Weight Management Using a Meal Replacement Strategy: Meta and Pooling Analysis from Six Studies

Heymsfeld SB, et al. Int J Obes. 2003;27:537-549.

Preamble

Meal replacements (MR) are used by millions of consumers annually to control weight. MR dietary strategies are grouped into two categories: replacement of all meals (total MR) or replacement of only 1 or 2 meals (partial MR).

Objective

This review examined six studies using a partial meal replacement (PMR) strategy by meta- and pooling analysis. Published studies of PMR were examined for both safety and effectiveness for weight changes and improvements in health markers. The chosen studies were those using one or two fortified meal replacements daily, in conjunction with regular food. PMRs are fortified with essential vitamins and minerals to help ensure that dieters receive a full complement of recommended nutrients daily while losing weight.

Design

The studies reviewed for inclusion in the analysis utilized low-calorie diets (> 800 ≤ 1600 calories daily). They included energy-reduced, fortified, commercially available PMRs as well as conventional foods. The studies had all of the following inclusion criteria:

1. used randomized techniques
2. lasted at least 3 months
3. involved subjects over 18 years of age and with body mass index ≥ 25kg/m²

Subjects from the studies were evaluated together as either the control (conventional diet plan) or treatment (PMR) group. The PMR strategy included the use of 1 or 2 meal replacements daily along with regular, calorie-controlled foods, while the conventional diet included regular, calorie-controlled foods only. Prescribed caloric intake for both groups were the same. Investigators for the six studies were contacted to supply individual data for analysis.

Results

Subjects in both control and PMR groups experienced statistically significant weight loss at both 3 months and 1 year. However, weight loss was greater for patients utilizing PMRs compared with reduced-calorie diets. Results differed for each diet type (PMR or conventional). In summary, meal-replacement dieters lost 7%-8% body weight compared to 3%-7% for conventional dieters. Analysis of completers showed an average weight loss after 3 months of 6.5 (14.3 lbs) ± 0.27 kg versus 2.54 (5.58 lbs) ± 0.37 kg (P<0.001) in the PMR and control diets, respectively ; after one year weight loss in the PMR group was 6.97 (15.3 lbs) ± 0.58 kg versus 4.35 (9.57 lbs) ± 0.76 kg in the control group.

Disease risk factors associated with being overweight and obesity were reduced with both groups at each time point. Such improvement was dependent on the level of risk factor abnormality at commencement of the studies. While the rate of attrition was similar for both groups at 3 months; there were significantly fewer dropouts for PMR users at one year. Neither diet program reported adverse effects.

Conclusion

This analysis of clinical trials shows that partial meal replacements used for weight control are safe and effective for achieving weight loss and weight management long term. In addition, they show that the risk of diseases associated with being overweight are reduced with such programs.

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