Hospitals diversify services by entering diet business.

The emerging wellness movement has prompted an increasing number of L.A.area hospitals to compete with the likes of Weight Watchers International Inc. and Jenny Craig Inc. by entering the diet business.

"In order to survive in the new health care paradigm, which includes wellness ... part of the plan for diversification for hospitals is that they have to develop new product lines," explained Jim Lott, senior vice president at the Healthcare Association of Southern California.

The diet business "is certainly one that works."

To a limited extent, health maintenance organizations, too, are realizing that keeping people trim is a way to keep them healthy - and thus a way to save money.

Kaiser Permanente has been expanding its nutrition programs in recent years, mainly in response to consumer awareness, according to Denise Schaefer, director of the nutrition center at Kaiser.

"Our emphasis has changed on preventative care," Schaefer said.

Kaiser has set up diet hotlines, where members get nutritional information, as well as a 16-week course on nutrition and a Web page that offers low-fat recipes.

Most HMOs, though, will only pay for a single session with a dietitian - except for people with ailments like high cholesteral or diabetes, for whom a continuous diet program is necessary.

"If it's connected to a legitimate prevention program, then of course an HMO will pay for this," said Lott. "It's questionable whether they'll pay for a 28-year-old who has never been sick in his life."

Still, most consumers who want to look better rather than get well don't seem to mind paying for diet services themselves, according to Lott.

Arnold Bertram, a 59-year-old business owner, plunked down $800 out of his own pocket for a state-of-the-art check-up and a diet consultation at the Fitness Institute at Centinela Hospital in Culver City.

"That's a lot of money to lay out," he said, noting that his insurer, Maxicare Health Plans Inc., would not cover either the physical or the diet consultation. "The bottom line, is you know you're going to live a little bit longer if you go there. You really feel good when you leave that place."

For the hospitals, diet programs like Centinela's are big business.

"It give us referrals," said Barbara Robino, division director at Centinela Hospital Medical Center in Inglewood, which owns and operates the Fitness Institute. "Then obviously there's the halo effect. It may be years down the road, but (clients) will come back to us for treatment ... they build an identification with the hospital."

Netty Levine, a dietitian who has been with the Cedars Sinai Nutritional Counseling Center for nearly 20 years, has noticed a significant increase in business lately because people are more willing to pay for a dietitian themselves.

"We probably have more people that pay out of pocket now," said Levine. "We've definitely increased business over the past few years and I think business will be getting better now, especially with those drugs being eliminated." "Those drugs" are the two controversial diet medications: fenfluramine, sold as Pondimin, and dexfenfluramine, sold as Redux. The two have been linked to heart valve problems, and were recalled by the Food and Drug Administration.

Nutritionists believe the recall will prompt more people to seek professional help in losing weight, rather than relying on the "quick fix" medication approach.

Learning how to make those lifestyle changes at Cedars Sinai costs consumers anywhere between $90 for a single diet counseling session to $385 for a 10-week nutrition program.

"The fact of the matter is, most people respond to healthy nutrition," said Dr. David Heber, director of the UCLA Center for Human Nutrition, which is scheduled to open this fall.

The 10,000-square-foot facility, which is located at the UCLA campus, will study the science of nutrition. Though primarily a research center, it will offer a nutritional clinic to the public, with a staff of about 35 dietitians.

It's too soon to tell whether the increasing competition from hospitals will harm commercial diet centers. But Brian Luscomb, a spokesman for one of the country's largest diet-firms, Jenny Craig, said he hasn't yet seen any noticeable impact on business caused by hospitals.

"If we had to attribute a loss of business to any one thing, it was the weight-loss medications," he said. Jenny Craig and Nutri/Systems offered Redux to consumers before the recall, but have since discontinued the practice.