London – This could be the most shocking, controversial diet ever to reach Britain. It is a regime so extreme, so drastic, it makes LighterLife’s shakes-only system look like a daily five-course banquet. The KEN, or Ketogenic Enteral Nutrition diet, involves eating absolutely nothing at all.
Instead, for ten days at a time, a patented, 130-calorie a day liquid formula made up of protein and nutrients is dripped directly into the stomach via a plastic tube that goes up the patient’s nose and is taped on to their face.
At the other end of the tube is an electric pump, which works day and night to deliver two litres of the formula over 24 hours.
While on the KEN, dieters can go about their lives as normal but must carry the pump and liquid in a bag or backpack and hang it by their bed at night. They are allowed to unhook themselves from the pump for one hour a day – for bathing – and can drink water, tea, coffee (with no milk, sugar or sweeteners) or sugar-free herb teas with the tube in.
Patients could still eat or drink the wrong things if they wanted to, but they don’t feel hungry after a couple of days and, of course, they’ve chosen to be on the diet.
KEN works by sending the body into controlled starvation, forcing it to use its own fat for energy. And it works fast. Each cycle of KEN strips up to 10 percent of body weight in just ten days, without, apparently, causing any loss of muscle, and without causing hunger.
The no-food diet originated in Italy and has taken the country by storm. It was invented by Gianfranco Cappello, associate professor of general surgery at the University of Rome’s La Sapienza Hospital. Cappello is a world expert in artificial feeding, and has successfully treated 40,000 patients with the KEN diet.
Now KEN has arrived in Britain, and it’s not being promoted by some fly-by-night quack. Instead, it has been introduced by Dr Ray Shidrawi, a highly respected consultant gastroenterologist at the NHS Homerton University Hospital in London, who believes it could be the future for weight loss in the UK.
It was working with severely obese patients that sparked Dr Shidrawi’s interest in the diet. “Without carbohydrates, two things happen,” he says. “First, you don’t feel hungry. Second, your body starts to burn fat stores at a huge rate. When the diet is administered steadily over 24 hours, the body remains in a fat-burning mode.
“The heavier you are, the more weight you lose, so patients shed, on average, between four to nine percent of total body weight in ten days.”
This means someone of 14 stone (about 90kg) will lose between eight and 18lb (3.6 to 8kg)). And, after ten days off the tube, when the person must stick to a healthy eating regime, the cycle is repeated.
So far, the UK clinic has treated about 60 patients, who between them have completed 150 ten-day cycles of KEN.
Last year, 45-year-old Helen Jones (not her real name), from London, weighed 15½st – which, at 5ft 8in, made her clinically obese. She says: “I’d tried to lose weight but I have a stressful job in the City and had got into a spiral of feeling bad, then treating myself with food.”
Her sister-in-law suggested Dr Shidrawi and Helen signed up. ‘I felt fine during the treatment – I had no hunger at all.
“I lost 15lb the first time and then booked a course of three more cycles. I had ten days off in between each one, during which I ate a healthy diet as recommended by the clinic.
“Not eating for ten days gives you a break from thinking about food – which, for me, was associated with stress and guilt. Socialising was difficult though – it’s hard to nurse a black coffee while everyone else is eating.” Helen finished her fifth KEN cycle last month and has lost a total of 50lb, bringing her weight down to 11st.
But is it safe to lose weight like this?
Helen Bond, state registered dietitian and spokesperson for the British Dietetic Association, says: ‘It simply strikes me as the latest in a whole series of faddy weight-loss diets.
“It shocks me that people are willing to have naso-gastric (NG) tubes inserted in order to lose weight. Can you imagine walking into a meeting with an NG tube in your nose?
“You will, of course, lose weight rapidly on such restricted calories – but no one should slim that quickly. We recommend losing 1lb to 2lb per week, over a long period, during which time you learn how to manage your food and drink intake. The psychological and emotional reasons for over-eating also need to be addressed, which this plan fails to do.”
But Dr Shidrawi is adamant that it is safe. He says: “Before we take on a patient, we take a fully detailed medical history.
“We also check their body composition – how much is fat, how much is muscle etc, both before and after the treatment. Sixty-six percent of the weight patients lose is fat, 30 percent is water, and they don’t lose muscle at all.”
Dr Shidrawi argues that his diet is more natural than our current carb-heavy way of eating. “Early humans all lived on a ketogenic (fat burning) diet of meat and fat. Of course, we couldn’t put someone on a diet like this for weeks on end, but for ten days it is safe and improves health.”
Almost anyone can go on the KEN diet, though it’s not suitable for people with kidney failure or an allergy to milk proteins.
And unlike the high-protein Atkins Diet, it is recommended for people with heart problems. The KEN diet formula “isn’t a super high-protein diet, which can strain the kidneys,” says Dr Shidrawi.
The main side-effect, he adds, is constipation, caused by a total lack of fibre. But all patients are given laxatives and are also asked to test their urine every day. Ketones (created when your body burns its own fat) are expelled via the urine and breath, so another side-effect is bad breath.
Dr Shidrawi agrees that being on the diet can be difficult.
“You don’t feel hungry, but you can feel very tired. My wife did it, and lost 11 lb in ten days, but she felt terrible – exhausted. But then she didn’t have much weight to lose.”
Isn’t the process of putting in the tube horribly unpleasant? Again, Dr Shidrawi insists not. “I know the concept is worrying and scary, but we use a superfine tube designed for children. There is no sensation of the liquid passing down the throat at all.”
Conventional wisdom has it that weight lost this fast will be regained with equal speed. Again Dr Shidrawi says this is not a problem.
“Cappello has data on 1,800 patients and it shows that, a year on, 85 percent of the weight has stayed off. KEN won’t stop you gaining weight as we all tend to, year on year, but it resets the clock – in ten days you can lose a year’s worth of creeping weight gain.”
As for the inconvenience of lugging the pump everywhere, and the social stigma of having a plastic tube hanging out of your nose, Dr Shidrawi shrugs. “The pump is very light and extremely quiet,” he says.
“And my patients report people helping them with their bags – they often think they have cancer and are under medical treatment.”
In his newly established private clinic in London, Dr Shidrawi has set the price for treatment, including ten days of nutrition, supplements and loan of the £1,000 pump, at £375 for the initial cycle and £350 for subsequent ones.
“It’s important to me that ordinary people can afford this treatment,” he says. “I see the difference it makes. They have often tried and failed, and lost all hope of losing weight. This gives them hope back. And for some of them, it gives them their life back.”
Other experts, though, are sceptical. Independent nutritionist Ian Marber says: “This is probably the most extreme diet I’ve ever encountered. I’m gobsmacked this is being offered to people who aren’t ill, or at the very least morbidly obese. It’s a terrible indictment of the times we live in that food is such an enemy that people want to do this.”
But Dr Shidrawi is unrepentant. ‘If diets worked, if healthy food worked, we wouldn’t have obesity.
“People try and fail, so what do we do, look at obesity and just let that happen? I will not do that.” – Daily Mail
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