The patient journey is the core product of the ThriveAB clinic. It must be a meticulously designed, supportive, and transformative experience that translates the clinical evidence of the DiRECT protocol into a clear, actionable pathway for patients. The proposed 12-month structure provides a solid framework integrating clinical care, education, and behavioral support.
Intensive Remission
Weeks 1-12
Objective: Achieve rapid, significant weight loss (>15 kg target) and induce metabolic remission. This phase directly implements the DiRECT trial's Total Diet Replacement (TDR) protocol.
Week 0: Onboarding
A comprehensive 60-minute in-person consultation with a physician. Includes full medical assessment, confirmation of diagnosis, baseline bloodwork review, education on the TDR protocol, and the critical, supervised de-prescription of antidiabetic and antihypertensive medications. The patient is introduced to their ThrivePod and the digital companion app.
Physician (MD)Weeks 1-4: Weekly Appointments
Weekly appointments alternating between in-person group sessions and virtual check-ins. Sessions led by a Nurse/CDE focus on managing side effects, reinforcing motivation, and building community within the ThrivePod.
RN/CDEWeeks 5-12: Bi-Weekly Appointments
Bi-weekly appointments continuing the mix of in-person group sessions and virtual support. Focus shifts to preparing for the transition to food reintroduction while maintaining momentum.
RN/CDEMetabolic Stabilization & Food Reintroduction
Weeks 13-18
Objective: Gradually reintroduce whole foods without compromising weight loss, and establish new, sustainable eating patterns. This phase mirrors the DiRECT Food Reintroduction (FR) stage.
Bi-Weekly Group Sessions
Bi-weekly in-person group sessions co-led by a Registered Dietitian and a Nurse/CDE. These sessions are highly practical, featuring "cooking lessons," meal planning workshops, and strategies for navigating social eating situations. The dietitian provides personalized macronutrient and caloric targets.
Registered DietitianRN/CDELong-Term Maintenance & Optimization
Months 5-12
Objective: Solidify new lifestyle habits, empower the patient for long-term self-management, and prevent weight regain. This aligns with the DiRECT Weight Loss Maintenance (WLM) phase.
Monthly Group Sessions
Monthly in-person group sessions. The focus expands to a holistic view of health, with sessions led by a Kinesiologist on safe physical activity, and continued support from the Nurse/CDE and Dietitian on behavioral strategies and nutritional refinement. The ThrivePod community remains a key source of peer support.
KinesiologistRN/CDERegistered Dietitian12-Month Graduation
At the 12-month mark, patients "graduate" from the AHS-funded program. This milestone represents a transformation from patient to empowered self-manager. Graduates are introduced to the ThriveAB+ cooperative membership for ongoing premium support.
The decline in remission rates over time (from 46% at year one to 13% at year five with low-intensity support) is not a failure of the initial intervention but a clear illustration of the profound challenge of long-term weight loss maintenance. This clinical reality represents the single greatest business opportunity for the venture. The initial 12-month, AHS-funded program is the "customer acquisition" phase. The challenge of maintenance becomes the powerful justification for the premium, subscription-based ThriveAB+ cooperative membership.