Translation of Evidence to Clinical Practice for Use of Meal Replacements in Weight Loss and Obesity-lessons Learned from Research Studies

Abstract

Meal replacements have been shown to be effective in assisting weight loss in many clinical trials; however, adherence is a major determinant of the reported success. Characterizing how meal replacements were used for weight loss in clinical studies can assist healthcare providers to replicate efficacy and improve adherence to achieve successful weight loss. This narrative review characterizes the treatment conditions that support meal replacements use for weight loss from 45 clinical trials. From these studies, the key treatment conditions that support the successful use of meal replacements include contact with healthcare providers; structured education and counseling sessions; and close monitoring of progress. Weekly contacts with healthcare providers that included a physician with dietitian/ nutritionist team for at least three months were needed in the initial phase of using meal replacements. Education and counseling sessions should be conducted at individual and group level to provide structured diet plans which included healthy eating, exercise plan and incorporation of cognitive/psychological motivation components. Frequent monitoring of progress included weekly to monthly weight monitoring, the use of food and exercise records, and self-monitoring of blood glucose in subjects with diabetes. In conclusion, similar with other lifestyle interventions, intensive follow ups and monitoring are required to ensure the success of using meal replacements for weight loss in everyday clinical practice.

Effects of ad libitum consumed, low-fat, high-fiber plant-based diet supplemented with plant-based meal replacements on cardiovascular risk factors

“…A review of interventional studies using MR for weight loss as a part of a low calorie diet plan showed adherence of 50–70% with varied retention between 48 and 100% (16). Inclusion of MR may represent one of the solutions for improving long-term success of weight-reducing diets combined with standard lifestyle changes in overweight free-living subjects, probably due to a simple preparation and general convenience (13).…”

Structured lifestyle intervention based on a trans-cultural diabetes-specific nutrition algorithm (tDNA) in individuals with type 2 diabetes: a randomized controlled trial

“…A review reported that self-monitoring in weight loss interventions was necessary to support behavior change for weight loss as it encourages the development of self-regulatory skills, such as evaluating and reinforcing progress made toward a particular behavior. 36 …”

The Most Undertreated Chronic Disease: Addressing Obesity in Primary Care Settings

“…A prescribed meal plan with meal replacements should last for at least 2 weeks and can be prescribed indefinitely without any laboratory monitoring if it has at least 1200 kcal/day [27•]. However, to most effectively incorporate meal replacements and prevent attrition, regular follow-up is needed to provide continued education, counseling, and track progress [31]. Patients with diabetes especially require intensive self-monitoring of blood glucose [31].…”

“…However, to most effectively incorporate meal replacements and prevent attrition, regular follow-up is needed to provide continued education, counseling, and track progress [31]. Patients with diabetes especially require intensive self-monitoring of blood glucose [31].…”