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.