Meal Replacement Plans in Managing Adolescent Obesity: A Systematic Literature Review

Abstract

Background: Adolescent obesity remains a significant public health issue, with rising prevalence and long-term health risks. While lifestyle modifications are the primary treatment, their effectiveness is often limited. Meal Replacement Plans (MRPs) have emerged as a potential alternative, though evidence in adolescents remains unclear. Objective: This systematic review aimed to assess the effectiveness, sustainability, and safety of MRPs in managing obesity among adolescents. Method: A systematic search was conducted across PubMed, Scopus, and Cochrane Library for studies published between 2013 and 2024. Eligible studies included randomised controlled trials, pilot trials, and cohort studies involving adolescents aged 10–18 years who were overweight or obese. Data on intervention design, weight loss outcomes, sustainability, and side effects were extracted and synthesised narratively. Results: Seven studies with sample sizes ranging from 30 to 2,825 adolescents were included. MRPs, delivered as very-low-energy diets or partial replacement regimens, consistently produced short-term weight reduction (3.4–6.3% BMI decrease within 4–12 weeks). Adjunctive supports, including caregiver involvement, pharmacologic agents (e.g., exenatide), and financial incentives, enhanced outcomes. However, long-term sustainability was mixed; several trials showed weight regain after 12 months, while caregiver engagement and digital health tools demonstrated potential for maintaining weight loss. Side effects were generally mild (e.g., hunger, fatigue, nausea) and transient, with no adverse impact on growth reported. Conclusion: MRPs are effective for short-term weight reduction in adolescents with obesity and may be most beneficial when integrated with behavioral therapy, caregiver participation, or pharmacologic support. Their long-term sustainability remains uncertain, underscoring the need for extended follow-up studies.