Using Meal Replacements for Weight Loss
A two-year randomized trial of obesity treatment in primary care
Our data support the screening by PCPs of all adults for obesity, as
well as efforts to help patients understand the health consequences of
excess weight and the benefits of modest weight loss. By providing
enhanced lifestyle counseling, [PCP and counseling visits plus a choice
of meal replacements (52%) or weight loss medications (48%)], PCPs could
help a considerable number obese persons achieve clinically meaningful
weight loss, which they might not achieve if they were simply told to
reduce their weight on their own. (New England Journal of Medicine.
2011; 365: 1969-79.)
Efficacy of a meal replacement diet plan compared to a food-based diet
A meal replacement diet plan of a fixed macronutrient composition
yielded clinically significant weight loss for 93% of obese
participants. The intervention with meal replacements yielded changes in
body composition that favorably impacted many cardiovascular health
outcomes. The meal replacement diet plan evaluated is an effective
strategy for producing robust initial weight loss and for achieving
improvements in a number of health parameters during weight maintenance,
including inflammation and oxidative stress, two key factors recently
understood to underlie our most common chronic diseases. (Nutrition
Journal 2010; 9:11.)
Meal Replacements and Energy Balance.
This collective information supports the view that meal replacements,
particularly in beverage form, are now an effective and safe component
for use in the clinical setting. Several studies suggest that the
addition of a PMR to pharmacotherapy may be additive for weight
loss. (Physiology and Behavior. 2010; 100: 90-94.)
Position of the American Dietetic Association: Weight Management
Individuals adhering to structured meal replacement plans lose more
weight at both 12 weeks and one year than individuals following a
conventional diet plan, with one year dropout rates for the structured
meal replacement plan significantly less than the conventional diet
plan. (Journal of the American Dietetic Association. 2009; 109;
One Year Weight losses in the look AHEAD Study: Factors Associated
The numbers of meal replacements consumed in the first six months was
significantly related to weight loss at week 26 as was the total number
consumed for the year to weight loss at week 52. (Obesity. 2009;
Value of Structured Meals for Weight Management: Risk Factors and
long-Term Weight Maintenance
For two groups, one with a 1,200-1,500 calorie diet and another with a
diet using 2 or 3 meal replacements, the differences were significant.
The first group lost an average of 1.5 pounds over 3 months and 3.3
pounds after 4 years. The second group lost 7.8 pounds after 3 months
and 8.4 pounds after 4 years. (Obesity Research. 2001; 9:
Should Overweight and Obese Primary Care Patients Be Offered a Meal
The average adult primary care patient who receives a single
motivational interview can lose about 3 kg in 1month using meal
replacements. The diet was 1200 cal per day using pre-packaged foods for
all calories other than fresh fruits and vegetables. Subjects were told
that fresh vegetables and fruits were 'free' and did not count against
their calorie budgets. Individual servings of snacks or desserts were
acceptable as were frozen meals. No particular brand was recommended. (Obesity
Research and Clinical Practice . 2008; 2: 263-268.)
Meal Replacements are as effective as Structured Weight-loss Diets for
Treating Obesity in Adults with Features of Metabolic Syndrome
Dietary compliance and convenience were viewed more favorably by
participants who consumed meal replacements than by those in a
conventional weight loss program. (The Journal of Nutrition. 2004;
Weight Management Using a Meal Replacement Strategy: Meta and Pooling
Analysis from Six Studies
All methods of analysis indicated a significantly greater weight loss
in subjects receiving the Partial Meal Replacement plan (usage of one or
two meal replacements per day) compared to The Conventional Reduced
Calorie Diet plan. This first systematic evaluation of randomized
Controlled trials using Partial Meal Replacement plans for weight
management suggests that these types of interventions can safely and
effectively produce significant sustainable weight loss and improve
weight related risk factors of disease. (International Journal of
Obesity. 2003; 27: 537-549.)
Efficacy of a Meal Replacement Diet Plan Compared to a Food-Based Diet
The meal replacement diet plan evaluated was an effective strategy for
producing robust initial weight loss and for achieving improvements in a
number of health-related parameters during weight maintenance, including
inflammation and oxidative stress, two key factors more recently shown
to underlie our most common chronic diseases. (Nutrition Journal
Dietary Approaches to the Treatment of Obesity
Protein has the greatest potential to enhance satiety. The high protein
group lost significantly more weight than the low protein group after 6
months and continued to have greater weight loss at 24 months. The high
protein group had a greater decrease than the low protein group in waist
circumference, waist-to-hip ratio, and intra-abdominal adipose tissue.
Structured approaches, including meal replacements and food provision,
have been shown to increase the magnitude of weight loss. (Psychiatric
Clinics of North America. 2005; 28(1): 117-139)
Meal Replacements in Weight Intervention
The main finding of this study was that use of one or more meal
replacements daily promoted significantly improved weight loss and
maintenance compared with a traditional diet plan. In the second year,
the weight maintenance phase of the study, using active intervention in
the group setting was more effective when meal replacements continued to
be part of the diet prescription. (Obesity Research. 2001; 9:
Effect of Meal Replacement on Metabolic Risk Factors in Overweight and
Even over a short period of time, a meal replacement diet (replacing 2
meals per day) is more effective in reducing metabolic risk factors,
insulin, and leptin, and on improving anthropometric measures than a fat
restricted low calorie diet. (Annals of Nutrition and Metabolism.
2008; 52: 74-78.)
Efficacy of Meal Replacements versus Standard Food Based Diet for
Weight loss in Type 2 Diabetes
Approximately 40% of the protein controlled meal replacement diet
participants lost greater than 5% of their initial weight compared with
12% of those on a standard diet. The retention rate and self reported
ease of adherence in the meal replacement group was significantly higher
throughout the study. At 34 week s, the meal replacement group
significantly lowered their fasting blood glucose and fasting insulin
level while the change in the standard diet group was non-significant. (The
Diabetes Educator. 2008; 34: 118-127.)
- (2011) Wadden TA, et.al. "A two-year randomized trial of obesity
treatment in primary care practice." New England Journal of Medicine.
2011; 365: 1969-79.
- (2010) Heymsfield SR. "Meal replacements and energy balance."
Physiology and Behavior. 2010; 100: 90-94.
- (2010) Davis LM, et al. "Efficacy of a meal replacement diet plan
compared to a food-based diet plan after a period of weight loss and
weight maintenance: a randomized controlled trial" Nutrition
Journal 2010; 9:11.
- (2009) Wadden, Thomas, et ai. "One-year Weight Losses in the Look
AHEAD Study: Factors Associated With Success."
Obesity. 2009; 17:713-722.
- (2009) Seagle, Helen, Gladys Witt Strain, Angela Makris, and Rebecca
Reeves. "Position of the American Dietetic Association: Weight
Management." Journal of the American Dietetic Association. 2009; 109:
- (2008) Rohrer JE, Takahashi P. "Should overweight and obese primary
care patients be offered a meal replacement diet?" Obesity Research
and Clinical Practice. 2008; 2:263-268.
- (2008) Konig, Daniel, Peter Deibert, Ingrid Frey, Ulrike Landmann,
and Aloys Berg. "Effect of Meal Replacement on Metabolic Risk Factors
in Overweight and Obese Subjects." Annals of Nutrition and Metabolism.
- (2008) Cheskin, Lawrence, Amy Mitchell, Ami Jhaveri, Andrea Mitola,
Lisa Davis, Rebecca Lewis, Mary Yep, and Thomas Lycan. "Efficacy of
Meal Replacements Versus a Standard Food-Based Diet for Weight Loss in
Type 2 Diabetes: A Controlled Clinical Trial." The Diabetes Educator.
2008; 34: 118-127.
- (2007) Tieken, S., H. Leidy, A. Stuff, R. Mattes, R. Schuster, and
W. Campbell. "Effects of Solid versus Liquid Meal replacement
Products of Similar Energy Content on Hunger, Satiety, and
Appetite-regulating Hormones in Older Adults." Hormone and Metabolic
Research. 2007; 39: 389-394.
- (2005) Makris, A., Foster G. "Dietary Approaches to the Treatment of
Obesity." Psychiatric Clinics of North America. 2005; 28(1): 117-139.
- (2004) Noakes, Manny, Paul Foster, Jennifer Keogh, and Peter
Clifton. "Meal Replacements are as Effective as Structured Weight-Loss
Diets for Treating Obesity in Adults with Features of Metabolic
Syndrome." TheJournal of Nutrition. 2004; 134: 1894-1899.
- (2003) Heymsfield, SB, CAJ van Mierlo, HCM van der Knapp, M Heo, and
HI Frier. "Weight Management Using a Meal Replacement Strategy: Meta
and Pooling Analysis from Six Studies." International Journal of
Obesity. 2003; 27: 537-549.
- (2001) Ditschunett, Herwig and Marion Flechtner-Mors. "Value of
Structured Meals for Weight Management: Risk Factors and Long-Term
Weight Maintenance." Obesity Research. 2001; 9: 284S-289S.
- (2001) Ashley, Judith, S. St. Jeor, Suzanne Perumean-Chaney, Jon
Schrage, and Vicki Bovee. "Meal Replacements in Weight Intervention."
Obesity Research. 2001; 9: 312S-320S.