UNDATED (MAYO) -- Marcia Guida says her weight gain happened very slowly. She says, You don't realize that until you see yourself in pictures or someone says, oh what happened?"

Over many years she put on about 40 pounds.

It was enough to cause health issues including possible diabetes. Maria considered bariatric surgery and went to MAYO Clinic for help. But instead, Maria found success with a medically monitored liquid meal replacement program.

Psychologist Dr. Gretchen Ames says the liquid meal program Maria completed is for people who have health problems and a lot to lose, but who may not want or be able to have surgery.

You see, many other weight loss programs are geared toward helping you lose one to two pounds a week. But people with a lot of weight to lose often feel frustrated with that rate. So this program reduces intake to 800 calories a day for at least 14 weeks.

Dr. Ames says, "If we put them on the reduce calorie plan it induces greater weight loss in a short period of time, but then we teach them how to keep it off."

Keeping it off is key so the program offers an ongoing support class for up to a year. To ensure safe weight loss, MAYO Clinic monitors patients weekly and teaches lifestyle education classes which include information about getting healthy portion-controlled meals back into your life, what to eat, how to fit in exercise, and what to do if you get off track.

Maria knows keeping it off will be a life long journey, but it's one she's happy to take.

Dr. Ames stresses that liquid meal replacement diets should be done under strict supervision of a physician and are for those of you who have a lot of weight to lose. The plan is not for those of you who need to drop a few after the holidays.

For more information about visit http://www.Mayoclinic.Org