The obesity epidemic of the past 30 years is not due to a single cause and there is no magic solution: it is misleading to say otherwise. People who are overweight and have struggled to reach and maintain a healthy weight understand that very well. The obesity epidemic in developed and developing countries is because we are consuming too much of everything: too much fat, protein and carbohydrate, calorie-dense snacks, sugary drinks and alcohol. Reduced activity levels also plays a part, but the overconsumption of everything is the real world culprit.

Food has an energy content measured in calories and in our experience many overweight adults are consuming more than 3000 calories per day when necessary levels for weight maintenance are in the order of 1700 to 2200 calories depending on age, gender and activity level. The overconsumption of food including calorie-dense snacks and sugary drinks leads to increased weight, obesity and many adverse health outcome including diabetes, heart disease and cancer. Any food — either natural or processed — when over-consumed will have adverse outcomes and these are documented daily by health professionals and researchers worldwide.

Wesley Weight Management Clinic is not a conspiracy or a product, it is well-balanced clinical program designed to help people achieve and maintain a healthy weight. We believe the criticism expressed in the David Gillespie’s article is based on a misunderstanding of how our clinical weight loss program works. We are staffed by doctors, dietitians, exercise physiologists and psychologists who work as a clinical team to help people lose weight and learn the skills to maintain a healthy weight. Our ownership group, of which I am a member, and our staff are committed to providing evidence-based, ethical and high quality preventative health services and we continuously track and share our results with our clients, their doctors and the community at large to demonstrate the benefits of investing in health. I believe we conduct the best weight-loss service in Australia demonstrated by our outstanding client results.

Meal replacements — Optifast 800: Meal replacements, when used properly under supervision are very beneficial at the start of weight loss. Moving clients safely from 3000 calories per day to 800-1000 calories per day places them in a negative energy state and so their bodies start  to process their fat stores for energy and they lose weight. In combination with moderate exercise, women can lose up to a 1kg per week and men up to 2 kg per week. There are up to 15 meal replacements available on the market and some are nutritionally balanced and others aren’t. We have used Optifast 800 safely for 10 years and it manufactured by Nestlé Healthcare Nutrition. Meal replacements are made from processed milk, similar to baby formula. They contain milk protein (14gm), fat (4gm), milk sugars (lactose 10gm), fructose (8-10 gm), vitamins and minerals. The percentage of each component is similar to a healthy balanced diet but the total portion size of the shake is 160 calories when made up with water. The energy content of one sachet is similar to two slices of bread. In our clinic, clients safely consume five sachets per day or 800 calories and that provides them with all their essential daily vitamins and minerals and keeps their hunger controlled. Importantly they are losing weight.

Fructose: Fructose is a natural sugar found in 50 different fruits and vegetables — all of us have been consuming fructose our whole life. Fructose is present in Optifast 800, but there is no more fructose than in one apple. In five sachets per day of Optifast 800, total fructose does not exceed 50gms, a quarter of the levels of people consuming 3000 calories per day including two cans of soft drink. It is wrong to say there is danger to health at the low levels present in Optifast 800. In fact 50gms of fructose a day is beneficial particularly to diabetics. It is only a danger to your health at artificially high levels of consumption, as seen in some published trials. These trials are conducted in a similar way to toxicological studies as opposed to food safety studies and no food would be considered safe under these conditions. Even pure water triggers adverse health at high repeat dose levels.

It is very difficult to consume high levels of fructose on its own because as a food additive it is combined with glucose in the form of sucrose (sugar) or as high fructose corn syrup (HFCS), a roughly equal mixture of glucose and fructose. The point is that in consuming sugary drinks or snacks on a daily basis, the total calorie content from their total sugar content is doing harm, not just the fructose content.

Our results from using Optifast 800 in weight loss: Over 10 years we have recorded the weekly visits of more than 6000 clients and their weight-loss results. We believe we have the largest database on weight loss in Australia and we publish our results on our website and in credible health journals and forums. The main reason for recording weekly progress is to make sure that weight loss is done in a safe and sustainable way. All clients who use Optifast 800 are medically counselled by a doctor and their blood is tested before starting Optifast 800. Those who are not suited to meal replacements are prescribed a meal plan with a set-calorie level. We know that Optifast 800 used in our clinic is safe, effective and well tolerated by clients. All clients transition off Optifast 800 during their weight loss program back to normal healthy meal plans. They are taught and counselled on healthy food choices, correct portion size and good exercise — habits that will last them a lifetime. Their challenge will be to continue those good habits when they leave our environment.

Our results show that our clients lose weight, lose fat, reduce their waist lines, maintain lean tissue (muscle), lower their blood pressure, lower their total cholesterol, lower their LDL (bad cholesterol) lower their blood triglycerides, lower their blood glucose and lower their cardiovascular risk (risk of heart attack) by up to 47%. We have presented these results to the International Congress of Obesity, the National Heart Foundation and the Federal Parliamentary Enquiry into Obesity and we are rightly proud of them.

In conclusion, we unashamedly stand by our clinic, our staff, our clients and our results. The obesity epidemic, its causes and solutions, are complex and multifaceted but we know what we do is safe, effective and sustainable. While the article by David Gillespie is right to highlight the dangers of overconsumption of sugars, his assertions in relation to our clinic, our stakeholders, our staff and our clients are factually incorrect.

Like good health, it’s all about balance.

Neil Holt is the managing director of Wesley Weight Management Clinic