from the University of California, Los Angeles
Office: (310) 825-8173
FAX: (310) 794-8837
Director: Dr. David Heber
OFFICIAL SITE
CENTER FOR HUMAN NUTRITION
The Director of the Risk Factor Obesity
Program (RFO) is David Heber., M.D., Ph.D., and Director of the Center for Human
Nutrition and Professor of Medicine, UCLA School of Medicine. He is internationally
prominent in the field of nutrition, metabolism, obesity and its associated
disorders. He has published seminal research articles in the fields of causes
of obesity, weight loss strategies and the mechanisms and relation of obesity
to cancer and cardiovascular disease.
The program has been in operation for twenty
years (originated in the mid 1970's by Morton H. Maxwell, MD). The program is
among the first university programs to investigate and utilize the use of very
low calorie diets (VLCD) in the treatment of severe obesity. Starting several
years ago, it was among the first to pursue studies in the use of appetite-suppressant
medication in the treatment of moderate and severe obesity.
THE RFO PROGRAM
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 each day, and caloric output is your
resting metabolic rate. 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 then caloric output, then your body fat supplies the necessary
calories and weight loss ensues. Reducing caloric intake is more efficient than
increasing exercise for weight loss.
Simply handing a patient a 1200 or 1500 calorie
diet seldom works. Individual choice of diet is ethnic, cultural and behavioral.
These factors are taken into account at the center.
Before or at the first visit patients fill out
a detailed questionnaire on their eating habits and their food preferences.
A registered dietician who specializes in weight loss then analyzes the results
of this questionnaire. Prior to the next visit, the dietician prepares a "tentative"
diet for each individual patient based upon his or her food preferences and
habits. The diet is tentative because everybody has a different life style.
Some individuals get up early and want a large breakfast, others hate green
vegetables and others want a bedtime snack. AT the next visit the dietician
has a prolonged conference with each patient and finalizes the diet prescription
with is or her input and approval. The caloric intake of each diet prescription
is calculated to result in a weight loss of approximately 1% of body weight
per week. This is a safe rate of weight loss and assures that at least 80% will
come from body fat and not muscle.
Patients see the dietician at least every four
weeks and more often if they wish. A patient's individualized diet, therefore,
may be modified several times in response to rate of weight loss and food choices.
Most of the individual diets are high carbohydrate, low fat regimens. However,
some patients are switched to high protein diets if they are unsuccessful or
so desire. Protein has the advantage of being the most satiating of the major
macronutrients (protein, carbohydrate, fat, alcohol).
If patients cannot adhere to their diets, they
receive advice and help from the dietician and the behavioral program. If a
patient thinks that he or she is adhering to the diet and losing insufficient
weight, then he or she 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 dietician, who can often see a food pattern, which is not apparent to the
patient. If a patient adheres to the prescribed diet and does not lose the anticipated
weight, this rarely may be due to a genetically low metabolic rate. The caloric
intake may then be lowered accordingly and/or the physician may prescribe elow
doses of triiodothyronine, a thyroid drug, to boost the metabolic rate.
Thus, a low calorie diet is not a simple matter.
Our dieticians, therapists and physicians work closely with each patient on
a weekly basis to assure success.
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