Active Weight Loss

Causes of Obesity

Expedition Programs 

These programs are medically supervised using medical meal replacements as part or all of your nutrition. They are an intensive medical intervention. They are not a casual diet. They require blood tests to start and monthly while in active weight loss,  medical visits every 1-2 weeks during clinical office hours, use of 3 supplements per week, and may require a baseline EKG. You can choose to use medical food for all of your nutrition or you can choose to have one meal a day of “grocery food.”Here is more information on the 2 Expeditions Programs: 

Very Low Calorie Diet- Complete Meal Replacements 

This program utilizes medical foods to administer a medical protocol called a Protein Sparing Modified Fast (PSMF), otherwise known as a Very Low Calorie Diet (VLCD). A VLCD is a medically supervised. Candidates for the program have a BMI over 30 or over 27 with a medical condition such as diabetes, cardiovascular disease, high blood pressure or high cholesterol. In general, a Very Low Calorie Diet (VLCD) is appropriate for women with approximately 30 pounds or more to lose and men with approximately 40 pounds or more to lose. Clients typically lose 2-5 lbs per week depending on age, height, gender, body fat percentage, and medical conditions or medications.

The anticipated benefits of the PSMF compared to other approaches may include: 

  - natural control of hunger through ketosis

  - more rapid improvements in blood sugar, blood pressure and fluid retention

  - more rapid weight loss

  - reduced cravings

  - reduced symptoms of inflammation.

Modified Low Calorie Diet- One grocery meal per day 

This program utilizes a Modified Low Calorie Diet (MLCD) program. A MLCD is medically supervised.  This may be ketogenic or non-ketogenic program for clients with less than 40 pounds to lose or for those who want grocery store food in their program. If your BMI 25-27, or 27-30 without diabetes, high blood lose 2-3 lbs per week. The MLCD program incorporates grocery foods with meal replacement products.

Medical foods are not commercially available and are typically utilized as the sole source of nutrition during active weight loss.  The advantages of the meal replacement products are that they are:

  • easy to use
  • fortified with all needed trace vitamins and nutrients,
  • usually less expensive than the cost of your food before you started the program (sometimes eligible for reimbursement through health savings account or flexible spending account.)


Peak Program -Grocery Store Meal Plan

This program is for those  who want a plan consisting of all grocery food.  Candidates for this program are those  who do not need or want to participate in any of the other offered programs, or can not participate for any reason, or those with goals other than weight loss. Candidates must attend  nutritionist visits. Schedule, cost, and insurance coverage factors should be considered.  This program does require  biweekly nurse visits, Monthly provider visits, and may require baseline blood work and EKG. You will be receiving your nutrition  predominantly from grocery store food with nutritional supplement options given based on individual needs that may be purchased at Rainier Medical. Clients typically lose about  0.5 - 2 pounds weight loss per week and total weight loss potential of approximately 50% of excess body weight or 10-15% of starting body weight (whichever comes first). Subject to availability.


Back on Path

This program is for individuals who have completed our program and have experienced weight regain of no more than 10% and at least 10 pounds. In this program, the nutrition and medication is determined individually with a provider. Weekly visits for 12 weeks are held focusing on grocery food,nutrition,and lifestyle strategies as well as exercise visits. If less than 10 pounds has been regained, this is just part of maintenance.