When the so-called “feeding tube diet” debuted in a Miami doctor’s office two years ago, many saw it as a “crazy” gimmick sure to go the way of the ThighMaster.
After all, how many people would pay $1,500 to walk around with a rubber hose up their nose to shed 10 or 20 pounds?
Hundreds, it turns out — many of them at their doctors’ recommendation.
Initially popularized by brides trying to slim down before their big day, the KE Diet has found a foothold in the bariatric medical world as a weapon in the fight against obesity.
Whether it’s to give the morbidly overweight a jumpstart on weight loss, or to help them slim down in time for gastric bypass surgery, the diet is making a difference for a community of patients desperate for viable options, said Dr. Michael Choi, a bariatric surgeon in Miramar.
“We needed to find a diet for these people because obesity is really a huge epidemic,” said Choi, who has put five patients on the KE Diet over the past two months in preparation for weight-loss surgery. “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.”
The KE diet is not meant as a long-term option, only as a complement to other weight-loss tools, including surgery, medication and proper nutrition, said its founder, Miami’s Dr. Oliver Di Pietro. Using a feeding tube inserted in the nose, the regimen pumps 800 calories a day of a proprietary mixture of proteins and vitamins into the dieter’s stomach over a 10-day period The patient carries the mixture in a portable pouch at all times and can’t ingest anything else except water, black coffee and unsweetened tea.
The diet also requires seeing the doctor every few days for monitoring, Di Pietro said. Afterward, the patient is instructed to maintain a low-carb lifestyle to keep the weight off.
It works, Di Pietro said, by sending the body into ketosis, meaning it burns stored fat instead of sugar for energy. Though dieters can see the same results from any plan that dramatically restricts calories and carbohydrates, those who’ve tried the KE Diet say the secret to its success is that, by its extreme nature, cheating isn’t much of an option.
Audrey Dayan, 51, a Miami Beach pension plan administrator, said the KE Diet helped her finally shed weight she’s been fighting throughout adulthood, after tipping the scales at nearly 200 pounds.
“It was a jumpstart for me,” said Dayan, who did the diet three times — in December, March and May — and lost a total of 26 pounds off her 5-foot frame. “At least now, I’ve kept the weight off and haven’t gained it back.”
With the help of the low-carb eating plan she’s followed since, Dayan said she’s dropped two dress sizes.
Skeptics continue to question the safety of a diet that uses a feeding tube — a device meant to keep sick people alive — to artificially limit calorie intake as a weight-loss measure.
“The danger is that if they’re not self-restricting their own calorie intake and making sure they have balanced nutrition, they may not be getting all the electrolytes and nutrition their body needs to function,” said Dr. Nabil El Sanadi, chief of emergency medicine at Broward Health hospitals. Risks, he said, include erosion of the nasal and throat tissue, inflammation of the sinus, infection, organ failure and damage to the lung if the tube is improperly inserted.
None of these complications have arisen in the application of the diet, Di Pietro countered.
“These are all valid concerns, but the research and the science behind it just does not support there being any safety issues,” he said.
According to a 167-patient study Di Pietro presented at last year’s conference of the American Society of Bariatric Physicians, the average patient lost 16 pounds on the 10-day plan, none suffered major side effects, and eight patients decided they couldn’t tolerate the feeding tube.
One study published in the journal Nutrition & Metabolism found that in Europe — where the diet has been used for years and more extensive research has been conducted — 19,036 people over five years lost weight without any significant side effects.
“Nutritional concerns are not an issue because it’s only for 10 days,” Di Pietro said.
The key to protecting the patient’s safety and health, he added, is ensuring that the diet only be administered by licensed, qualified doctors trained on how to properly insert the feeding tube and monitor for signs of complications. So far, 10 U.S. weight-loss doctors — all of them “screened and qualified,” Di Pietro said — have signed on as licensees, paying a $15,000 fee to be trained on the diet and offer it to patients.
Choi, the Miramar surgeon and one of the licensees, said he was impressed not just with the diet’s effect on the waistline but with results showing that is also helps shrink the liver.
Reducing the size of the liver and the belly, Choi said, “means there’s less torque and more room for surgeons to operate.”
Choi is participating in a double-blind study — along with a University of Miami doctor and others — to scientifically track the KE Diet’s effectiveness in shrinking the liver.
“It’s medically supervised,” Choi said. “Actually, I think this diet is safer than a lot of other diets out there.”
Another doctor approached about becoming a licensee, West Palm Beach bariatric medicine specialist Dr. Daisy Merey, opted not to — but not because of safety concerns, she said. She agreed to put KE Diet brochures in her office for a few months, but other than generating some curiosity, none of her patients were willing to try it. She called it “a gimmick.”
“It’s for a little amount of time, and my patients were reluctant to spend so much money,” said Merey, who prefers long-term diets that stress lifestyle changes and balanced nutritional goals. “Weight loss is for the rest of your life. This is just a kick in the butt.”
Still, obesity medicine specialist Dr. Eric C. Westman, an associate medical professor at Duke University and president of the American Society of Bariatric Physicians, said the growing body of research shows promise for the diet’s future role in bariatric medicine.
“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 Westman, who signed on as chairman of the KE Diet’s Scientific Advisory Board eight months ago and considers it both safe and effective. “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.”