Metabolic health · Johannesburg
More than a diet. A measured intervention.
For people whose bloodwork already shows what is coming — and who would rather act in the window before it becomes a diagnosis.
GLUCOSE
Continuous monitoring, every day of your stay
HOMA-IR
Insulin resistance, a decade early
VISCERAL FAT
The fat that matters, by DEXA
RMR
Your measured energy requirement
VO₂ MAX
Cardiorespiratory fitness to maximal effort
AHI
Overnight sleep and breathing study
Insulin resistance is detectable roughly a decade before anyone tells you about it.
Most people arrive here having been told their bloods are fine. And by the measures a standard medical uses, they usually are. Fasting glucose is normal. Cholesterol is unremarkable. Weight has crept up but not alarmingly.
What that panel does not measure is fasting insulin, and therefore does not detect the years in which your body is working progressively harder to keep glucose normal. It does not measure visceral fat, which accumulates around the organs independently of what the scale says. It does not measure lean mass, or liver fibrosis risk, or how your own glucose actually behaves after your own dinner.
The Metabolic Reset measures all of it, and then spends seven to ten nights acting on what it finds — supervised nutrition built on your measured energy requirement, training prescribed in your own heart rate zones, and a continuous glucose monitor that turns dietary advice into something you can watch happening.
What we measure, and why.
Your blood panel is collected roughly ten days before you arrive, at a partner laboratory in your own city, so your results are interpreted with you on your first day rather than posted to you a fortnight after you leave.
Your DEXA scan, VO₂ max test and resting metabolic rate are performed at our accredited diagnostic partner nearby, completed in a single accompanied morning. Everything else takes place at Vivari.
- Continuous glucose monitoring
- A sensor worn for the whole of your stay, and the single most useful thing on this page. It shows how your body responds to your meals in real time — which foods spike you and which do not, how a poor night’s sleep degrades your glucose control the following day, what a walk after dinner actually does. Nothing else changes behaviour as reliably as watching your own data move in front of you.
- Fasting insulin and HOMA-IR
- Insulin resistance is detectable years before blood sugar becomes abnormal, and it is the process sitting underneath most of what brings people to this programme. Almost always omitted from a standard medical, which is why so many people are told their bloods are fine while the problem builds.
- HbA1c and fasting glucose
- Your three-month glycaemic average and a single-point reading, interpreted together and re-tested at twelve weeks — one of the few markers that genuinely moves in that window.
- Visceral adipose tissue by DEXA
- The fat around your organs, which is metabolically active and cardiometabolically dangerous in a way that subcutaneous fat is not. It accumulates independently of what the scale says, and it is the fat this programme is actually targeting.
- Lean mass and bone density
- Also from the DEXA scan. Weight loss that takes muscle with it is a poor outcome dressed as a good one. We measure lean mass at the start so that we can protect it, and bone density because rapid weight loss and low bone mass often travel together.
- Resting metabolic rate
- Measured by indirect calorimetry rather than estimated from a formula. Predictive equations misestimate individual metabolic rate substantially, and building an eating plan on a wrong number is how most diets fail quietly.
- VO₂ max
- A cardiopulmonary exercise test to maximal effort with continuous ECG monitoring, conducted by an exercise physiologist and reported by a physician. It establishes your cardiorespiratory fitness and your individual heart rate thresholds — which turns generic exercise advice into an exact prescription, and doubles as an exercise stress test.
- Grip strength and anthropometry
- Measured at the same visit as your scan, so muscle mass and muscle function are recorded together. Waist circumference and waist-to-height ratio are tracked alongside weight, because they move differently.
- Liver assessment
- ALT, AST and GGT with a calculated fibrosis index. Metabolic dysfunction-associated fatty liver disease is highly prevalent, almost entirely asymptomatic, and closely tied to exactly the pattern this programme addresses.
- ApoB, Lp(a) and lipid profile
- ApoB counts the particles actually capable of depositing in an artery wall, which a normal cholesterol result can conceal. Lp(a) is inherited and measured once in a lifetime.
- hs-CRP
- A quantified measure of low-grade systemic inflammation, which travels with visceral fat and insulin resistance. Re-tested at twelve weeks.
- Thyroid and hormonal profile
- Thyroid dysfunction must be excluded before weight change is attributed to lifestyle. Testosterone in men and the female hormonal profile where age-appropriate are read alongside your body composition rather than in isolation.
- Overnight sleep study
- Obstructive sleep apnoea and metabolic disease travel together, each worsening the other, and it is substantially undiagnosed. On this programme the study is standard rather than optional — if you have it, treating it will do more for your metabolic health than any diet.
Where clinically indicated. A CT coronary calcium score is offered to guests whose pre-admission screening questionnaire and blood results point towards it — family history of early cardiac disease, raised Lp(a) or ApoB, or an accumulation of cardiovascular risk factors. It is recommended by your physician rather than selected from a menu, involves a low dose of ionising radiation, and is quoted separately.
Four things change metabolic health.
Metabolic medicine has produced an enormous amount of noise and a small number of interventions that reliably work. This programme concentrates on those, applied to your results rather than to a general population.
Seeing your own data
Continuous glucose monitoring across the full stay. Advice about carbohydrate is abstract; watching your own glucose curve after your own lunch is not. Most guests change more in response to their sensor than to anything anyone tells them, which is why it is the first thing fitted and the last thing removed.
Eating to a measured number
Your resting metabolic rate is measured, not estimated, and your nutrition plan is built on it by a registered dietitian working from your bloods and body composition. Meals across your stay are prescribed and prepared to that plan, so you leave having eaten it rather than having been handed it.
Protecting muscle
Weight loss that takes lean mass with it is a poor outcome dressed as a good one, and it is what most rapid interventions produce. Resistance loading from the first session, prescribed against your DEXA result and progressed into a twelve-month plan you take home.
Sleep and behaviour
Poor sleep degrades glucose control measurably by the following day, and obstructive sleep apnoea sits undiagnosed in a large share of this population — which is why the sleep study is standard here. Alongside it, structured psychological work on the eating patterns that undo good intentions once you are home.
Seven to ten nights, in four phases.
Sequenced around the biology, not the diary. Fasted measurements come before food. Exercise testing follows clearance issued before you travel. Hyperbaric oxygen therapy and a restorative spa treatment happen every day, and hydrotherapy and sauna are available throughout.
Measure — Day one
You are collected from OR Tambo or Lanseria if you are travelling, and taken to our accredited diagnostic partner nearby. DEXA establishes visceral fat, lean mass index and bone density. Grip strength and anthropometry are measured at the same visit. Indirect calorimetry measures your resting metabolic rate.
Breakfast, then your VO₂ max test at the same facility. All instrumented testing is complete in a single visit.
Your continuous glucose sensor is fitted. Extended physician consultation — pre-arrival bloods and the morning’s results reviewed together, with your programme for the following days set here.
Your first hyperbaric oxygen session and spa treatment. Your sleep study is fitted before rest.
Recalibrate — Days two and three
Two consultations with a registered dietitian, the first building your plan from your measured metabolic rate and blood results, the second reviewing your first days of glucose data against what you actually ate. Meals are prescribed rather than chosen from a menu.
Daily training prescribed in the heart rate zones your test established, with resistance loading from the outset — protecting lean mass is not an afterthought to weight loss, it is the point of doing it properly.
Hyperbaric oxygen therapy and a restorative spa treatment daily. Lymphatic drainage massage, sauna and hydrotherapy.
A session with a clinical psychologist on eating behaviour — the patterns, triggers and situations that undo good intentions at home. Structured, practical, and built around your own circumstances rather than general advice.
Consolidate — Days four to six
The middle of the programme is where the change actually happens. Training progresses. Your glucose data accumulates into a pattern you can read yourself. Your dietitian adjusts against it rather than against a plan written in advance.
A cooking demonstration with our kitchen team, turning metabolic nutrition principles into food you can make at home on a Tuesday.
Daily hyperbaric oxygen therapy, daily spa treatment, hydrotherapy and sauna access, and a structured sleep protocol of light, temperature and timing.
A mid-programme physician review, including your sleep study results and any adjustment your findings require.
Integrate — Departure
Your results consultation with the physician and a final session with your dietitian. Every measurement explained: what it means, how it sits against reference ranges for your age and sex, which numbers matter most, and precisely what to do about each.
A written metabolic plan — nutrition built on your measured requirement, a twelve-month training progression in your own heart rate zones, a sleep and recovery protocol, and any onward referrals.
A physician and dietitian teleconsultation at twelve weeks with repeat HbA1c, insulin, lipids and hs-CRP, and a further review at six months. Weight regain after a residential programme is common when nothing structural changes, which is why the follow-up is part of the programme rather than sold separately.
Nothing for you to arrange.
Diagnostic imaging and exercise testing take place at our accredited partner facility nearby, in a single accompanied visit. Every other element is delivered at Vivari. Airport transfers, booking, sequencing and scheduling are handled for you.
Assessment
- Pre-arrival cardiometabolic, endocrine and inflammatory blood panel
- Extended physician consultation on your first day
- Mid-programme physician review
- DEXA — visceral fat, lean mass index, bone density
- VO₂ max test with ECG monitoring
- Resting metabolic rate by indirect calorimetry
- Continuous glucose monitoring, full stay
- Overnight sleep and breathing study
- Grip strength and anthropometry
- Accompanied transfers to and from the diagnostic partner
- Physician results consultation on departure
Programme
- Seven or ten nights in a luxury suite
- All meals and soft beverages, prescribed to your plan
- Hyperbaric oxygen therapy daily
- A restorative spa treatment daily
- Daily hydrotherapy and sauna access
- Daily personalised training sessions
- Three registered dietitian consultations
- Clinical psychology session on eating behaviour
- Lymphatic drainage massage
- Cooking demonstration
- Structured sleep protocol
- Return transfers from OR Tambo or Lanseria
Afterwards
- Written metabolic plan
- Nutrition plan built on your measured metabolic rate
- Twelve-month training progression in your own heart rate zones
- Sleep and recovery protocol
- Onward referrals where indicated
- Twelve-week physician and dietitian teleconsultation
- Repeat HbA1c, insulin, lipids and hs-CRP at twelve weeks
- Six-month review
What seven nights can, and cannot do.
Glucose control, blood pressure, sleep and inflammatory markers can all begin to move within days, and most guests feel the difference before they leave.
Sustained weight change does not happen in ten nights, and we will not tell you it does. What happens here is that the mechanism is measured, the plan is built on your own numbers, and you spend a week eating and training to it under supervision so that it is a practised routine rather than a document. The rest is the twelve months that follow, which is why you are re-tested at twelve weeks and reviewed again at six months.
Responses vary with starting health, adherence and what the assessments find. Where your results point to a condition needing investigation or treatment, we will tell you plainly and refer you properly.
Not sure whether this is the right programme? The Longevity Scan is a full day of the same diagnostic work, and produces a written answer on whether a residential programme is warranted.
Everything above is included.
Accommodation, all meals and soft beverages prescribed to your plan, the complete diagnostic suite, continuous glucose monitoring, daily training, daily hyperbaric oxygen therapy, daily spa treatment, hydrotherapy and sauna, three dietitian consultations, airport transfers, your written metabolic plan and your twelve-week and six-month reviews.
Programme numbers are limited each week so that clinical attention is not divided.
Every guest completes a pre-admission medical screening questionnaire. Together with your pre-arrival blood results, this establishes clearance for maximal exercise testing and for hyperbaric oxygen therapy before you travel, and identifies anything requiring the programme to be adjusted. Consultations are held in confidence and there is no obligation to proceed.
Before you enquire.
How much weight will I lose?
We will not give you a number, and you should be sceptical of anyone who does. What happens over seven to ten days is that the process starts and the mechanism is measured – insulin sensitivity, glucose response, visceral fat, lean mass, inflammatory load. Sustained weight change comes from the twelve months that follow, which is why you leave with a plan and are re-tested at twelve weeks and six months rather than weighed at the gate.
Is this a detox?
No. Your liver and kidneys perform that function continuously and do not need assistance from a programme. What we do assess is whether they are working properly, including a fibrosis index for fatty liver change, which is common in this population and almost entirely without symptoms.
Do you prescribe weight-loss medication?
Where a clinical indication exists, medical weight management is discussed at your consultation with the physician, along with the risks, the contraindications and the follow-up it requires. We do not advertise prescription medicines and we do not start treatment that cannot be properly continued after you leave – continuity with your own doctor is part of the conversation, not an afterthought.
Can I have liposuction or body contouring as part of this?
Not as part of this programme. Body contouring is a cosmetic procedure that does not improve insulin sensitivity, visceral fat or any metabolic marker, and surgical recovery is incompatible with daily training, hydrotherapy and sauna. Aesthetic procedures are available through Vivari separately and are discussed on their own terms.
Why is a sleep study included?
Because obstructive sleep apnoea and metabolic disease worsen each other, and it is substantially undiagnosed. If your study is positive, treating it will do more for your metabolic health than any dietary intervention we could offer, and identifying it is one of the most valuable outcomes of the stay.
What is the CT coronary calcium score, and will I need one?
It is a low-dose CT scan measuring calcified plaque in the coronary arteries, producing a score that refines cardiovascular risk beyond what bloods alone show. It is not part of the standard programme. Your physician recommends it where your screening questionnaire and blood results indicate – family history of early cardiac disease, raised Lp(a) or ApoB, or several risk factors together. It involves ionising radiation and is quoted separately.
Seven nights or ten?
Seven is enough to establish the measurements, build the plan and begin. Ten gives more training progression, more glucose data to read patterns from, and a longer period of prescribed eating before you return to making your own decisions. Your physician will advise at pre-admission screening.