Meal Replacement Programs for Weight Loss
First of all, what is obesity, and are there good medical reasons to lose weight? We explored this issue in a another article (“New Light on Getting Lighter”). In summary, obesity exists when one has excess body fat. But, when is fat excessive? In my mind, this occurs when one enters a higher risk group for various chronic diseases.
The National Institutes of Health (NIH) has reported that the following diseases have been statistically correlated with obesity: Hypertension (resulting in increased risk for heart disease and strokes), diabetes mellitus (resulting in increased risk for heart disease, blindness, kidney disease, limb blood vessel impairment), coronary artery heart disease, and cancer of the rectum and prostate (in men), cancer of the gallbladder, biliary passages, breast, uterus and ovaries (in women).
Indeed, long-term, large population studies have shown a dramatic increase in mortality (the likelihood that one will die during a given time frame) with increasing weight.
For solid medical reasons, then, many people choose to lose weight. Although overeating and lack of exercise are common causes, metabolic and hormonal abnormalities may also play an important role. It’s appropriate, therefore, to get a medical evaluation from a physician who can help uncover these underlying problems. Two common factors are a low thyroid condition (which can slow down the rate at which we metabolize or “burn off” ingested calories) and the presence of food allergies that cause fluid retention, impaired metabolism, and cravings for certain foods. These often require specialized laboratory tests for diagnosis.
Certainly, a low fat, high fiber, reduced-calorie diet (or a low carb diet for those with an appropriate “metabolic type”) accompanied by a regular aerobic exercise program will usually result in weight reduction for those who are modestly overweight and are able to make these lifestyle changes. But, for those with more weight to lose and who would benefit from taking a “break” from their normal lifestyle pattern, meal replacement programs have become an increasingly attractive option, especially as these programs have improved over the years.
With the new breed of “protein Enhanced/Attenuated Lipid” (high protein/low fat) programs, one can generally expect to lose three to five pounds per week, and with a remarkable degree of safety. Prospective studies of many thousands of participants have failed to show any increased likelihood of serious side effects, in the presence of appropriate medical monitoring and supervision. Recently there have been some suggestions that previously undiagnosed gallstones might be slightly more likely to become more apparent following cessation of a weight loss program, but this has not been confirmed. Other studies have failed to show any such problems.
In any case, it would not be appropriate for anyone with the following conditions to participate in a modified fasting program: history of a stroke, severe diabetes (with history of a coma), recent heart attack or unstable angina, bleeding ulcer, current need for steroid medications or lithium, active blood vessel inflammation (thrombophlebitis), suicidal tendency, chronic substance abuse, severe kidney or liver disease, and pregnancy.
In a good program, meal replacement can begin after appropriate history, physical exam, and laboratory tests have been performed. One must be strongly motivated to begin with, but the program should provide ongoing emotional support and encouragement, in the form of periodic counseling sessions. These can also provide the opportunity for ongoing medical and laboratory monitoring, which should be accomplished on a regular basis. Regular aerobic exercise and adequate fluid intake are also essential, and should be strongly encouraged.
Unfortunately, despite many similarities, not all meal replacement products are created equal. In a modified fasting situation, one’s body becomes extremely sensitive to everything one ingests, so read the contents label carefully. When I was first looking for a meal replacement formula to recommend to my patients, I was shocked to discover that nearly all of them (including all of the well-known ones you’ve heard about and many others which I examined), contained sugar, artificial colors, artificial flavorings, common food allergens, poor quality mineral components, and inadequate soluble fiber!
I was about to give up looking for a formula I could stand behind, when I discovered that a highly respected nutritional biochemist, named Jeffrey Bland, Ph.D., had developed a program called UltraMeal, which fulfilled all of these criteria. At its best, a liquid food replacement should be free of sugar and chemicals, formulated to be hypoallergenic (so it can even be used in the diagnosis and treatment of food allergies, apart from its usefulness in weight loss) and have sophisticated peptone-bonded minerals which ensure adequate absorption and utilization by the body. It should also include a soluble fiber and absorbent formula which encourages appropriate elimination (essential during this time of detoxification) and acts as a natural appetite suppressant by giving one “full” feeling after ingestion.
It is probably due to this combination of qualities that participants in UltraMeal programs (which I use in my practice) have experienced improvement in a wide range of health problems, in addition to weight loss, according to several studies. The results of these studies show that on the average approximately 75% of the people showed improvement in conditions such as hypertension, constipation, diabetes, diarrhea, fatigue, edema, gastric disturbances, and elevated serum lipids.
Another important feature in any weight loss program is flexibility. Not everyone needs to replace all three meals each day in order to have good results. A good program will allow the participant to also choose to replace only one or two meals per day, and it’s often useful to move from one level of replacement to another as the program enters different phases.
A comprehensive meal replacement program will provide a special opportunity for nutritional and health education. During this time of greatly simplified choices it’s often much easier to reevaluate one’s lifestyle, and plan appropriate changes. The trick of course is to make these changes permanently. The “yo-yo” syndrome of ups and downs in body weight is very unhealthy, generally causing a gradual increase in the percentage of body fat over time as one returns to a previously elevated body weight. A good program will have a carefully designed transition phase during which normal maintenance dietary and lifestyle patterns are gradually reintroduced.
As with moderate weight reduction programs, the best long-term weight maintenance programs involve a combination of a low fat, high fiber diet, attitudinal healing, and regular aerobic exercise. For some people, an appropriately conceived and formulated meal replacement program can provide a safe and effective way to achieve their goals.
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