  I went home to see if I could buy Optifast on the internet.  I checked eBay and there was nothing available in the UK.  There was a seller in Australia but with the postage and possible customs duty, it would be cheaper to get it from my pharmacist.  I then checked out Amazon and I found a seller in the US that was offering over 50% discount but unfortunately they wouldn't ship to the UK.

Next I found that Lloyds Pharmacy online were selling Optifast at £2.90 per sachet but their website said that you needed a prescription - either an NHS or a private one.  What was odd was that with a private prescription they charged an extra £1.45 for postage.  Being a bit confused by the requirement for a prescription, I phoned Lloyds who confirmed they would only supply Optifast with a prescription and when I pushed them that my GP said she couldn't write a prescription for Optifast, they said to get a private one and I got the impression they wanted me to talk with their online doctor and pay for a private prescription.

I then telephoned Nestle Nutrition.  They told me that Optifast does require a prescription but that the patient would still have to pay full price for the product. Hmm.

Back to the pharmacist - I told him I wanted to order the product but as it is so expensive and I need quite a lot, could he do me a deal especially as it was cheaper at Lloyds pharmacy.  He mad a few calls and found he couldn't get it from his usual suppliers.  He phoned Nestle who were now closed till the 3rd of January and so he would get back to me then.

On the Cycle of Change - see post 25 December 2011 - I would put myself at the Preparation stage - intent on taking action..

Sunday 1 January 2012

28 Dec 2011 - Research

I decided to look into this Newcastle study a bit more by searching on Google for information. I found 4 articles of interest (links provided to all items below).

The first was a press release put out by the university in June 2011 entitled 'Diet reverses Type 2 Diabetes'.  There were related news items on the SKY and BBC websites.  The press release confirmed the results however it was a small study and the conclusion was that more research is needed.

The second item was some more information about the low calorie diet programme.  Basically the three meal replacements provide 600 calories per day which is supplemented by 3 portions of non-starchy vegetables and recipe ideas are given to make the vegetable dishes appetising. 

The third article was an FAQ put together by Prof Taylor as a result of the interest generated particularly by diabetics.

The final article was a document for doctors providing detailed information about the programme and how to monitor their patients if they were going to use it.

Whilst the research motivated to take some action it also made it clear that the patient needs to be medically monitored throughout the programme if they are currently on medication.  For instance if they have been prescribed a diuretic pill (a medication to increase urination) as part of high blood pressure control, this might need to be reduced or stopped as the diet requires the patient to increase their water intake.  Similarly, the diabetes medication needs to be constantly monitored because there is a possibility of  getting a hypo from too lower a sugar level.  Also, iron levels can fall too low on this diet so that the doctor might advise taking a vitamin supplement.

Also, the Optifast Reference Guide from makers Nestle, states that the product has been developed specifically for medically supervised weight loss but it also implied that Optifast was available in the UK.

So my conclusion was that this was something I wanted to do but I needed to talk with my doctor first.  I phoned for an appointment and was surprised to be offered an appointment the next day.

I also went to see my local pharmacist and took along the ordering information I gleaned from the Optifast reference guide.  He told me that he could order it for me but it was very expensive, for instance a pack of 6 soups sachets would cost about £30.  He said that I didn't need a prescription to get it but if I did have a prescription then this would make the programme not so costly (this turned out not to be correct).

So another good reason to see the doctor tomorrow.

27 Dec 2011 - Two week diet to lose diabetes

I read an article today in the Daily Mail entitled 'Dieting for two weeks stopped my diabetes'.

What was all this about - if I could diet for two weeks and lose a stone and lose my diabetes, this would be a miracle.  Not only this but the guy in the story was also able to come off his blood pressure pills which was something I wanted to do as well.

The story was about a guy who had read about a controlled study carried out at Newcastle University, funded by Diabetes UK that researched into the observation that patients that underwent gastric band surgery often reversed their type 2 diabetes as a side-effect of rapid weight loss.

The study with 11 volunteers carried out by Prof Taylor simulated gastric band surgery by putting the people on meal replacement regime that only provided 800 calories per day for eight weeks.  This caused rapid and substantial weight loss and when the body started burning its own fat reserves (known as Ketosis) from the liver and pancreas (fat stored in the wrong places is used up first), apparently the pancreas started working properly again and producing insulin hence the reversal of diabetes.

The meal replacement product used in the study was called Optifast which is not readily available in the UK.  In the US, Canada and Australia it is only available as part of clinic based and medically overseen programme.

Because Optifast was not available in the UK, the guy in the Daily Mail article decided to do his own DIY programme with an own label meal replacement product bought at relatively low cost from ASDA.

This was beginning to sound interesting - here is a link to the Daily Mail article that kicked off my interest.

25 Dec 2011 - Christmas Day 2011 - Contemplation

Christmas Day - everything was out of the window - diet, diabetes control, exercise plans, etc.   Surrounded by chocolate, sweets, biscuits, cream soda and other treats plus full traditional Christmas Day dinner with all the trimmings - just gave in to temptation.

Same thing again on Boxing Day.


There is a chart that I use with my quit smoking clients called the Cycle of Change - I was at the stage called 'Contemplation' which basically means I was aware of the problem but hadn't made any commitment to do anything about it.  Here is a picture of this chart:

You can download a copy of this chart from cycle_of_change.pdf .