Ching Li Lee and Winnie SS Chee
Meal replacements have been shown to be effective in assisting weight loss in many clinical trials; however, adherence is a major determinant of the reported success. Characterizing how meal replacements were used for weight loss in clinical studies can assist healthcare providers to replicate efficacy and improve adherence to achieve successful weight loss. This narrative review characterizes the treatment conditions that support meal replacements use for weight loss from 45 clinical trials. From these studies, the key treatment conditions that support the successful use of meal replacements include contact with healthcare providers; structured education and counseling sessions; and close monitoring of progress. Weekly contacts with healthcare providers that included a physician with dietitian/ nutritionist team for at least three months were needed in the initial phase of using meal replacements. Education and counseling sessions should be conducted at individual and group level to provide structured diet plans which included healthy eating, exercise plan and incorporation of cognitive/psychological motivation components. Frequent monitoring of progress included weekly to monthly weight monitoring, the use of food and exercise records, and self-monitoring of blood glucose in subjects with diabetes. In conclusion, similar with other lifestyle interventions, intensive follow ups and monitoring are required to ensure the success of using meal replacements for weight loss in everyday clinical practice.