In response to my last article on meal replacements, I had this insightful response from Cindy, so insightful I want to reprint it in full. Here is what she said:

I have been on the Tony Ferguson meal replacement diet, and it has worked well. It has a Progress phase where you add in normal meals and snacks with some MR. This has been great in learning about food, carbohydrates in particular. It also encourages mindfulness, and after shakes for a while, every mouthful of normal food is a taste sensation and I certainly enjoy it.

What Cindy did not know is that I did some consulting to Tony Ferguson (TF) and actually developed their Progress program. I was very impressed by their preparedness to embrace the principles of the psychological research that I cover in my book. To clarify a couple of points, right from the start the TF program encourages having at least one healthy meal a day made up of lean protein and salad or vegetables. In the Progress phase, this is increased to two meals on some days as we gradually rebuild our relationship with food. This is the phase where we also add back in the more fattening foods that people love like chocolate and cheese. The trick is to learn to eat these foods on your terms, where you control them rather than them controlling you! The reason why diets fail is because people a) feel deprived of these foods and b) when they sneak back into the person???s diet, they go back to their old ways of overeating – having  not learnt to eat them mindfully as Cindy reminds us.

Which brings me to an interesting question I was asked recently. The question was essentially: If you want people to develop a healthy eating lifestyle, would not having a chocolate meal replacement (shake or munch bar) for lunch go against this principle? Would it not make people less inclined to eat a healthy, balanced lunch? Don???t you train them up to eat poorly? In the decade plus that I have been working in this space with hundreds of people this has never been a problem. But that is only a part answer to the question. The real question is: Why is it that people don???t find it more difficult to eat healthy meals after a period on meal replacements (MRs)? This is for two reasons.

First, we can cope with deprivation of calories and an eating experience, if we are not also having deprivation of taste/emotional satisfaction. This is why the flavours of MRs are chocolate and coffee and not broccoli and rolled oats. This is why MRs have a role and are the next best weight loss strategy (see my recent post on MRs) after trying to eat a healthy diet to lose weight has failed. This is also why shakes are not enough for some people and they need an energy controlled munch bar to give them a chewing experience. In essence, we can???t feel too deprived ??? whether it be of chewing or flavour – or else it all becomes too hard and the weight loss program is abandoned.

As Cindy has highlighted ???after shakes for a while, every mouthful of normal food is a taste sensation and I certainly enjoy it.??? Once we can increase the eating experience, we can afford to decrease the taste experience. Whether it is a shake or a munch bar, they do not come close to replicating the range of flavours, tastes and chewing experiences of real, healthy food. Moreover, through the process of psychological ???habituation??? these MRs, no matter how intense the flavour, become boring if eaten repeatedly. The human mind becomes hungry for new taste experiences.

Second, even when people have lost weight, I encourage them to continue using MRs in two situations ??? when they are going to skip a meal anyway or when they need the convenience of ???fast food???. Nothing is quicker, or more convenient (or cheaper) than grabbing a munch bar or adding water to a shake. And when people are at risk of grabbing a burger with fries, or some fried chicken,  or a or candy/chocolate bar, a balanced MR, while not as good as a healthy meal, is a better choice. I find that people who struggle with their weight, even after they have lost it, need to keep using MRs (as indeed I do) to keep their weight off. So for these reasons, while it sounds like a concern, in clinical reality, it???s not a problem at all.

As I said in my post on the treatment pyramid, when people have tried to lose weight by just eating a healthy diet, MRs are the next best thing ??? further up the treatment pyramid, things get much more problematic.