in the Treatment of Obesity
Since obesity is at epidemic proportions in the United States and elsewhere, efforts to change the food environment, as well as lifestyle and individual appetite and metabolism, will be required to solve this public health problem (see Chapter 78). With fast-food restaurants literally minutes away from most Americans, the urge to eat high-fat and highcalorie foods can be easily satisfied. Meal replacements may be one means of helping some people control their weight.
“Meal replacements” are defined as functional foods in the form of drinks or bars meant to replace a meal. They were developed as over-the-counter modifications of the very-low-calorie diets popular in the 1970s, but have more calories and a more complete profile of micronutrients.
Meal replacements have become very popular among consumers; it is estimated that tens of millions of Americans use them each year. In a number of carefully controlled studies described below, meal replacements have proven to be a useful tool in the treatment of obesity by providing patients with reliable and good-tasting alternatives to eating calorically restricted meals. Meal replacements simplify food choices, aid in adherence to dietary regimens, and enable patients to restrict calories more effectively during weight loss and weight maintenance, since the dieter is confident of the number of calories per meal. Often, the estimation of food calories is much less certain. Many patients can sustain this approach without the need for ongoing professional intervention.
Meal replacements are safe and, when used as directed, provide measured amounts of calories, protein, minerals, fiber, and vitamins in the form of either ready-to-drink liquids, powders that are mixed with milk or other liquids, or meal replacement bars. They can be integrated into meal plans that include whole foods and most often provide more nutritional value than the dieter’s usual food choices that they replace. After commenting