Meal replacement with a low-calorie diet formula in weight loss maintenance after weight loss induction with diet alone


C Vázques, C Montagna, F Alcaraz, JA Balsa, I Zamarrón, F Arrieta and JI Botella-Carretero


European Journal of Clinical Nutrition (2009), 63, 1226–1232; doi:10.1038/ejcn.2009.48

Patient group:

The study included 62 patients aged 18 to 75 years who successfully lost at least 5 percent in weight over the past six months by participating in a weight loss program in which the daily calorie intake was reduced by 400-500 kcal.


Many studies show that different treatment methods lead to significant weight loss, but few have focused on maintaining weight loss over time. Drug treatment may provide results, but at the price of side effects, as well as inadequate compliance and weight gain once treatment is concluded. Studies using meal replacements for weight loss have demonstrated significant efficacy and improvement in weight-related risk factors. This study aims to evaluate the use of meal replacements to maintain successful weight loss.


Participating patients had lost at least five percent of their original weight over a six-month period by participating in a weight-loss program. The program primarily involved a prescribed diet where daily calorie intake was reduced by about 400-500 calories.

Patients were then randomized into two groups, one of which replaced dinner with an LCD-type meal replacement for the following six months. Both the intervention group and control groups were advised to continue the energy-restricted diet from the weight loss phase and met monthly with a dietician. No other intervention was carried out in the control Group.

Results and discussion:

The study shows that to maintain weight loss, it is more effective to use LCD-type meal replacements for one meal per day than to solely eat an energy-restricted diet of ordinary food. The intervention group maintained their weight to a greater extent and lost more than twice as much in weight as the control group, without any major loss of lean body mass. Of the 31 patients in the intervention group, 83.9% (26 people) succeeded in maintaining or further reducing their weight during the maintenance phase, compared with 58.1% (18) in the control group (p=0.025).

Patients in the intervention group lost an additional 3.2 ±3.7% of their initial weight, compared with the control group, which lost 1.3 ±3.6%. Even though the difference is only 1.9% of the initial weight, total weight loss in the intervention group was more than 10%. It has been demonstrated (Hamman et al., 2006) that the risk of diabetes drops by 16% for each kilogram lost, so even a seemingly small difference may be considered of clinical interest.

The study results show that the strategy to replace one meal a day with a meal replacement is as effective or more effective than other weight loss maintenance strategies. Compared with drug treatment (orlistat or sibutramine) the therapeutic strategy with meal replacement also eliminates associated side effects, offers improved compliance and is less expensive, even though it is at least as effective.


Replacing one meal per day with an LCD meal is an effective way to maintain weight loss, compared with diet alone.