Upavasa. Fasting under real medical supervision — with Ayurvedic re-feeding built in.
One of eight Focuses · available on Pause · Reset · View · £1,300 – £2,000 indicative
A structured therapeutic fast delivered under real medical supervision, with the Sama Clinic GP running clearance and daily check-ins, and Dr Prasanna Kerur running the Ayurvedic pre-fast preparation and the kitchari re-feeding protocol on the other side. Pause and Reset guests do a 5-day Prolon Fast-Mimicking Diet under supervision; View guests can elect a longer supervised water-only or modified fast where the risk profile supports it. CGM and blood-ketone tracking across the fast; written home-fasting protocol on departure. Traditional Ayurveda has a formal fasting practice — upavāsa — with millennia of clinical judgement about who should fast, when, how, and how to break the fast. This Focus is the modern medical version of that practice with the Ayurvedic frame kept intact.
The full arc of a supervised therapeutic fast.
Therapeutic fasting is one of the interventions where the difference between doing it well and doing it badly is very large. The Focus is built around three principles: proper clinical clearance and daily supervision (Dr Shiv Chande GP), traditional Ayurvedic preparation and re-feeding (Dr Prasanna Kerur), and objective data across the fast (CGM, blood ketones, daily biometrics). Every guest leaves with a written home-protocol so the practice becomes repeatable rather than a one-off retreat event.
- Full pre-fast medical clearance — Dr Shiv Chande GP consult and full electrolyte / renal / hepatic panel via the Medilab Nidana route, plus a review of every current medication for fast-relevant adjustments (SGLT2 inhibitors, sulphonylureas, insulin, antihypertensives, warfarin, and others require specific supervision protocols during a fast). The clearance either signs off the fast, modifies it, or defers it — this is the load-bearing safety layer.
- Ayurvedic pre-fast preparation with Dr Prasanna Kerur — a full session covering dosha assessment, the traditional langhana preparation practices (dietary tapering, kitchari-only day, dinacharya adjustment), and the guest's own subjective anchor for the fast. Ayurveda has been running this protocol for two millennia; layering it on top of the modern medical work is the differentiator against a Prolon-in-a-hotel-room experience.
- 5-day Prolon Fast-Mimicking Diet (standard for Pause / Reset) — the validated Prolon FMD kit delivering ~750-1,100 kcal per day of a specifically-formulated micronutrient-adequate low-protein / low-carb / plant-based diet. Triggers the metabolic markers of fasting (glucose drop, ketone rise, IGF-1 reduction, autophagy signals) while retaining an eating-based experience with a much lower risk profile than water-only fasting. Prolon is the specific fast-mimicking product with the strongest clinical-trial evidence base and the format most compatible with a hotel stay.
- Extended water-only or modified fast for View (elective) — View guests may elect a longer supervised protocol (5-7 day water-only, or a modified bone-broth / vegetable-broth fast) where the pre-fast clearance supports it. This requires additional GP supervision intensity and additional lab work, and is not offered on Pause or Reset. Adds a supplementary cost of ~£300 to the Focus fee for the extended clinical touch and lab work.
- Daily GP check-in across the fast — 10-15 minute daily touch with Dr Shiv Chande covering BP, HR, weight, hydration status, blood ketone, blood glucose finger-prick, and subjective symptom review. Escalation protocol defined in advance for any red-flag symptom (orthostatic hypotension, arrhythmia, refeeding-risk indicators).
- Continuous glucose monitor + blood ketone strips — Abbott Freestyle Libre 3 CGM for the full stay plus 3-7 days post-departure, and a supply of Abbott / Keto-Mojo blood ketone strips for the daily read. Both are the objective data layer — the CGM shows the glucose drop and the timing of ketogenic switch; blood ketones confirm ketosis depth.
- Guided re-feeding with Dr Prasanna Kerur — the Ayurvedic re-feeding protocol is critical (refeeding syndrome is the well-known risk on the other side of a fast) and is where the traditional practice adds most value beyond the modern medical framing. Kitchari-focused, dosha-adjusted, sequenced across three days from broth through soft rice through solid food. Prepared by the main Ahara kitchen and delivered to the guest by the dietitian — this is therapeutic food, not a cooking class, so no dedicated teaching-kitchen space is needed.
- Written home-protocol on departure — a written protocol covering when the next fast is appropriate (a quarterly Prolon cadence is the standard recommendation for the metabolic maintenance case; a monthly 24-hour intermittent cadence is the alternative), how to run it safely at home, red-flag symptoms to watch for, and the medications and health conditions that would call for GP supervision before repeating. Also: a note for the guest's own GP explaining what was done in-stay so ongoing care is coordinated.
Therapeutic fasting is a genuine medical intervention — real physiological effects, real risk profile, real contraindications. Most "detox retreats" and "cleanse programmes" in the wellness industry do not have GP-level clinical supervision; the Upavasa Focus does. That is the load-bearing distinction from the generic wellness-industry fasting offer, and the reason the Focus fee reflects real GP time.
Where each part of the £1,600 actually goes.
The Upavasa Focus is priced at £1,600 recommended (indicative range £1,300 – £2,000). £280 flows through as pass-through: £180 to L-Nutra for the Prolon FMD kit, £70 to Abbott for the CGM sensor, and £30 for the blood ketone strip supply. The remaining £1,320 stays with the hotel and funds Dr Shiv Chande's clearance and daily supervision, Dr Prasanna Kerur's pre-fast and re-feeding sessions, nurse biometric supervision across the fast, and the drafting of the written home protocol. After costing hotel delivery at £435 (clinician time at Programmes-page baseline rates — Dr Chande £90/hr loaded, Dr Kerur £65/hr, practice nurse £35/hr), the net contribution to new investment is £885 per Focus — a 67% margin on the net-to-hotel residual. Upavasa carries the highest clinician-time-per-guest ratio in the Focus set (GP presence across every fast day is the load-bearing safety layer), so the delivery cost is still meaningful in absolute terms — but at correct baseline rates the margin sits alongside Kaya (75%) and above Vikrama (55%).
The Prolon kit and monitoring consumables are true third-party pass-through — the Prolon retail is ~£220 and negotiates down to ~£180 at planning-stage trade volumes. The other pass-through items are the CGM and ketone strips. Hotel delivery is dominated by GP time (Dr Shiv Chande clearance + 4-5 days of daily check-ins at £90/hr loaded) and Ayurvedic physician time (Dr Prasanna Kerur prep + kitchari re-feed at £65/hr), with nurse supervision at £35/hr loaded. This is still the Focus with the highest clinician-time-per-guest ratio in the set (five to six discrete clinician sessions per stay), so the delivery cost is meaningful in absolute pounds even at correct baseline rates. The 67% margin is the honest number.
What price does each margin imply?
Costs are fixed: £280 of pass-through (Prolon + CGM + ketone strips), plus £435 of hotel delivery (clinician time at Programmes-page baseline rates: Chande £90/hr, Kerur £65/hr, nurse £35/hr). The only thing that changes with a different target margin is the Focus fee. Drag the slider.
Recommended: £1,600 — a supervised 5-day fast at a specialist medical clinic in Europe (Buchinger Wilhelmi, F. X. Mayr clinics) runs £2,500-£4,500 for the fasting-week programme alone before accommodation. The bundled Upavasa Focus at £1,600 with Prolon, GP supervision, Ayurvedic framing and a written home protocol sits below that tier but well above the unsupervised at-home Prolon retail (~£220 for the kit only). The slider lets you test alternatives — the low end of the range assumes a lighter GP-touch model, the high end assumes richer clinical involvement or the extended water-only View variant.
Session-by-session, per programme tier.
Upavasa is the most time-consuming Focus in the set — the 5-day Prolon FMD alone needs 5 continuous days, plus pre-fast preparation and 2-3 days of guided re-feeding either side. That means the fit across the three programme tiers is materially different, and Pause is genuinely tight — most of the pre-fast prep sits at home and the last re-feeding day sits after departure, with the dietitian on video for both. Reset is the sweet spot; View has the room to add either an extended water-only option or a fuller two-day pre-fast + three-day re-feed at both ends.
| Session / touchpoint | Pause (5 nights) | Reset (7 nights) | View (14 nights) |
|---|---|---|---|
| Pre-stay video with Dr Shiv Chande + medication reviewtapering plan, medication adjustments, langhana prep with dosha screen | 7-10 days pre | 3-5 days pre | on-site Day 1 |
| On-site GP clearance + full pre-fast bloodselectrolytes, renal / hepatic function, insulin, glucose baseline | Day 1 | Day 1 | Day 2 |
| Dr Prasanna Kerur Ayurvedic pre-fast sessiondosha + langhana practices; kitchari-only reset day | Day 1 | Day 1 | Day 2 |
| CGM sensor applied + blood ketone kit issued | Day 1 | Day 1 | Day 2 |
| Prolon FMD Day 1 (start)or extended water-only start (View optional) | Day 1 | Day 2 | Day 3 |
| Prolon FMD Days 2-5 (+ daily GP + nurse touch)15-min GP + 30-min nurse; BP, HR, weight, ketones, glucose, symptoms | Days 2-5 | Days 3-6 | Days 4-7 (Prolon) or 4-9 (extended) |
| Ayurvedic re-feeding — broth dayfrom Ahara main kitchen; Dr Prasanna Kerur present at first feed | at-home Day 6 (video) | Day 7 | Day 8 / Day 10 |
| Re-feeding Days 2-3 — kitchari & soft foodfrom Ahara main kitchen; dietitian daily check | at-home (dietitian video) | Day 7 finish + at-home | Days 9-11 / 11-13 |
| Departure debrief + written home protocol | Day 5 (mid-fast) | Day 7 | Day 14 |
| Post-stay follow-up callGP + dietitian; check on refeeding, subjective response, home cadence | Day 10-14 post | Day 10-14 post | Day 10-14 post |
| Fasting days on-site · re-feeding on-site · fast type | 5 days · 0 days · Prolon only | 5 days · 1 day · Prolon only | 5-7 days · 3 days · Prolon or extended water-only |
Honest note on Pause + Upavasa: the Focus is offered on Pause but genuinely tight — the whole 5 nights are the Prolon fast, most of the pre-fast prep sits at home before arrival, and re-feeding happens at home with the dietitian on video. Reception flags this at booking and typically steers first-time fasters toward Reset (where 6 nights of on-site fast + refeed sit comfortably) or View (where the extended water-only option is available). Repeat-fast guests who know the protocol are the natural Pause + Upavasa bookers. The £1,600 fee is held flat across tiers because the clinical safety layer (GP time, nurse supervision, Ayurvedic input) is the same regardless of stay length; what differs is where the pre-fast and re-feeding conversations happen.
What the £1,600 buys, priced against private-market equivalents.
Two natural benchmarks: buying the equivalent components privately (Prolon retail + GP consult + private dietitian + supplements), or booking a specialist fasting-clinic week in Europe. The a-la-carte comparison below is the first; the Buchinger / F. X. Mayr benchmark sits in the note beneath.
| Component | Private a-la-carte cost | In the £1,600 Upavasa Focus |
|---|---|---|
| GP consultation + pre-fast bloods clearanceprivate GP (45 min) + electrolyte/renal/hepatic panel at private-lab retail | £200 – £350 | ✓ included |
| Ayurvedic physician pre-fast preparation (60 min)private BAMS consultation, UK rates | £120 – £200 | ✓ included |
| Prolon FMD 5-day kit (retail)L-Nutra direct-to-consumer | £220 | ✓ included (trade rate £180) |
| CGM sensor + monitoring kitAbbott Libre 3 self-purchase + ketone strip supply | £130 – £180 | ✓ included |
| Daily GP check-in across the fast × 4-5 daysprivate GP time — not commonly available as a fasting-supervision service outside a clinic | £300 – £500 | ✓ included |
| Nurse biometric supervision × 4-5 daysspecialist / private nurse hourly rates | £150 – £300 | ✓ included |
| Guided Ayurvedic re-feeding across 3 daysDr Prasanna Kerur time + kitchari materials from Ahara main kitchen | £150 – £250 | ✓ included |
| Written home-fasting protocolGP + dietitian, drafted around the guest's specific pre/in/post-fast data | £100 – £200 | ✓ included |
| Total a-la-carte value | £1,370 – £2,200 | £1,600 |
The £1,600 Focus sits inside the a-la-carte range and materially below the specialist fasting-clinic benchmark. The natural comparators at the clinic tier — Buchinger Wilhelmi, F. X. Mayr Original, MAYRLIFE — price a 7-day supervised fasting week (fast programme only, before accommodation and food) at ~£2,500 – £4,500. Buchinger Wilhelmi's basic 7-night week including accommodation, food and treatment plan runs €3,400+; F. X. Mayr Original starts around €3,600 for 7 nights all-in. The Long Hotel's Upavasa Focus at £1,600 plus the underlying Reset or View programme fee (£3,290 or £8,050) is either broadly comparable to (Reset) or above (View) those benchmarks, but with a materially fuller experience — full clinical spine, Ayurvedic frame, Ahara food operation, and the wider Sama Clinic depth around the fast rather than just the fast in isolation.
Who Upavasa isn't for.
- Type 1 diabetes — extended fasting is contraindicated on standard clinical guidance; the risk of DKA and severe hypoglycaemia is unacceptable in a hotel setting. Focus not offered; alternative metabolic-health work discussed at intake.
- Type 2 diabetes on insulin or sulphonylurea therapy — supervised fasting is possible but requires endocrinologist coordination, medication adjustment protocol agreed in advance, and continuous glucose supervision. Deferred until the guest's home endocrinology team has signed off; the Sama Clinic Naya GP can support the referral conversation.
- Pregnancy or actively trying to conceive — fasting reduces circulating IGF-1 and shifts hormonal signals in ways that are contraindicated in pregnancy and unhelpful during active conception attempts. Focus deferred; alternative nutritional-optimisation work available.
- Active eating disorder or history of eating disorder (anorexia, bulimia, ARFID, orthorexia) — fasting protocols are known to reactivate restrictive-eating patterns. The Focus is not offered; the Sama Clinic Manas psychologist can support a referral conversation.
- BMI < 20 or unintended recent weight loss (> 5% in 3 months) — refeeding syndrome and further lean-mass loss are the risks. Focus not offered; the Ayurvedic brumhana nourishing-therapy protocols with Dr Prasanna Kerur are the alternative.
- Active malignancy under treatment — fasting is currently being studied in oncology (fasting-mimicking diets around chemotherapy cycles show promise) but the evidence is not yet sufficient to offer in a hotel setting. Focus deferred; guest referred back to their oncology team.
- Age 70+ or frailty markers — the risk / benefit calculus shifts materially with age; sarcopenic-risk guests may lose meaningful muscle mass during even a short fast. Modified or deferred; discussed individually at intake.
- On multiple daily medications requiring food (e.g. warfarin dosing, certain antibiotics, thyroid replacement) — the timing complexity is workable but requires case-by-case protocol; discussed at intake and often results in a modified fasting protocol rather than a full deferral.