Improving Compliance with Very Low Energy Diets (VLEDs) Prior to Bariatric Surgery—a Randomised Controlled Trial of Two Formulations

Lucy Davenport, Yazmin Johari, Alexandria Klejn, Cheryl Laurie, Andrew Smith, Geraldine J. Ooi, Paul R. Burton, Wendy A. Brown

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: Preoperative very low energy diets (VLEDs) improve access during bariatric surgery. Compliance with traditional VLED is variable, mainly due to gastrointestinal side effects. Formulite™ is a new formulation of VLED, with higher protein, soluble fibre and probiotics. Aims: To compare traditional VLED (Optifast™) with the new VLED (Formulite™) and assess compliance, weight loss, satisfaction, side effects and surgical access. Methods: This was a randomised double-blinded study involving patients scheduled for bariatric surgery. The primary outcome was compliance, assessed by urinary ketone concentration and proportion of patients in ketosis at 2 weeks. Secondary outcomes were weight loss, satisfaction and patient reported outcomes, gastrointestinal side effects and operative conditions. Results: There were 69 participants: 35 in the Formulite™ group and 34 in the Optifast™ group. Ketosis at 2 weeks was achieved in both groups (88.5% vs 83.3%, Formulite™ vs. Optifast™, p = 0.602). Urinary ketones were higher with Formulite™ (1.5 vs 15 mmol/L, p = 0.030). Total body weight loss percentage, hunger and operative conditions were similar in both groups. Formulite™ produced less flatulence (score 3 vs 2, p = 0.010) and emotional eating (score 2 vs 1, p = 0.037); however, Optifast™ ranked higher in terms of taste (score 4 vs 3, p = 0.001) and overall satisfaction (score 5 vs 7, p = 0.011). Conclusions: Compliance over 2 weeks was high in both VLEDs with most subjects achieving ketosis. Overall satisfaction was moderately high, although variable. Whilst Formulite™ is a viable alternative to Optifast™, better formulations of VLED that addresses key adverse effects, whilst achieving ketosis, would be of significant value.

Original languageEnglish
Number of pages8
JournalObesity Surgery
DOIs
Publication statusAccepted/In press - 21 May 2019

Keywords

  • Bariatric surgery
  • Compliance
  • Very low energy diet

Cite this

@article{1316476948434c0d8e2022969e1bd03d,
title = "Improving Compliance with Very Low Energy Diets (VLEDs) Prior to Bariatric Surgery—a Randomised Controlled Trial of Two Formulations",
abstract = "Introduction: Preoperative very low energy diets (VLEDs) improve access during bariatric surgery. Compliance with traditional VLED is variable, mainly due to gastrointestinal side effects. Formulite™ is a new formulation of VLED, with higher protein, soluble fibre and probiotics. Aims: To compare traditional VLED (Optifast™) with the new VLED (Formulite™) and assess compliance, weight loss, satisfaction, side effects and surgical access. Methods: This was a randomised double-blinded study involving patients scheduled for bariatric surgery. The primary outcome was compliance, assessed by urinary ketone concentration and proportion of patients in ketosis at 2 weeks. Secondary outcomes were weight loss, satisfaction and patient reported outcomes, gastrointestinal side effects and operative conditions. Results: There were 69 participants: 35 in the Formulite™ group and 34 in the Optifast™ group. Ketosis at 2 weeks was achieved in both groups (88.5{\%} vs 83.3{\%}, Formulite™ vs. Optifast™, p = 0.602). Urinary ketones were higher with Formulite™ (1.5 vs 15 mmol/L, p = 0.030). Total body weight loss percentage, hunger and operative conditions were similar in both groups. Formulite™ produced less flatulence (score 3 vs 2, p = 0.010) and emotional eating (score 2 vs 1, p = 0.037); however, Optifast™ ranked higher in terms of taste (score 4 vs 3, p = 0.001) and overall satisfaction (score 5 vs 7, p = 0.011). Conclusions: Compliance over 2 weeks was high in both VLEDs with most subjects achieving ketosis. Overall satisfaction was moderately high, although variable. Whilst Formulite™ is a viable alternative to Optifast™, better formulations of VLED that addresses key adverse effects, whilst achieving ketosis, would be of significant value.",
keywords = "Bariatric surgery, Compliance, Very low energy diet",
author = "Lucy Davenport and Yazmin Johari and Alexandria Klejn and Cheryl Laurie and Andrew Smith and Ooi, {Geraldine J.} and Burton, {Paul R.} and Brown, {Wendy A.}",
year = "2019",
month = "5",
day = "21",
doi = "10.1007/s11695-019-03916-2",
language = "English",
journal = "Obesity Surgery",
issn = "0960-8923",
publisher = "Springer-Verlag London Ltd.",

}

Improving Compliance with Very Low Energy Diets (VLEDs) Prior to Bariatric Surgery—a Randomised Controlled Trial of Two Formulations. / Davenport, Lucy; Johari, Yazmin; Klejn, Alexandria; Laurie, Cheryl; Smith, Andrew; Ooi, Geraldine J.; Burton, Paul R.; Brown, Wendy A.

In: Obesity Surgery, 21.05.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Improving Compliance with Very Low Energy Diets (VLEDs) Prior to Bariatric Surgery—a Randomised Controlled Trial of Two Formulations

AU - Davenport, Lucy

AU - Johari, Yazmin

AU - Klejn, Alexandria

AU - Laurie, Cheryl

AU - Smith, Andrew

AU - Ooi, Geraldine J.

AU - Burton, Paul R.

AU - Brown, Wendy A.

PY - 2019/5/21

Y1 - 2019/5/21

N2 - Introduction: Preoperative very low energy diets (VLEDs) improve access during bariatric surgery. Compliance with traditional VLED is variable, mainly due to gastrointestinal side effects. Formulite™ is a new formulation of VLED, with higher protein, soluble fibre and probiotics. Aims: To compare traditional VLED (Optifast™) with the new VLED (Formulite™) and assess compliance, weight loss, satisfaction, side effects and surgical access. Methods: This was a randomised double-blinded study involving patients scheduled for bariatric surgery. The primary outcome was compliance, assessed by urinary ketone concentration and proportion of patients in ketosis at 2 weeks. Secondary outcomes were weight loss, satisfaction and patient reported outcomes, gastrointestinal side effects and operative conditions. Results: There were 69 participants: 35 in the Formulite™ group and 34 in the Optifast™ group. Ketosis at 2 weeks was achieved in both groups (88.5% vs 83.3%, Formulite™ vs. Optifast™, p = 0.602). Urinary ketones were higher with Formulite™ (1.5 vs 15 mmol/L, p = 0.030). Total body weight loss percentage, hunger and operative conditions were similar in both groups. Formulite™ produced less flatulence (score 3 vs 2, p = 0.010) and emotional eating (score 2 vs 1, p = 0.037); however, Optifast™ ranked higher in terms of taste (score 4 vs 3, p = 0.001) and overall satisfaction (score 5 vs 7, p = 0.011). Conclusions: Compliance over 2 weeks was high in both VLEDs with most subjects achieving ketosis. Overall satisfaction was moderately high, although variable. Whilst Formulite™ is a viable alternative to Optifast™, better formulations of VLED that addresses key adverse effects, whilst achieving ketosis, would be of significant value.

AB - Introduction: Preoperative very low energy diets (VLEDs) improve access during bariatric surgery. Compliance with traditional VLED is variable, mainly due to gastrointestinal side effects. Formulite™ is a new formulation of VLED, with higher protein, soluble fibre and probiotics. Aims: To compare traditional VLED (Optifast™) with the new VLED (Formulite™) and assess compliance, weight loss, satisfaction, side effects and surgical access. Methods: This was a randomised double-blinded study involving patients scheduled for bariatric surgery. The primary outcome was compliance, assessed by urinary ketone concentration and proportion of patients in ketosis at 2 weeks. Secondary outcomes were weight loss, satisfaction and patient reported outcomes, gastrointestinal side effects and operative conditions. Results: There were 69 participants: 35 in the Formulite™ group and 34 in the Optifast™ group. Ketosis at 2 weeks was achieved in both groups (88.5% vs 83.3%, Formulite™ vs. Optifast™, p = 0.602). Urinary ketones were higher with Formulite™ (1.5 vs 15 mmol/L, p = 0.030). Total body weight loss percentage, hunger and operative conditions were similar in both groups. Formulite™ produced less flatulence (score 3 vs 2, p = 0.010) and emotional eating (score 2 vs 1, p = 0.037); however, Optifast™ ranked higher in terms of taste (score 4 vs 3, p = 0.001) and overall satisfaction (score 5 vs 7, p = 0.011). Conclusions: Compliance over 2 weeks was high in both VLEDs with most subjects achieving ketosis. Overall satisfaction was moderately high, although variable. Whilst Formulite™ is a viable alternative to Optifast™, better formulations of VLED that addresses key adverse effects, whilst achieving ketosis, would be of significant value.

KW - Bariatric surgery

KW - Compliance

KW - Very low energy diet

UR - http://www.scopus.com/inward/record.url?scp=85066906255&partnerID=8YFLogxK

U2 - 10.1007/s11695-019-03916-2

DO - 10.1007/s11695-019-03916-2

M3 - Article

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

ER -