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Five teens lost weight by using what’s known as a meal replacement approach, in which you use special drinks or bars in place of some meals. Two of them used Slim-Fast products this way-one did so under her physician’s supervision, and the other checked with her doctor but was advised against using this method of weight loss. Karen D., who was supervised by her doctor, used Slim-Fast to lose her first 20 pounds, then switched to Weight Watchers to lose another 100-plus pounds. (Slim-Fast recommends that those under eighteen see a doctor before following its diet.) Another teen consumed a soy-based shake or bar for breakfast and lunch. A small number of other teens used drinks and bars in place of some meals, but such use seemed to be more sporadic.

Two teens used meal replacements as part of the medically supervised weight management program Health Management Resources (HMR). Matt A. went this route because he was very overweight-280 pounds at his heaviest and just 5′7" tall-and because he was impressed with the success of an adult friend who’d lost a lot of weight with the help of HMR. Nearly two years later, Matt stands 6′ tall and weighs 220 pounds. He still goes to the program. Joe M., a 6′ sixteen-year-old who weighed 270 pounds, also used meal replacements as part of the HMR program. Having kept off his weight for more than a decade, he now weighs 210 pounds, stands 6′5" tall, and is twenty-seven years old.

Although it’s certainly healthier to have a nutritious drink or bar than to skip meals entirely, meal replacement approaches are not advised for teens who are trying to lose weight on their own. However, James Anderson, M.D., a prominent obesity researcher from the University of Kentucky, has treated more than 150 teenagers using a low-calorie diet of several liquid meals per day along with generous servings of fruits and vegetables. He says that this approach can be effective for weight loss in teens when it’s used as part of a comprehensive, medically supervised weight management program involving trained educators, lots of physical activity, and support from parents. He uses this approach only with very overweight teens who are past the peak adolescent growth spurt as determined by a physician.

Dr. Anderson believes that such programs should be used before very obese teens resort to weight loss surgery. It is unknown how effective this approach is for keeping weight off, particularly in teens. Although none of the young people in his studies have experienced eating disorders, Dr. Anderson feels that teens who are considering this or other intensive treatment for weight problems should be screened to assess whether they have such disorders or other psychiatric problems.