PROF. GIANFRANCO CAPPELLO

Obese patients

Since 1986 we have used a protein-based AN to get a good weight loss in obese patients who were placed in treatment for a variety of illnesses (inflammatory bowel disease, abdominal fistulae, dysphagia from neurological conditions).
Four years ago, a young lady with colic fistula, and after the anterior resection of the rectum, obtained within one month the spontaneous healing of the fistula and a weight loss of 20 kg. The daughter, who was also heavily overweight, asked to be subjected to the same treatment with the only purpose to lose weight. Since it was accepted that the infusion of protein was of no risk of any kind, she was put on the tube and after 20 days she had lost 12 kg. It was the first case that dealt with obesity as an illness in its own right. From then on, and by word of mouth, patients begun increasing day by day. Since the slow infusion of protein generates ketosis (which eliminates the feeling of hunger) the technique was called Ketogenic Enteral Nutrition (KEN).
Up till the end of 2009, 8,834 patients have been treated with KEN who have lost around 106 tons collectively.

How much does it cost?

Domiciliary Artificial Nutrition for obese patients is not yet granted by the National Health Service in Italy. It is entirely financed by the patient who has to pay visits and purchase the materials.

The cost however is very low, patients spend in practice from a minimum of 19 euro per day to a maximum of 25, considering that during the cycle they do not consume any food, the cost of a breakfast, lunch and a dinner is a saving.

The prices are as follows:
> First visit to 167 euros
> 30 euros for end of cycle check-up
> Subsequent visits 122 euros
> 60 euro 1 tub of protein solution ( 1 cycle supply)
Each patient is equipped with a computerized nutrient pump free of charge, but must leave a deposit of 300 euros which will be refunded upon return of the pump on time. Who holds the pump after the deadline will lose the right to a refund of deposit.

In addition to the protein solution, the patient must obtain some medicines from the pharmacy to inhibit gastric secretions, a vitamin compound and a laxative