Meal replacement products have come a long way since they first appeared on the scene more than half a century ago. Once the sole domain of the liquid meal-in-a-can, they have evolved over the years to fulfill a variety of dietary needs and tastes. From high-calorie nutritional supplements to vegan weight loss aids, the options abound.
This rapidly emerging market now offers a wide variety of bariatric meal replacement options. Here’s a closer look at what you should know about bariatric meal alternatives, along with how they fit into the post-bariatric surgery diet.
“Meal replacements are defined as any food that's eaten or drunk as a substitute for a meal or part of a meal. They provide a prepackaged meal with a defined amount of energy and nutrients, although these vary greatly among products. They can replace one meal (a breakfast on the go) or be the sole source of nutrition, consumed as often as five or six times per day. While most provide about 150 to 200 kcal, some offer more than 400 kcal each,” writes Densie Webb, PhD, RD, for Today’s Dietitian.
Meal replacements offer an abundance of benefits for bariatric patients. In providing specific calorie, protein and nutrient levels, they spare patients the time-consuming act of weighing and measuring portion sizes. They can also prevent patients from taking in too many calories due to the inaccurate estimation of portions. The best meal replacements share other attributes as well, including portability, minimal cleanup, and a stable shelf-life.
All of which begs the question: Do they work? Continues Webb: “There's research to suggest that the monotony of consuming the same type of meal replacement with a similar texture each day leads to ‘sensory-specific satiety’ i.e., the decreasing pleasure of tasting, smelling, or eating a food until full or satisfied. The result of the monotony can be reduced appetite and fewer calories consumed.”
Given their many benefits, meal replacements can be a valuable tool for postoperative weight loss patients. But where — and when — do they fit into the equation? When can patients start to include them in their meal plans, and how long can they continue to do so?
For starters, it’s important to remember that weight loss surgery itself will not lead to weight loss. While the size of the stomach is smaller, which can lead to feelings of fullness after even small meals, patients must also commit to permanently altering the way they eat.
While reducing the volume of the food begins as a healing imperative immediately following surgery, the shift to a reduced calorie, nutritionally balanced intake is essential to long-term success. Enter the bariatric diet's staged approach.
In Stage One, which typically occurs within a day of surgery, patients are limited to a fluid ounce of water every hour.
Usually beginning some time the next day, Stage Two allows small amounts of water, broth, sugar-free gelatin, and decarbonized “flat,” diet ginger ale.
In Stage Three, which may begin on the second day after surgery and last for two to three weeks (until a follow-up appointment with the dietitian), additional fluids, as well as popsicles, are allowed.
During Stage Four, which commences two to three weeks after the operation, pureed and soft foods can gradually be added to the diet. These may include blenderized soup; oatmeal, grits and cream of wheat; scrambled eggs; cottage cheese; yogurt with fruit pieces; soft fruit; soft, well-cooked, skinless vegetables; soft-cooked eggs (chopped/ground well); toast or crackers with peanut butter; and light, white fish. Certain meal replacement products, such as ready-to-eat Achieve from Rational Foods, may be appropriate to add during this stage.
Occurring four to five weeks following surgery, Stage Five involves the gradual reincorporation of regular foods. However, patients must still abide by the core requirements of bariatric eating, including consuming protein portions first; avoiding cheap calories, fats, high-calorie liquids and sweets; and stopping when they feel full.
While bariatric patients have a wide variety of foods from which to choose during this stage, meal replacement options can be a vital way to meet nutritional needs without consuming excessive calories.
Of course, it’s important to remember that all meal replacement products aren't created equal. Choosing, high-protein, nutrient-dense, low-sugar meal replacements is crucial. Additionally, looking for products which are easily accessible, portable, and shelf-stable can further facilitate compliance.
One last thing to keep in mind? The dietitian’s role in helping patients ensure the healthiest outcomes cannot be overstated — nor can the value of education throughout the weight loss journey.
As dietitian Lauren Sullivan, RD, LD, told the Cleveland Clinic, “Research supports a direct relationship between nutrition assessment, dietary guidance and weight loss success.”