Mastering Medical-Grade Meal Replacements: A Guide for Optimal Use

Graphic of meal replacement shake

With the flooding of protein bars and shakes in supermarkets, drug stores, and discount stores such as Walmart and Costco, many consider meal replacements a new phenomenon. But the truth is, meal replacements have been around since the 18th century! 

In the past, meal replacements consisted of foods such as meat and fruit that were dried and then broken into a powder. In 1974, however, Optifast popularized liquid meal replacements as a dietary tool, developing an all-shake meal replacement plan that was nutritionally balanced. The start was a little rocky, with modifications to electrolytes like potassium due to early cardiac arrhythmias, but the 800-calorie plan was soon accepted as a meal replacement diet that could be safely followed under a physician’s supervision. 

Optifast went on to add bars and, eventually, soups to the plan for variety. It is one of the brands we still use in our office today. Several other physician-supervised meal replacement diets were developed following in their footsteps. Some improved taste and protein content, such as New Direction, which are also offered at our office and on our website. 

As the obesity epidemic grew across the country and the world, many food companies decided to jump in as well. This flooded the market with protein shakes and bars that were sometimes incorrectly labeled as meal replacements. 

What are Medical-grade Meal Replacements?

Medical-grade meal replacements are designed to be nutritionally complete. They are high in protein, fiber, and essential vitamins and minerals while providing a calorie deficit for weight loss. Protein content tends to be high to sustain muscle mass in the process, which helps to maintain long-term weight loss. Many medical-grade meal replacements can be used under a physician’s supervision to replace all food for the day. They can also be used with food—for example, replacing breakfast and lunch and then eating a healthy dinner.

If you are having a hard time getting access to a physician-directed program but are looking to lose weight quickly and in a healthy way that can be sustained, a partial meal replacement plan is the way to go. 

It is important to mention that you should never go on a full meal replacement diet unless you are under the direction of a physician. 

How is Medical-grade Better Than Regular Meal Replacements?

Medical-grade meal replacements are formulated, tested, and FDA-approved to meet higher standards of nutritional content and quality. Many are perfectly balanced from an electrolyte standpoint to safely replace all food in the diet. Think of them like staying at a 5-star hotel vs. a 2-star. The standards are not even close.  

Many over-the-counter “meal replacements” are mislabeled and are not truly meal replacements, but are more like milkshakes and candy bars. There are also now a wide variety of protein shakes and bars out there that contain unhealthy (sometimes hidden) ingredients. It’s so important to understand that these companies are out to sell products, not to meet your weight loss needs in a healthy manner. If you are not convinced, go to your favorite product’s website and look at all the disclaimers. 

I can’t emphasize enough how important it is to look at the ingredients. When you do, you will notice that many contain the following:

  • Added sugars: Many store-bought protein bars and shakes are full of sugar in various forms. There are now what we call in our industry “secret sugars.” If you don’t think the food industry has ulterior motives, consider this: to date, there are 56 different names for secret sugars and the list keeps growing.
  • Artificial sweeteners, colors, and flavors: This is a real problem. Some of us can tolerate artificial sweeteners in low doses, but at higher doses can get very sick. For example, if you see sugar alcohols in your products, be very careful how much you ingest. For many, sugar alcohols can cause digestive problems such as stomach aches, diarrhea, headaches, and a potential risk of disruption to the gut microbiota (intestinal bacteria shifting that can impede weight loss and make it harder to fight infections). 
  • Fillers and thickeners: Without safety and quality standards, cheaper ingredients are added that reduce the price and can impact safety and efficacy. Maltodextrin or carrageenan are some fillers that are added to store-bought meal replacements.
  • Low-quality protein sources: Most medical-grade meal replacement shakes contain whey protein—a natural but more expensive protein source that is created from cow’s milk. Bars tend to be more soy-based—again, a natural but more expensive source.  Store-bought products tend to have collagen & gelatin—cheaper protein sources that are much less effective at building and repairing muscle tissues. Since preventing muscle loss during weight loss is key to maintaining metabolism, these lower-quality protein sources can not only prevent weight loss but make it difficult to maintain any weight loss long term. 

What Meal Replacement Plans Does MWL Offer?

At Medical Weight Loss of NY, we offer 3 different plans, 2 of which involve meal replacements—the Partial and Full Meal Replacement Plans.  

As an obesity medicine specialist for 16 years, I can tell you that those who choose a plan with meal replacements will always do better with both weight loss and maintenance than those who don’t. This is because meal replacements are satisfying, easy, convenient, nutritionally complete, and take the guesswork out of meal planning. As I tell my patients, “Meal replacements usually provide a better choice than you would make on your own.” 

Meal replacements also cause “stimuli narrowing,” which makes you less interested in food in general, and takes away most cravings. In addition, meal replacements in maintenance have been shown in the National Weight Control Registry to be a major key to maintaining weight loss. 

We offer 3 different brands of medical-grade meal replacements. Our best-selling by far (and my personal favorite due to taste and quality) are from New Direction. You can find these products on our website and we offer them to everyone who visits our website, regardless of if you are a patient at our clinic. If you have met me (or seen any of my social media posts), you know that I am obsessed with helping people lose weight and be free from pain and weight-related diseases! For this reason, I feel very strongly that these products are available to everyone trying to lose weight, whether they are full-time patients or not. 

Full Meal Replacement Plan

Our fastest weight loss plan is the full meal replacement plan. As mentioned above, this plan must be monitored by a physician and is only available to patients who come to our office. For full meal replacement programs, all meals are replaced with products, typically 5-6 products per day. Patients are seen weekly, and bloodwork is carefully monitored. They also attend weekly behavioral groups, which helps them focus on eating behaviors and offers comradery and emotional support. 

The full plan is perfect for those who need to lose more than 40 pounds, as the weight drops quickly yet safely with excellent muscle preservation. With any weight loss, patients can begin the process of reversing obesity-related disease, especially if they hit a 5-10% weight loss. It happens very quickly with patients on a full plan (the weight loss is actually much higher than 10%). Many patients can reverse the majority of their weight-related diseases, such as hypertension, fatty liver, sleep apnea, high cholesterol, type II diabetes, pre-diabetes, Metabolic Syndrome, and Insulin Resistance. We have had many patients lose and keep off more than 100 pounds on full meal replacement plans. Our “biggest loser” lost 350 pounds!

Partial Meal Replacement Plan

The partial meal replacement plan is available to patients and non-patients alike and can be tried safely at home. It usually involves 4 products and a lean and green dinner (4-8 oz of protein, veggies, and a salad)  Dinner does not have to be the meal that is replaced, but it is usually chosen so the participant can eat with family or friends if they desire. If 4 meal replacements are used, the weight loss is still quite fast, as there is only one meal that the patient has to plan. 

Research on Medical Grade Meal Replacements as a Tool For Weight Loss

There have been hundreds of studies showing the benefits of medical-grade meal replacement programs over a food-based plan. As mentioned, they help promote weight loss by eliminating choices, controlling portions, and providing satiation at lower calorie intakes. A majority of the studies have shown a significant weight loss advantage in using meal replacements over a food-based diet, with better maintenance and muscle preservation. The greater number of meal replacements, the more weight loss was achieved, often at least doubling the weight loss of a food-based plan. This 2001 study provides a nice graph of what a program using the 4 pillars of weight loss can do with the addition of meal replacements.

As seen from the graph above, adding meal replacements to medication and behavioral modification doubled weight loss, maintaining that weight loss through the end of the year.  

More recently, the 2018 Optiwin study showed a doubling of weight loss with full meal replacements over a food-based plan with comparable arms. Fat mass loss was greater for OP; lean mass loss was proportional to total weight loss. There was no difference in serious adverse event rates between groups.

Meal Replacements Are Imperative for Weight Loss! 

True meal replacements that are medical-grade show at least double the weight loss over food-based diets and provide weight loss that is sustained over time. This has been proven in hundreds of clinical trials over the last 50 years. 

Medical-grade meal replacements are effective because they eliminate choices, control portions, are filling, and are nutritionally complete at a lower calorie intake. Beware of store-bought products, as they often have hidden ingredients that can cause health issues, use inferior sources for their protein, and are not nutritionally complete. They are held to different standards with limited, if any, research backing up their claims. 

Despite some Internet messaging, medical-grade meal replacements have stood the test of time. They’ve provided over 100 pounds of weight loss for many of the patients I have seen over the last 16 years that is sustained over time. I could honestly not run a successful practice without them! 

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