One of the goals of a dietitian is to teach people that there is no such thing as a “bad food” and thus all foods can fit into a healthy diet. This advice may work well with people who have a healthy psychological relationship with food, but it can be problematic for individuals who use food as a coping mechanism. Data collected by researchers associated with the National Weight Control Registry and the University of Pennsylvania demonstrate that limiting the variety of readily available foods, and serving pre-portioned foods decreases the amount of food eaten at any one time. These observations were so well accepted that they were incorporated into the 2001 Dietary Guidelines for Americans, which now advise eating a wide variety of fruits, vegetables, and whole grains each day, but limiting the variety of other foods consumed. Extending stimuli narrowing into the transition and maintenance phases of the OPTIFAST weight loss program can give patients an added measure of control they have over their eating habits.
The transition phase of the OPTIFAST program makes use of the stimuli narrowing approach by slowly adding different categories of self-prepared foods back into the patient’s diet. The stimuli narrowing characteristics of the transition diet can be strengthened by allowing patients to select a single food from each food group for a period of several days to a week at a time.
Several programs use an intensified Transition protocol. It allows patients to add a single 3 oz serving of one type of low-fat meat (either chicken breast, turkey breast, or pork loin) and a ½ cup serving of one type of vegetable (either carrots or green beans) to their daily diet during the entire first week of transition. The same meat and vegetable combination must be eaten all week long. During week two, patients are allowed to alternate between two of the three types of meat and may choose either carrots or beans to meet their vegetable servings. They are also allowed to add one serving of a single type of fruit to their daily diet. Other food choices are added at a gradual pace, until a well balanced diet has been achieved.
Patients are encouraged to develop a maintenance diet of simply prepared foods they eat on a routine basis. The goal is to choose from foods that are pleasant, but not overly appealing in terms of taste or appearance. Moderately appealing foods do not over stimulate appetite (psychological desire for food driven eating) to the same extent that highly palatable foods do. Limiting availability of highly palatable foods can foster weight management. Favorite foods can still be eaten on special occasions provided they are worked into the meal plan.