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Extreme weight loss options: Pound a Day versus feeding tube diet

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Losing weight on a diet limited to 800 calories per day of rice cakes and celery might work - but it's almost impossible to stay on that type of bland plan long-term. So celebrity chef Rocco DiSpirito decided to concoct his own tasty weight loss plan, which he discussed on Bethenny Frankel's Aug. 22 talk show. Plus: Find out how his extreme weight loss plan compares to the feeding tube tube.

Detailed in Rocco's "The Pound a Day Diet: Lose Up to 5 Pounds in 5 Days by Eating the Foods You Love" book, the weight loss plan is designed to help you lose up to five pounds in five days. Rocco told Bethenny that he concocted the recipes to provide a chef's point of view when it comes to dieting.

The diet consists of different phases. The first phase involves six small meals that total 850 calories a day. The high protein diet helps curb cravings and boosts fat-burning.

Dieters can eat more on weekends and during phase two. Because many diet plans provide help with losing weight but fail to offer guidance when it comes to maintenance, Rocco emphasizes that he has created guidelines for lifelong weight loss maintenance.

However, the diet has been criticized by some dietitians because of the low calorie count initially. "The title of this book alone bothers me. No one—I repeat, no one—should be looking to lose a pound a day," said dietitian Keri Gans in Shape magazine.

And Gans contends that even the increased calorie allotment to 1,2000 calories in the subsequent phases is too low. "Sure you will lose weight, but at what cost mentally and physically?" she asked.

The dietitian cited research showing that losing more than one to two pounds a week might result in problems ranging from headaches to fatigue to hair loss to "gallstones, dehydration, malnutrition, and electrolyte imbalances."

Given those concerns, it's intriguing that several physicians defend the feeding tube diet. Known as the KE diet and popularized by brides desperate to lose weight quickly prior to their wedding day, the plan has offered weight loss help for a wide range of patients, said Dr. Michael Choi, a bariatric surgeon in Miramar, in an Aug. 22 interview with the Sun Sentinel.

What it involves and how much it costs: Patients pay approximately $1,500 to have feeding tubes inserted into their noses. They do not eat, but rely on the carefully calculated nutrients that flow through the tube from a portable pouch.

"We needed to find a diet for these people because obesity is really a huge epidemic," defended Dr. Choi. He uses the feeding tube diet as a jump-start to weight loss or as a way to help patients lose weight prior to a procedure such as a gastric bypass.

"At first, they were a little uncomfortable about how they'd look with a feeding tube coming out of their nose, but once they got used to it, they were able to lose weight and not feel hungry," he added. He feels it is a useful approach for obese patients who can't lose weight on their own.

The physician who takes credit for creating the KE diet contends that it is designed to complement other weight loss options. Dr. Oliver Di Pietro clarified that the feeding tube diet lasts only 10 days, during which time patients receive 800 calories per day that consist of a mix of vitamins and protein. Only water, black coffee and plain, unsweetened tea are allowed for beverages.

The mixture puts the body into ketosis, said Di Pietro, which means that patients burn stored fat for energy. Although similar to the Atkins low carb diet in using nutritional ketosis for weight loss, the KE diet does not require dieters to calculate carbohydrate allotments.

The KE diet has been used for years in Europe. According to a study published in the journal Nutrition & Metabolism, 19,036 people during a five-year period successfully lost weight with no serious side effects.

Obesity medicine specialist Dr. Eric C. Westman is an associate medical professor at Duke University and president of the American Society of Bariatric Physicians. He is the co-author of "Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet."

"The idea of a feeding tube is icky to some people, but this is something that is almost as strong as surgery, but without the permanent change," said Dr. Westman, who has served as chairman of the KE Diet's Scientific Advisory Board for eight months and also co-authored one of the Atkins ketogenic diet books. "I think it's going to be a significant player in the weight-loss world in the right hands, whether as a jumpstart in getting through a plateau or in getting ready for surgery."

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