The majority of AEs observed in this intervention were expected and similar to other studies.10 Among the 20 participants, 18 experienced a total of 60 AEs, of which 38 (63%) were considered to be study-related. Although constipation was a known AE, 25% of participants subjectively complained of decrease in frequency of bowel movements. The 2 most frequent and unanticipated AEs were increased blood urea nitrogen/ creatinine (n = 9) and reduced sodium (n = 7).
Nonadherence was often related but not limited to the following: inappropriate social cues for eating, lack of social support, sabotage by family or peers, filling an emotional void with food, and/or psychological eating related to depression and posttraumatic stress disorder. Prior to starting a similar intervention, a complete mental health assessment for individuals with known or suspected mental health diagnoses seems warranted.
Conclusion
The study limitations are its small and predominantly male sample size and lack of a randomized control. Nonetheless, this study demonstrated the feasibility of the medically supervised weight loss program to obtain the necessary weight loss in 50% of the veterans (with higher comorbidities and more advanced age). Because of the results of this investigation, the authors have initiated a randomized controlled trial utilizing this intervention. The Optifast program had a high success rate, was cost-effective, and may obviate the need for surgery.
Acknowledgements
This work was supported by pilot funding from the Department Veterans Affairs awarded on a competitive basis to Julie Kurtz. Additional support was provided by the Department of Veterans Affairs. The authors would like to acknowledge the contribution of Julie Stoneroad-Vedda, PA-C, MPAS, Northern Arizona VA Health Care System in Prescott.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
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