Medical Meal Replacement for Weight Loss

Meal replacement formulas, often referred to as diet shakes or protein drinks, have been a staple of do-it-yourself, commercial, and medical weight loss programs for nearly three decades. Over the years, their formulation has changed as research develops and food processing techniques evolve.

During the 1960s, medical researchers realized that the most efficient way to help obese people lose weight was to hospitalize them so they could fast while receiving intravenous glucose infused with vitamins and minerals. Pounds pealed off, but doing without protein had undesirable effects on lean body tissue and led to rough, dry skin, brittle nails, and hair loss.

In the early 1970s, Drs. Saul Ganuth and Victor Vertes at Mount Sinai Hospital in Cleveland, Ohio developed a very low calorie, protein-rich diet formula that could be taken orally. They referred to their creation as a protein-sparing modified fast because it limited loss of muscle protein, supplied just enough calories (400 per day) to cover essential energy needs and promoted rapid weight loss. Without the need for intravenous administration of fluid and vitamins, the new formula could be used on an outpatient basis, providing the dieters reported for weekly medical monitoring to ensure their bodies’ were tolerating the rapid weight loss. 

Drs. Genuth and Vertes soon sold the recipe for their formula to Delmark. Shortly thereafter, the formula was named OPTIFAST^® and became the first meal replacement formula available to physicians nationwide. Imitators soon followed. Some of the competitive products were formulated using poor quality proteins and their use led to adverse medical outcomes including the deaths of a few users. This gave protein shakes a bad image. However, meal replacement formulas have remained an important tool for physicians who are trying to help their obese patients lose weight and improve their health.

Well over 100 studies have explored the use of full and partial meal replacement formula diets for weight loss, and in the process, identified clear metabolic and behavioral advantages.

Benefits of meal replacement formula diets include:

• Precise portion and calorie control.
• Nutritional completeness unmatched by conventional food diets. Full meal replacement diets  provide over 100% of all essential vitamins minerals, fatty acids, and amino acids. It is not possible to achieve this same level of nutrition in as few calories using whole foods.
• Quicker and safer weight loss than can be achieved with a typical low calorie diet
• A rapid improvement in the weight-related health risk factors associated with metabolic syndrome and cardiovascular disease. Many people experience an improvement in blood sugar and blood pressure levels after following the diet for just a few weeks.
• Limited contact with food. Full meal replacement formula diets give patients the opportunity to take a vacation from food and their daily struggles to control their eating habits. This allows them to explore the role food and eating have played in their everyday lives, identify behaviors that need to be changed, and practice new ways of relating to food.
• Reduced gut capacity. Chronic overeating increases the capacity of a person’s stomach and intestines, making it easier to keep overeating. The full formal diet has very little volume and few calories. As weight is lost, the gut capacity shrinks. Many researchers have said this is the closest people can get to reducing stomach size without having bariatric surgery.
• A narrowing of stimuli. This is a phenomenon in which people eat less because they are exposed to a limited variety and quantity of foods. Investigators who study appetite control have found that if people are given only the same one or two foods to eat at every meal, they tend to eat less as the days go by- even if the food they are being offered is their favorite meal. Conversely, if they are offered a wide variety of foods (think buffet table), they want to sample everything and end up eating more food.

Nutrition experts such as the American Dietetic Association originally criticized meal replacement diets as not teaching people how to eat traditional food in healthy ways. However, the ongoing obesity crisis and new data has caused the ADA, the NIH, and other organizations of health experts to reconsider meal replacement formulas as valuable tools for weight loss and maintenance. The ability to provide high quality nutrition in few calories makes meal replacement formulas useful in many situations. For example, meal replacement formulas can be used to replace only 1 or 2 meals per day. These plans, known as partial meal replacement formula diets, use 2-3 formula and 1-2 frozen diet meals each day. They provide around 1200 calories, which makes them a good choice for people with a modest amount of weight to lose, for those who have a health condition that requires them to lose weight more slowly than they would on a full formula diet, or for people trying to maintain the weight they lost while following a full formula meal plan.

During the 1960s, medical researchers realized that the most efficient way to help obese people lose weight was to hospitalize them so they could fast while receiving intravenous glucose infused with vitamins and minerals. Pounds pealed off, but doing without protein had undesirable effects on lean body tissue and led to rough, dry skin, brittle nails, and hair loss.

In the early 1970s, Drs. Saul Ganuth and Victor Vertes at Mount Sinai Hospital in Cleveland, Ohio developed a very low calorie, protein-rich diet formula that could be taken orally. They referred to their creation as a protein-sparing modified fast because it limited loss of muscle protein, supplied just enough calories (400 per day) to cover essential energy needs and promoted rapid weight loss. Without the need for intravenous administration of fluid and vitamins, the new formula could be used on an outpatient basis, providing the dieters reported for weekly medical monitoring to ensure their bodies’ were tolerating the rapid weight loss. 

Drs. Genuth and Vertes soon sold the recipe for their formula to Delmark. Shortly thereafter, the formula was named OPTIFAST^® and became the first meal replacement formula available to physicians nationwide. Imitators soon followed. Some of the competitive products were formulated using poor quality proteins and their use led to adverse medical outcomes including the deaths of a few users. This gave protein shakes a bad image. However, meal replacement formulas have remained an important tool for physicians who are trying to help their obese patients lose weight and improve their health.

Well over 100 studies have explored the use of full and partial meal replacement formula diets for weight loss, and in the process, identified clear metabolic and behavioral advantages.

Benefits of meal replacement formula diets include:

• Precise portion and calorie control.
• Nutritional completeness unmatched by conventional food diets. Full meal replacement diets  provide over 100% of all essential vitamins minerals, fatty acids, and amino acids. It is not possible to achieve this same level of nutrition in as few calories using whole foods.
• Quicker and safer weight loss than can be achieved with a typical low calorie diet
• A rapid improvement in the weight-related health risk factors associated with metabolic syndrome and cardiovascular disease. Many people experience an improvement in blood sugar and blood pressure levels after following the diet for just a few weeks.
• Limited contact with food. Full meal replacement formula diets give patients the opportunity to take a vacation from food and their daily struggles to control their eating habits. This allows them to explore the role food and eating have played in their everyday lives, identify behaviors that need to be changed, and practice new ways of relating to food.
• Reduced gut capacity. Chronic overeating increases the capacity of a person’s stomach and intestines, making it easier to keep overeating. The full formal diet has very little volume and few calories. As weight is lost, the gut capacity shrinks. Many researchers have said this is the closest people can get to reducing stomach size without having bariatric surgery.
• A narrowing of stimuli. This is a phenomenon in which people eat less because they are exposed to a limited variety and quantity of foods. Investigators who study appetite control have found that if people are given only the same one or two foods to eat at every meal, they tend to eat less as the days go by- even if the food they are being offered is their favorite meal. Conversely, if they are offered a wide variety of foods (think buffet table), they want to sample everything and end up eating more food.

Nutrition experts such as the American Dietetic Association originally criticized meal replacement diets as not teaching people how to eat traditional food in healthy ways. However, the ongoing obesity crisis and new data has caused the ADA, the NIH, and other organizations of health experts to reconsider meal replacement formulas as valuable tools for weight loss and maintenance. The ability to provide high quality nutrition in few calories makes meal replacement formulas useful in many situations. For example, meal replacement formulas can be used to replace only 1 or 2 meals per day. These plans, known as partial meal replacement formula diets, use 2-3 formula and 1-2 frozen diet meals each day. They provide around 1200 calories, which makes them a good choice for people with a modest amount of weight to lose, for those who have a health condition that requires them to lose weight more slowly than they would on a full formula diet, or for people trying to maintain the weight they lost while following a full formula meal plan.