Dear DOCTOR Owen:

I lost weight with a commercial diet meal replacement that I found on a shelf in the grocery store, and I am maintaining most of that weight loss using these supplements five days a week during work. I eat a well-balanced meal in the evening with the family and take a multivitamin. A friend told me that this is crazy and that I’ll ruin my health and my metabolism. Is this safe?

Shake Man

Dear “Shake Man”:

If you ruin anything, then so will I, since this is how I maintain my weight and cholesterol. I’ve used meal replacement shakes for almost 10 years now. I find them filling, inexpensive, and convenient. In addition, I feel much better than when I eat “normally.” In fact, I tell my wife every Monday morning that I have “food poisoning” from the weekend. With the meal replacements during the week, I am able to make up for all the excess calories I ate while having fun over the weekend!

Dietary supplements have flooded the market, making wonderful claims about weight management and better health. Many have made such claims with only marginal science to support them, and the Federal Food and Drug Administration has reprimanded some of them for making such claims. At my clinic, some patients take a powdered, engineered food product mixed with water as a shake as part of a very low calorie diet (VLCD). However, when they go back to “normal” eating, many of them will put on some or all of their previous weight—even though we diet and health counselors tell them that they will need to “diet” forever and that it makes little difference which diet method they choose to follow after their weight loss. Many like the ease of pre-packaged or powdered food shakes, which are convenient and tasty.

Many studies support the health benefits and the success of using meal-replacement products long term. For example, an article in The American Journal of Clinical Nutrition, Vol. 69, 198–204, reviewed the use of Slim-Fast® as a meal replacement. This article also reviewed other data on the subject of very low calorie dieting. Group I was given diet instructions by a nutritionist, using conventional food, which the participants selected from a plan. Group II used Slim-Fast® meal replacements for two out of three of their meals. In three months, the meal-replacement group (Group II) lost 7.8% of their weight vs. 1.5% of the conventional group (Group I). Then, both groups were placed on a one-meal-a-day replacement for two years, and both groups maintained their weight loss. In the general population, average weight would be expected to increase 3% during the same two-year period. Substantial declines in cholesterol, blood pressure, glucose, and insulin were also seen in these groups initially and were maintained during the two-year period.

The study reaffirmed earlier work, which revealed that greater successes in the short run keep patients on a routine as well as motivated. When food was pre-selected, people had less exposure to the temptation of eating large portions or indulging in “high risk” foods. Dieters need all the help they can get, and whatever keeps them away from preparing meals and exposure to food is of immense value in our Western culture.

I have had similar experiences with patients at my clinic. We now make supplements available after the weight-loss phase—which, we emphasize, lasts forever. As for the pressure to “eat right,” there are no data to show that eating perfectly balanced meals all the time (a pipe dream anyhow) is any better than avoiding meals; eating once a day; fasting periodically; using “fillers” or meal replacements (as discussed in this column); or other methods. I never see patients who are suffering from malnutrition! All we physicians see is over-nutrition, and its disease consequences.

I advise all of my patients not to act on hearsay and “sidewalk” advice when it comes to weight management. Instead, read books and literature. Look at audio/video information. Listen to everything you can hear. Talk to your physician. Then make your diet plan, develop your style, and stick to it.