Use of the Medifast Meal Replacement Program for Weight Loss in Overweight and Obese Clients: A Retrospective Chart Review of Three Medifast Weight Control Centers (MWCC)

Christopher Coleman, Jessica Kiel, Andrea Hanlon-Mitola, Carmine Sonzone, Nicholas Fuller, Lisa Davis

Medifast, Inc, Owings Mills, MD 21117.
Mitola, Clifton Park, NY, 12065..

DOI: 10.4236/fns.2012.310187                

Abstract

Objective: A chart review was performed to evaluate the effectiveness of the Medifast (MD) meal replacement (MR) plan in a Medifast Weight Control Center (MWCC) on body weight, body composition, and other health measures at 4, 12, 24 weeks, and final weight loss visit. Methods: Charts included adults aged 18 - 70 (n = 446) with a BMI ≥ 25 kg/m2 who attended one of three MWCCs and were following the MD MR program. Data were collected electronically and included weight, systolic and diastolic blood pressure, pulse, lean muscle mass (LMM), body fat mass, % body fat, and abdominal circumference. Compliance measures included attendance at weekly visits, intake of MRs and supplements, food journals, and ketone testing. Results: Significant weight loss and % weight loss were achieved at all time points with clinically significant weight loss (>5%) occurring in just 4 weeks. Additionally, significant improvements in body composition were seen at all time points coupled with increases in % total body weight as LMM (% LMM improved by 3.5%, 9.8%, 16.0%, and 13.9%, respectively). Blood pressure and pulse were significantly improved, demonstrating the clinical benefit for clients. Multivariate regression revealed a strong inverse relationship between weight change, % compliance with attendance, and the number of weeks that MRs were taken as recommended as well as a positive association with number of ketone tests. Conclusion: The MD MR plan, combined with the support and accountability available in the MWCC, is an efficacious program that promotes significant weight loss and improvements in body composition. These results reveal significant associations between components of compliance and weight loss, but particularly highlight the importance of attendance, a focus of the MWCC model compared to nonclinic models.

Keywords

Meal Replacements; Weight Loss; Compliance; Body Composition; Obesity

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	A. Alwan, “Global Status Report on Noncommunicable Diseases,” World Health Organization, 2010. http://www.who.int/nmh/publications/ncd_report2010/en
[2]	C. L. Ogden and M. D. Carroll, “Prevalence of Overweight, Obesity, and Extreme Obesity, among Adults: United States, Trends 1960-1962 through 2007-2008,” National Health and Nutrition Examination Survey. National Center for Health Statistics: Health-E Stats, 2010. http://www.cdc.gov/nchs/data/hestat/obesity_adult_07_08/obesity_adult_07_08.pdf
[3]	M. S. Westerterp-Plantenga and E. M. R. Kovacs, “The Effect of (-)-Hydroxycitrate on Energy Intake and Satiety in Overweight Humans,” International Journal of Obesity, Vol. 26, No. 6, 2002, pp. 870-872.
[4]	B. A. Swinburn, I. Caterson, J. C. Seidell and W. P. T. James, “Diet Nutrition and the Prevention of Excess Weight Gain and Obesity,” Public Health Nutrition, Vol. 7, No. 1A, 2004, pp. 123-146.
[5]	B. Arsenault, J. Rana, K. Khaw, et al, “Physical Inactivity, Abdominal Obesity and Risk of Coronary Heart Disease in Apparently Healthy Men and Women,” International Journal of Obesity, Vol. 34, No. 2, 2010, pp. 340-347. doi:10.1038/ijo.2009.229
[6]	L. J. Prior and J. A. Armitage, “Neonatal Overfeeding Leads to Developmental Programming of Adult Obesity: You Are What You Ate,” The Journal of Physiology, Vol. 587, No. 11, 2009, pp. 2419-2419. doi:10.1113/jphysiol.2009.174045
[7]	S. Ramachandrappa and I. Farooqi, “Genetic Approaches to Understanding Human Obesity,” The Journal of Clinical Investigation, Vol. 121, No. 6, 2011, pp. 2080-2086. doi:10.1172/JCI46044
[8]	F. Tsai and W. Coyle, “The Microbiome and Obesity: Is Obesity Linked to Our Gut Flora?” Current Gastroenterology Reports, Vol. 11, No. 4, 2009, pp. 307-313. doi:10.1007/s11894-009-0045-z
[9]	“What is Obesity?” 2 June 2009. http://www.obesity.org/information/what_is_obesity.asp
[10]	J. Jakicic, et al., “Appropriate Interventions Strategies for Weight Loss and Prevention of Weight Regain for Adults,” Medicine & Science in Sports & Exercise, Vol. 41, No. 2, 2001, pp. 2145-2154. doi:10.1097/00005768-200112000-00026
[11]	L. Grant and L. Gotthelf, “Successful Weight Maintenance in a Telephone-Based Treatment Program,” Obesity Research, Vol. 12, No. A44, 2004, p. A44.
[12]	L. Gotthelf, J. Anderson and B. O’Brien, “Weight Loss in Overweight or Obese Individuals with Different Structured Interventions in an Intense Behavioral Program,” Obesity Research, Vol. 12, No. A40, 2004, p. A40.
[13]	E. A. Furlow and J. W. Anderson, “A Systematic Review of Targeted Outcomes Associated with a Medically Supervised Commercial Weight-Loss Program,” Journal of the American Dietetic Association, Vol. 109, No. 8, 2009, pp. 1417-1421. doi:10.1016/j.jada.2009.05.003
[14]	S. B. Hemsfield, C. A. J. Van Mierlo, H. C. M. Van der Knaap, M. Heo and H. I. Frier, “Weight Management Using a Meal Replacement Strategy: Meta and Pooling Analysis from Six Studies,” International Journal of Obesity, Vol. 27, No. 5, 2003 pp. 537-549. doi:10.1038/sj.ijo.0802258
[15]	L. M. Davis, C. D. Coleman, J. Kiel, J. Rampolla, T. Hutchisen, L. Ford, W. S. Anderson and A. Hanlon-Mitola, “Efficacy of a Meal Replacement Diet Plan Compared to a Food-Based Diet Plan after a Period of Weight Loss and Weight Maintenance: A Randomized Controlled Trial,” Nutrition Journal, Vol. 9, 2010, pp. 11-20. doi:10.1186/1475-2891-9-11
[16]	C. K. Haddock, W. S. Poston, J. P. Foreyt, J. J. DiBartolomeo and P. O. Warner, “Effectiveness of Medifast Supplements Combined with Obesity Pharmacotherapy: A Clinical Program Evaluation,” Eating and Weight Disorders Vol. 13, No. 2, 2008, pp. 95-101.
[17]	G. D. Foster, K. E. Borradaile, S. S. V. Veur, K. Leh-Shantz, R. J. Dilks, E. M. Goldbacher, T. L. Oliver, C. A. Lagrotte, C. Homko and W. Satz, “The Effects of a Commercially Available Weight Loss Program among Obese Patients with Type 2 Diabetes,” Postgraduate Medicine, Vol. 121, No. 5, 2009, pp. 113-118. doi:10.3810/pgm.2009.09.2046
[18]	C. Wilborn, J. Beckham, B. Campbell, T. Harvey, M. Galbreath, P. La Bounty, E. Nassar, J. Wisman and R. Kreider, “Obesity: Prevalence, Theories, Medical Consequences, Management, and Research Directions,” Journal of the International Society of Sports Nutrition, Vol. 2, No. 2, 2005, pp. 4-31. doi:10.1186/1550-2783-2-2-4
[19]	S. A. Jebb, A. L. Ahern, A. D. Olson, L. M. Aston, C. Holzapfel, J. Stoll, U. Amann-Gassner, A. E. Simpson, N. R. Fuller, S. Pearson, N. S. Lau, A. P. Mander, H. Hauner and I. D. Caterson, “Primary Care Referral to a Commercial Provider for Weight Loss Treatment versus Standard Care: A Randomised Controlled Trial,” Lancet, Vol. 378, No. 9801, 2011, pp. 1485-1492. doi:10.1016/S0140-6736(11)61344-5
[20]	C. Collins, J. Jones and D. Sherwood, “Formulated Meal Replacements: A Comparison of the Nutritional Adequacy of Available Products,” Nutrition and Dietetics, Vol. 66, No. 1, 2009, pp. 12-19. doi:10.1111/j.1747-0080.2008.01312.x
[21]	A. M. Coppen, J. A. Risser and P. D. Vash, “Metabolic Syndrome Resolution in Children and Adolescents after 10 Weeks of Weight Loss,” Journal of the Cardiometabolic Syndrome, Vol. 3 No. 4, 2008, pp. 205-210. doi:10.1111/j.1559-4572.2008.00016.x
[22]	J. S. Bland and F. Dibiase, “Physiological Effects of a Doctor-Supervised versus an Unsupervised Over-the-Counter Weight-Loss,” Journal of Nutritional Medicine, Vol. 3, No. 3-4, 1992, p. 285. doi:10.3109/13590849208997984
[23]	J. W. Anderson and M. A. Jhaveri, “Reductions in Medications with Substantial Weight Loss with Behavioral Interventions,” Current Clinical Pharmacology, Vol. 5, No. 4, 2010, pp. 232-238. doi:10.2174/157488410793352030
[24]	R. B. Kreider, C. Rasmussen, C. M. Kerksick, C. Wilborn, et al, “A Carbohydrate-Restricted Diet during Resistance Training Promotes More Favorable Changes in Body Composition and Markers of Health in Obese Women with and without Insulin Resistance,” The Physician and Sports Medicine, Vol. 39, No. 2, 2011, pp. 27-40. doi:10.3810/psm.2011.05.1893
[25]	A. Tsai and T. Wadden, “Systematic Review: An Evaluation of Major Commercial Weight Loss Programs in the United States,” Annals of Internal Medicine, Vol. 142, No.1, 2005, pp. 56-66.
[26]	F. R. Volkmar, A. J. Stunkard, J. Woolston and R. A. Bailey, “High Attrition Rates in Commercial Weight Reduction Programs,” Archives of Internal Medicine, Vol. 141, No. 4, 1981, pp. 426-428.
[27]	C. K. Martin, L. Talamini, A. Johnson, A. M. Hymel and O. Khavjou, “Weight Loss and Retention in a Commercial Weight Loss Program and the Effect of Corporate Partnership,” International Journal of Obesity, Vol. 34, No. 4, 2010, pp. 742-750. doi:10.1038/ijo.2009.276
[28]	A. L. Ahern, A. D. Olson, L. M. Aston and S. A. Jebb, “Weight Watchers on Prescription: An Observational Study of Weight Change among Adults Referred to Weight Watchers by the NHS,” BMC Public Health, Vol. 11, 2011, p. 434. doi:10.1186/1471-2458-11-434
[29]	S. C. Bischoff, A. Damms-Machado, C. Betz, S. Herpertz, et al., “Multicenter Evaluation of an Interdisciplinary 52Week Weight Loss Program for Obesity with Regard to Body Weight, Comorbodities and Quality of Life: A Prospective Study,” International Journal of Obesity, Vol. 36, No. 4, 2012, pp. 614-624. doi:10.1038/ijo.2011.107
[30]	T. Wadden, R. Neiberg, M. Vitolins, et al., “Four-Year Weight Losses in the Look Ahead Study: Factors Associated with Long-Term Success,” Obesity, Vol. 19, No. 10, 2011, pp. 1987-1998. doi:10.1038/oby.2011.230
[31]	P. R. Thomas, “Weighing the Options: Criteria for Evaluating Weight Management Programs,” National Academy Press, Washington DC, 1995. doi:10.1037/10510-000
[32]	D. J. Goldstein, “Beneficial Health Effects of Modest Weight Loss,” International Journal of Obesity and Related Metabolic Disorders, Vol. 16, No. 6, 1992, pp. 397-415.
[33]	FDA, “VI-0521 (Qnexa?) Advisory Committee Briefing Document,” Endocrinologic and Metabolic Drugs Advisory Committee Meeting, Mountain View, 22 Feburary 2012.
[34]	M. Lowe, T. Kral and K. Miller-Kovach, “Weight-Loss Maintenance 1, 2 and 5 Years after Successful Completion of a Weight-Loss Programme,” The British Journal of Nutrition, Vol. 99, No. 4, 2008, pp. 925-930. doi:10.1017/S0007114507862416
[35]	C. Rock, S. Flatt, N. Sherwood, N. Karanja, B. Pakiz and C. Thomson, “Effect of a Free Prepared Meal and Incentivized Weight Loss Program on Weight Loss and Weight Loss Maintenance in Obese and Overweight Women: A Randomized Controlled Trial,” Journal of the American Medical Association, Vol. 304, No. 16, 2010, pp. 1803-1811. doi:10.1001/jama.2010.1503
[36]	X. Wang, G. Miller, S. Messier and B. Nicklas, “Knee Strength Maintained Despite Loss of Lean Body Mass during Weight Loss in Older Obese Adults with Knee Osteoarthritis,” Journals of Gerontology Series A: Biological Sciences & Medical Sciences, Vol. 62A, No. 8, 2007, pp. 866-871. doi:10.1093/gerona/62.8.866
[37]	R. Kreider, M. Serra, S. Jonnalagadda, et al., “A Structured Diet and Exercise Program Promotes Favorable Changes in Weight Loss, Body Composition, and Weight Maintenance,” Journal of the American Dietetic Association, Vol. 111, No. 6, 2011, pp. 828-843. doi:10.1016/j.jada.2011.03.013
[38]	L. Garby, J. Garrow, J. Webster, et al., “Relation between Energy Expenditure and Body Composition in Man: Specific Energy Expenditure in Vivo of Fat and Fat-Free Tissue,” European Journal of Clinical Nutrition, Vol. 42, No. 4, 1998, pp. 301-305.
[39]	K. Nelson, R. Weinsier, C. Long and Y. Schutz, “Prediction of Resting Energy Expenditure from Fat-Free Mass and Fat Mass,” The American Journal of Clinical Nutrition, Vol. 56, No. 5, 1992, pp. 848-856.
[40]	J. Cunningham, “A Reanalysis of the Factors Influencing Basal Metabolic Rate in Normal Adults,” The American Journal of Clinical Nutrition, Vol. 33, No. 11, 1980, pp. 2372-2374.
[41]	A. Kotronen, H. Yki-J?rvinen, T. S?rensen, et al., “Comparison of the Relative Contributions of Intra-Abdominal and Liver Fat to Components of the Metabolic Syndrome,” Obesity, Vol. 19, No. 1, 2011, pp. 23-28. doi:10.1038/oby.2010.137
[42]	V. Ajay and D. Prabhakaran, “Coronary Heart Disease in Indians: Implications of the Interheart Study,” The Indian Journal of Medical Research, Vol. 132, No. 5, 2010, pp. 561-566.
[43]	B. Balka, P. Picard, S. Vol, L. Fezeu and E. Eschwège, “Consequences of Change in Waist Circumference on Cardiometabolic Risk Factors over 9 Years: Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR),” Diabetes Care, Vol. 30, No. 7, 2007, pp. 1901-1903. doi:10.2337/dc06-2542
[44]	A. Fernandez-Sanchez, E. Madrigal-Santillan, M. Bautista, et al., “Inflammation, Oxidative Stress, and Obesity,” International Journal of Molecular Sciences, Vol. 12, 2011, pp. 3117-3132. doi:10.3390/ijms12053117
[45]	C. Finley, C. Barlow, F. Greenway, C. Rock, B. Rolls and S. Blair, “Retention Rates and Weight Loss in a Commercial Weight Loss Program,” International Journal of Obesity, Vol. 31, No. 2, 2007, pp. 292-298. doi:10.1038/sj.ijo.0803395
[46]	L. Cheskin, A. Mitchell, T. Lycan, et al., “Efficacy of Meal Replacements versus a Standard Food-Based Diet for Weight Loss in Type 2 Diabetes: A Controlled Clinical Trial,” The Diabetes Educator, Vol. 34, No. 1, 2008, pp. 118-127. doi:10.1177/0145721707312463
[47]	ADA, “Evidence Analysis Library,” 2012. http://www.adaevidencelibrary.com