Meal replacement therapy and

patient response: A review

SASHA SHEFTEL
NTRS 513

Background
7.86 million

adults obese
BMI > 30 kg/m2
Comorbidities
Difficult to treat

Suggestion for Change: Meal Replacement

Therapy
People looking for

magical dietary cure

Meal replacements
common for people
looking to lose weight
Calorically formulated to
meat nutritional needs
Many different formulas

Method
MEDLINE, Academic Search Premiere, Psychinfo
Meal replacements, appetite, weight loss,

blood glucose
Published between 2004-2014
Any language
No restrictions on BMI, amount of weight loss,
patient gender, age, biomarkers used to asses success
of meal replacment

Results
6 primary research articles used for reivew
Length of intervention ranged from 10 days to 12

months
1 study included follow up and 1 and 2 years post
intervention
Total of 699 participants
540 (90%) female, 159 (23%) male
Range of participants per study 14-380

Majority of participants were Caucasian (77%),

followed by African American (15%), other (7%), and

Hispanic (1%)

Results Continued
BMI ranged 30-38.2
Average BMI 33.8
Age ranged 18-79
Average age 55 years old
All studies prospective
Two followed cross-over design
Variables used to examine effectiveness of meal

replacements:

Type of meal replacement, gender, current health status,

length of intervention, measurement instruments used, and
patient lab values

Measurement Instruments
Lab values
Fasting blood glucose, fasting insulin, blood lipids, hemoglobin
A1c, OGTT, Cholesterol
MOS 36-Item Short Form Health Survey (SF-36)
Eating Behavior Inventory
Power of Food Scale
Food Craving Questionnaire
Food cravings on hedonic scale
1.5 GTE MRI scanner
Evaluated differences in brain networks between participants
on meal supplement vs. patients drinking water

Meal Replacements and Weight Loss

Theim, Brown, Jurascio, Malcom, & ONeil
15-week Focus Program (behavioral intervention)
Slowly incorporate foods back into diet
Improvements in behaviors to control weight along with
decreases in food-related cravings
Lowe, Butryn, Thomas, & Coletta
Meal replacements as a form of maintenance
Meal replacement therapy in conjunction with reduction in
consumption of foods with high caloric content
3, 12, 24 and 36 month follow ups
Study found the group learning to incorporate conventional
foods into diet had better results

Meal Replacements and Weight Loss Continued

Koohkan et al.
380 obese women
12-month lifestyle intervention
Weight reduction
Improvement in health related quality of life
Results

more pronounced in meal replacement group

Meal Replacements and Health Related

Conditions
Stenvers et al.

Use of low glycemic response meal replacement on blood sugar

regulation
Cross-over study design
Replacing breakfast with low glycemic response could prove
beneficial

Konig et al.

Studied pre-diabetic patients

One group used diet and exercise, other group used meal
replacements
Meal replacement group showed significant reduction in ability to
control blood glucose and insulin levels
Control group showed reduction also, but more pronounced in group
using meal replacments

Meal Replacements and Appetite

Paolini et al.
RCT
Found consumption of a meal replacement after period of food
restriction lowered cravings and hunger
Small sample size

Suggestions for Further Research

Weight loss maintenance
Low energy density food diets and food

environments for weight maintenance

Long term-impact of low glycemic meal
replacements and their impact on glycaemia
More investigation on meal replacements and
appetite

Conclusions
Meal replacements for short term conditions and

help initiate change

Much more research required in order to implement
them for treatment of obesity

The End
THANK YOU!