Adult Weight Management (AWM) Meal Replacements
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
AWM: Meal Replacements
For people who have difficulty with self selection and/or portion control, meal replacements (e.g., liquid meals, meal bars, calorie-controlled packaged meals) may be used as part of the diet component of a comprehensive weight management program. Substituting one or two daily meals or snacks with meal replacements is a successful weight loss and weight maintenance strategy.
Recommendation applies to people who have difficulty with self selection and/or portion control.
- Eight RCTs (3 positive-quality and 5 neutral-quality), three neutral-quality nonrandomized clinical trials and a positive-quality meta-analysis report equivalent or greater weight loss in subjects receiving a diet containing 1 – 3 daily meal replacements (Ahrens et al, 2003; Allison et al, 2003; Ashley et al, 2001; Ditschuneit et al, 1999; Ditschuneit et al, 2001; Flechter-Mors et al, 2000; Hannum et al, 2004; Heber et al, 1994; Heymsfield et al, 2003; Mattes, 2002; Noakes et al, 2004; Rothacker, 2000; Rothacker et al, 2001; Winick et al, 2002)
- Conclusion statements were grade I
- Consistent findings among a variety of study designs
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
In adults, how effective (in terms of client adherence and weight loss and maintenance) are meal replacements (liquid meals, meal bars, frozen prepackaged meals)?
Ahrens RA, Hower M, Best AM. Effects of weight reduction interventions by community pharmacists. J Am Pharm Assoc 2003; 43: 583-589.
Allison DB, Gadbury G, Schwartz LG, Murugesan R, Kraker JL, Heshka S, Fontaine KR, Heymsfield SB. A novel soy-based meal replacement formula for weight loss among obese individuals: a randomized controlled clinical trial. Eur J Clin Nutr 2003; 57(4): 514-522.
Ashley JM, St. Jeor ST, Schrage JP, Perumean-Chaney SE, Gilbertson MC, McCall NL, Bovee V. Weight control in the physician's office. Arch Intern Med 2001; 161: 1599-1604.
Ditschuneit HH, Flechter-Mors M. Value of structured meals for weight management: risk factors and long-term weight maintenance. Obes Res 2001; 9: 284-289S.
Ditschuneit HH, Flechter-Mors M, Johnson TD, Adler G. Metabolic and weight-loss effects of a long-term dietary intervention in obese patients. Am J Clin Nutr 1999; 69(2): 198-204.
Flechter-Mors M, Ditschuneit HH, Johnson TD, Suchard MA, Adler G. Metabolic and weight loss effects of long-term dietary intervention in obese patients: four-year results. Obes Res 2000; 8(5): 399-402.
Hannum SM, Carson LA, Evans EM, Canene KA, Petr EL, Bui L, Erdman JW. Use of portion-controlled entrees enhances weight loss in women. Obes Res 2004; 12: 538-546.
Heber D, Ashley JM, Wang HJ, Elashoff RM. Clinical evaluation of a minimal intervention meal replacement regimen for weight reduction. J Am Coll Nutr 1994; 13(6): 608-614.
Heymsfield SB, van Mierlo CAJ, van der Knaap HCM, Heo M, Frier HI. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord 2003; 27(5): 537-549.
Mattes RD. Ready-to-eat cereal used as a meal replacement promotes weight loss in humans. Journal of the American College of Nutrition. Vol. 21, No. 6, 570-577 (2002).
Noakes M, Foster PR, Keogh JB, Clifton PM. Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. J Nutr 2004; 134(8): 1894-1899.
Rothacker DQ. Five-year self-management of weight using meal replacements: comparison with matched controls in rural Wisconsin. Nutrition 2000; 16(5): 344-348.
Rothacker DQ, Staniszewski BA, Ellis PK. Liquid meal replacement vs traditional food: a potential model for women who cannot maintain eating habit change. J Am Diet Assoc 2001; 101(3): 345-347.
Winick C, Rothacker DQ, Norman RL. Four worksite weight loss programs with high-stress occupations using a meal-replacement product. Occup Med 2002; 52(1): 25-30.