Digital and Food Replacement Program Proven Effective for Weight Loss

Credit: Adobe Stock/Simamkele K/peopleimages.com

The Metawell program, which combines food replacement products, a mobile app and a wireless scale, was effective for weight loss among a cohort of Chinese participants. Individuals using Metawell showed significantly greater reductions in body mass index (BMI), total body fat, visceral fat and subcutaneous fat than the control group, while preserving lean muscle mass.

“Nutrition therapy is considered to be the foundation of obesity management,” a team of Chinese investigators wrote. “Meal replacement products provide an easy way for participants to follow a weight loss program, and rapid weight loss during the initial stage of the intervention can help to build the confidence of participants, thus leading to greater weight loss.”

According to the Doctor Referral of Overweight People to Low Energy Total Diet Replacement Treatment (DROPLET) study, doctor-prescribed total meal replacement programs are an effective strategy for weight loss, and other research reported the benefits of both partial and total meal replacements. In addition, the delivery of the intervention program—such as using the internet or a mobile app—can also influence the efficacy of such a program, although more research is needed in this area.

Conducted over three months with a six-month follow-up, the two-arm, parallel-designed study included 220 adult patients with overweight or obesity who were randomized 1:1 into either the intervention group or control group.

Subjects in the intervention group consumed food replacement products and used a scale for monitoring and weight loss. They were instructed to download a mobile app and diet, body composition and urine ketone were monitored every day. In the first part of the study, patients ate the food replacement biscuits in addition to a selection of healthy recipes and took a multivitamin. Their caloric intake was restricted to 800-1200 kcal/day. In the maintenance phase, they stopped eating the meal replacement while continuing to monitor their weight and upload data. If a participant regained a noticeable amount of weight, investigators initiated a short weight loss intervention period.

Controls were given a printout of a sample diet combined with in-person education on weight loss at enrollment. Male participants were instructed to consume 1050 kcal/day and females followed a 1200 kcal/day plan.

Although most studies focus on changes in BMI, investigators said body fat—particularly visceral fat mass—is the primary pathogenic factor in obesity. Dual-energy x-ray absorptiometry and quantitative computed tomography were used to determine body fat at enrollment, month three and month six.

No differences were observed between groups regarding baseline characteristics, the mean age of participants was 33 years and most (57.8%) were women.

Results demonstrated that digital and food replacement-based interventions can effectively combat obesity. Patients in the intervention group exhibited significantly greater reductions in BMI at month six compared with controls, with 28% in the intervention group achieving a ≥10% weight loss compared with 3% of controls.

Additionally, patients in the Metawell group had significantly greater visceral and subcutaneous fat loss when compared with the control cohort. Interestingly, the rate of change in lean mass was comparable between groups.

Although 35 participants reported minor adverse events including constipation, dizziness, fatigue, gastritis and hypoglycemia, the program was generally well-tolerated, highlighting its potential as a practical weight-loss solution in China.

Investigators noted limitations including the short follow-up period that did not allow for long-term observation. Additionally, they observed a statistically significant decrease in bone mineral density (BMD) among subjects in the intervention group and were not sure if there would be any lasting impact post-intervention.

“An extended follow-up will be performed to investigate whether participants will regain their body weight and whether their BMD will continue to decrease,” investigators concluded.