RNPC’s Program: Supporting health and well-being through the cooperation of doctors and dieticians
Long-term epidemiological studies have shown that being overweight increases the risks for many diseases and health conditions. To significantly reduce the dangers and prevent the complications of being overweight, dieticians and doctors are working together through the application of good practices and the use of an innovative method validated by a scientific committee.
A substantial proportion of individuals living with excess weight fail to correctly identify their weight status as being overweight. Yet, having excess weight is not just a physical characteristic. It contributes to the development of coronary heart disease, stroke, type 2 diabetes, cancer, and many other conditions, significantly lowering the quality of life and increasing the risk of premature death from all causes.
Intraperitoneal fat, also known as visceral adipose tissue (VAT), is considered a particularly important marker of metabolic syndrome. It is the most dangerous type of fat, producing substances that, in excess, cause chronic inflammation and induce the onset, the development and the aggravation of cardiovascular and metabolic diseases. The VAT lies deep within the abdomen, surrounding organs such as the liver, the pancreas and the kidney, but it can also extend to the heart and even infiltrate all these organs. For this very reason, it is critically important to choose a safe and effective programme targeting this specific fat when looking to treat and control a global and growing weight-gain epidemic.
A multidisciplinary approach to weight management
Poor dietary knowledge and unhealthy lifestyle (too much sugar, no physical activity, stress, lack of sleep…) catch people with excess weight in a vicious circle: they do not really know what to do to lose weight, try long-term ineffective and even dangerous methods, do not lose any kilos or regain them when they stop dieting, resulting in discouragement and low self-esteem and increasing the risk of health complications that keeps worsening with time. Growing pathologies thereby force the person to see a doctor more often, but recommendations to reduce weight may go unheeded or unsuccessful if expressed in the form of simple advice.
Breaking habits that cause weight gain result in radical changes in one’s lifestyle, and studies have shown that a lack of support, in particular exceedingly high autonomy, may contribute to a poor weight loss outcome. “It is the mental part we need help with”, said one of the participants in another study, conducted in 2017. Data from numerous findings indicate that a multidisciplinary approach that includes comprehensive support for patients at all levels is necessary and that programmes must provide adequate support for the mental well-being of overweight individuals.
The French company Groupe Éthique & Santé, founded and presided over by Rémy Legrand, effectively employs this tactic. Patients following its programme, known as RNPC (Programme de Rééducation Nutritionnelle et Psycho-Comportementale for Nutritional and Psycho-Behavioral Rehabilitation Program), receive coaching and supervision from qualified dietitians, and follow-up by their GP. “In general, people who are referred by their doctor to an RNPC centre have gained weight over a fairly long period, from 5, 10, to 15 years, for reasons that are often beyond their control but that can accumulate over the years, with bad habits and a lack of information about the consequences that this weight gain can have. This is where we step in”, explains Rémy Legrand.
According to an American study published in 2019, providing specific and detailed advice effectively removes obstacles to weight loss. In addition, empathy and understanding of the patient’s difficulties in losing weight increases the chances of success. Making sure that the patient is closely monitored is an important part of the programme. Accordingly, throughout the program, the patient is supervised with an appointment with a dietician at an RNPC centre every two weeks. “It is essential that we all continue to work together closely”, emphasizes Rémy Legrand. “As effective as the RNPC programme and dietitians can be, if the doctor is not involved, is not supportive of the patient’s life plan to lose weight and is not insisting on the importance of stabilising the weight lost, then the process becomes more complicated, both for the patient and for us”.
Combining comprehensive and operational strategies
The behavioural aspect and support given by professionals is essential, but it is not the only thing needed in the journey to a healthy weight. Achieving clinically significant weight loss requires comprehensive strategies, an assessment of physiological factors by the GP, and a step-by-step programme.
RNPC’s approach occurs at several levels and the aim of the programme’s first phase is to lose weight quickly and efficiently. Rapid weight loss is achieved by restricting calorie intake, while closely considering the patient’s medical records and consultations with their GP. “First of all, there are a few medical tests that are prescribed by the attending physician and that the patient must carry out in order for us to accept to treat him/her at the RNPC centre”, explains the founder. “It is a matter of safety. The results of these tests allow the dietician to adapt the treatment to the patient’s condition and specific needs in the first phase of the programme. This phase corresponds to the so-called weight loss phase, which is effective, safe, and fast, given that a weight loss of 10 to 15% is essential for curing such serious chronic diseases as diabetes, atrial fibrillation, NASH and sleep apnea.”
Contrary to popular belief, this approach is by no means dangerous if the patient’s medical records are known: findings from numerous studies from leading scientific journals show an improvement or total cure in patients with very serious pathologies mentioned above.
The patient is also coached on his or her dietary needs and is given guidance to follow a diet, comprised of meat, fish, egg and vegetable dishes, supplemented with low-calorie snacks enriched in proteins and beneficial nutrients but depleted in sugars and fats. The aim of the moderate enrichment in proteins is on the one hand the maintenance of muscle mass during weight loss and on the other hand a feeling of satiety, proteins being long to digest. Without it, the weight loss phase of the program would be accompanied by hunger and fatigue due to muscle loss, and patients would give up before reaching their goal weight. Here again, medical monitoring plays a key role and places the patient in the safest zone possible. Regular checks with the GP are performed, blood and urine are tested, and creatinine is measured to determine the patient’s kidney functions in order to adjust the amount of protein the patient receives accordingly. “Protein-enriched does not mean high-protein. In our programme, the amount of protein required is strictly calculated and determined according to the patient’s medical condition”, says Rémy Legrand.
Qualifications matching the chosen strategy are also necessary which is why dieticians at RNPC’s centres receive scientifically-based certified training that corresponds to the needs of people who develop pathologies. “This is an integral component of our work, as it allows us to enforce the processes we have put in place”. Therefore, a large part of the company Groupe Éthique & Santé’s activity also consists of training their team on the methodology employed.
One of the company’s core values is to acknowledge dietetics as a science that can significantly improve a patient’s quality of life and it strives to give dieticians training in both the medico-scientific best practice and the human relations aspect. “Given the effectiveness, safety and scientific quality of RNPC’s Programme, I highly encourage them to share it with as many doctors as possible”, recommends Professor Arne Astrup, one of the global leaders in nutrition and obesity research. By bringing together the skills and expertise of different professionals to assess, plan, and manage care jointly, structures such as RNPC are invaluable partners in the fight against excess weight and obesity.