Children under 18 years
Presence of porphyria
Recent myocardial infarction
Severe/ advanced renal or liver failure
VLCDs should never be used by normal weight subjects because it may lead to excessive loss of lean body mass. If your patient’s BMI is under 25kg/m2 you may consider starting them on either the Transition phase or Maintenance phase of the OPTIFAST VLCD Program.
OPTIFAST® VLCD™ Program is not recommended during pregnancy for a number of reasons. The low carbohydrate content is designed to induce ketosis (fat breakdown) which leads to ketones in the blood. Although the level of ketones is fairly low, the effect on the foetus is unknown. In addition, the OPTIFAST® VLCD™ Program is not designed to meet the increased nutrient requirements of pregnancy (e.g. protein, iron and some B group vitamins).
The Intensive phase of the OPTIFAST® VLCD™ Program (replacing all 3 meals with OPTIFAST® VLCD™ products) is not recommended for women who are breastfeeding as it is not designed to meet the increased nutritional demands of lactation. Patients may start on the Maintenance phase (ie replacing one meal per day with an OPTIFAST® VLCD™ product). They can gradually increase the amount of meals replaced once the baby has started to wean off breast milk and is also consuming a reasonable quantity of solids.
VLCDs are contraindicated in children who are still growing; however there may be children in whom severe obesity is resistant to other treatments. In such individuals the risks associated with obesity should be weighed against the risks of using a VLCD and should only be prescribed and monitored by a qualified healthcare professional.
Porphyria is the umbrella term for a group of rare disorders that involve a particular molecule called ‘haem’. Haem contains iron and is used in metabolic processes throughout the body. Porphyria occurs when the body cannot convert naturally occurring compounds (called ‘porphyrins’) into haem. While all tissues have haem, those that use it the most are the red blood cells, liver and bone marrow. Porphyria can affect the skin, nervous system and gastrointestinal system, depending on the specific type. Porphyria is contraindicated with OPTIFAST® VLCD™ as extreme calorie restriction can provoke an acute attack.
Patients should be referred to a cardiologist to determine suitability for a VLCD or severe calorie restriction.
Persons with advanced liver or renal disease are not suitable for the OPTIFAST® VLCD™ Program, as they may require altered intakes of electrolytes and nutrients.