Friday, September 22, 2006

Medifast Response

My August 29th post on Medifast appears to have hit a nerve. While I typically haven't commented on older posts, I feel it's important to address some of the reader comments that now appear on this post.

I am happy to hear that some readers have lost significant amounts of weight on Medifast and even happier that they report being healthier and feeling more energetic than they did before. I have consistently written that the subjects of eating and weight-loss are largely idiographic, and it makes perfect sense that different philosophies/approaches will work for different people. If Medifast has worked for you, feel free to stop reading here.

That said, as I wrote in an email to one reader, my personal experience working with patients (some of whom have had bariatric surgery, some of whom have clinical eating disorders, many of whom use food emotionally) is that there is very commonly a long and painful road of yo-yo dieting, which wreaks significant emotional havoc on them. By the time they see me (or my colleagues), they have tried numerous diets (some VLCD's), have lost weight, gained it back (plus some), and are absolutely dejected and demoralized. Through the years, I have also seen many patients who suffer from anorexia, bulimia, and EDNOS. This is the bulk of the readership of my blog (as judged by comments and emails to me). For these individuals, too, their relationship with food is an incredibly deep and emotional one and not one that can be addressed simply with a food plan or other behavioral measures. This does not, in any way, suggest that I believe that people cannot lose weight on Medifast. As some of you have reported, there is often a substantial weight-loss associated with VLCD's--and how could there not be?

To clarify a point on my post, I was not saying that Medifast allows only 167 calories per day. What I was saying is that in order to lose five pounds per week (as the Medifast website states is possible with the plan), you would have to have a deficit of 17,500 calories per week. You do the math. I have consulted with physicians and nutritionists on diets such as Medifast. As with everything, there are varying points of view. I will not, however, accept a doctor's approval of a diet plan as carte blanche to plow ahead. If you recall, Bextra/Vioxx/Celebrex, Fen-Phen, and even Thalidomide were once approved for use.

A couple of readers have questioned my credentials: I am a psychologist, with a master's degree in exercise science and a doctorate in clinical psychology (with an emphasis on health psychology). You're absolutely right that, outside of what's provided to me by the physicians and nutritionists with whom I consult, I do not claim to have specialized knowledge of specific nutritional programs. What I do claim to have knowledge and training in (and experience with) are the psychological factors that influence eating, dieting, and weight-loss cycles. In my experience, programs like Medifast are not a long-term solution to the psychological antecedents and sequelae of eating disorders. They may, however, work for you.

I do appreciate controversy. Without different (and often opposing) ideas, it is difficult for us to move forward as a science and a society. Attack my ideas as much as you'd like--I'm happy to provide a forum for you to do so; however, please, as I have advised before, challenge the ideas and not the writers. When attacks become personal, they are unnecessarily hurtful and obscuring of our ultimate goal.

11 comments:

PalmTreeChick said...

Interesting! I thought you did a great job with saying what you had to say. I agree that (most of the time) there are psychological reasons for weight related issues, that of which this diet, and most, do not deal with. I don't think diets are necessarily "bad" but you're right, lots of times the psychological aspect behind what's feeding (no pun intended) the weight issue is not addressed.

flowerchild said...

Empirically you are right, of course. Those of us with black and white thinking and with our own pile of denial will wrestle anything that comes in a different shade to the ground. Our sense of balance can be so precarious and our grip so tight that anything that threatens to tip us can send us over the edge. But you with whom and what you are dealing. Thank you for illuminating the very dark grey area.

Anonymous said...

I can only speak for myself here. When I hear about MediFast and other VLC programs, I am...tempted! As a former anorexic, these diets look very much like salvation and happiness to me. But after several years of counselling, I now know that for me, these kinds of plans lead to an obsessive fixation on food and weight.

Also note the fine print: "results not typical".

Anonymous said...

DrStacey,
I appreciate your revisiting the issue of your Medifast article. Obviously you did hit a nerve with your earlier article, and it was because you categorized it as a review of the Medifast plan. It is important to fully understand something before criticizing it. It was apparent from your article that the extent of your research into the products was a cursory look at their website rather than an attempt to validate the program's claims. I hope in the future before panning a product or diet plan, you will in fact thoroughly research it. You do a disservice to your readers to so quickly dismiss a highly effective program. Does it work for everyone? NO. Only for those who actually FOLLOW it. And for those people, it works dramatically. I receive compliments on my weight loss literally EVERY day, several times a day in fact.
I realize that in your practice you may deal with numerous people who have body image issues and who do, in fact, have eating disorders. However, I think the vast majority of women and men out in the world who are overweight or obese (including myself) simply are in the instant gratification mode. We want to eat what we like and as much as we like of it. That's not an eating disorder, it's just self-indulgence or, in the case of fast food, laziness. Maintaining optimum weight and health takes discipline and a willingness to admit your weaknesses. A good support system wouldn't hurt either! So many people are without these requirements for success, it's easy to see why we are in the condition that we are as a country. I continue with my own struggle, I still have at least 20 pounds more to go, and I hope that those who are also struggling will find a program, or strategy, that works for them. I will try not to criticize their choices as long as they (and DrStacey) likewise, don't criticize mine. Medifast has taught me a lot about a new way to eat and keep my metabolism fired at a higher level. I will carry this info with me into the future. It has also taught me a new appreciation for vegetables and a different concept of portion sizes. It makes me more mindful of my eating choices and has taught me that I possess far more self-discipline than I imagined. Thanks Medifast. Good luck with your book Dr Stacey. Although I do not agree with your premise, the wonderful thing about this country is that we are all free to express our viewpoints.

TTSSacto

Beth said...

If Medifast has worked for some dangerously obese people, then good for them. ANY person with nutritional knowledge can read the ingredients in their shakes and bars, which are filled with addictive, cheap, chemicals. These are the bars' ingredients: [Soy protein Isolate, High fructose corn syrup, Honey, high maltose corn syrup, sugar, cocoa (processed with alkali), Calcium caseinate (milk protein), toasted Soybeans, partially hydrogenated vegetable oils]. We all know how addictive and refined high fructose corn syrup is, and the 1st ingredient, soy protein isolate, is a highly processed, potentially dangerous form of broken down soy parts. In fact, manufacturing of soy protein isolate is similar to that of plastic production. These refining processes remove "off flavors," "beany" tastes, and some of the worst flatulence-producing components. They improve digestibility, but vitamin, mineral, and protein quality are sacrificed, and levels of carcinogens such as nitrosamines are increased.
If Medifast is so healthy and revolutionary, why do its products consist of common, cheap fillers like these? They don't care about the welfare of the bodies which ingest their products, but maintaining control by their system of blind faith. Oh, on a final note, their bars contain a mere 2g of fiber per serving, while some organic ones I've found have up to 10g for the same calories. The soy protein isolate actually has less fiber after it's been processed. Why does Medifast want people to buy it's plan and products rather than giving the sick people real food? My guess is for a profit.

Anonymous said...

"What I was saying is that in order to lose five pounds per week (as the Medifast website states is possible with the plan), you would have to have a deficit of 24,500 calories per week."

Ok, I'm doing that math...

Shouldn't that weekly deficit be 17,500 calories a week -- or 3,500 x 5?

I thought 3,500 calories was the stored energy in a pound of fat.

So, a 2,500 reduction in calories per day. If the person's BMR and additional calorie-burning puts them at 3,300+ calories daily, then I'd say it is possible to burn off 5 pounds a week. Not probable admittedly, but possible.

drstaceyny said...

ptc--I like your last sentence--and agree.

fc--you're welcome. Thanks for reading.

anon--I'm not sure I'd agree w/your statement that a "vast majority of women and men out in the world who are overweight or obese (including myself) simply are in the instant gratification mode" or are simply "self-indulgent" or "lazy." I think it's incredibly difficult to tease this apart from what are classic eating-disordered thoughts, feelings, and behaviors.

Congratulations on your continued success with the program.

beth--thanks for the info.

anon--yes, you're right, it's 3,500. Apparently, my (new) math was for a 7-pound weight-loss, which I saw somewhere else. Apologies (switched it in the post). Yes, that's a pretty high "calories out" value, but perhaps still possible, depending on BMR/activity.

Anonymous said...

Medifast is a diet... a diet that teaches you portion control and how to keep your metabolism up. Medifast is not something that you will be on the rest of your life. It is a start to a healthier life.

I believe that if you find a program which helps you live a healthier life.. go for it. This program has worked for many very obese people.

Of course, there are many psychological reasons why we gain weight. But there are also psychological consequences of losing weight especially when we are trying to lose weight. You Feel GOOD.

As long as the program is safe, I say go for it.. and once you reach your weight goal... Medifast has a maintance plan for you to follow..which incorporates real food into your diet.

anonymous said...

I did Medifast over a year ago and have kept my weight off and I still incorporate it into my life today. I lost 30 lbs in 2 months and I did it safely. It helped me learn portion size and eating a lot healthier than ever before . Of course like someone said before this plan is not going to work for everyone and its not something that you will do for ever, but for a while until you get where you need to be.So that you learn how to manage food and not let it manage you. Its a tool for a healthier start in eating.

Anonymous said...

The weight loss is supposed to kind of like it is on atkins- your body goes into mild ketosis because of the low carb nature of this diet.

It is a low calorie diet, but it certainly more than 167 calories per day, and this weight loss is possible.

Brenda said...

I agree with Beth about the cheap and addictive ingredients. I was actually considering Medifast until I googled the nutritional info, and also just found this blog. The bars and shakes I can buy myself are much healthier and use natural sweeteners like stevia.