Medifast, Part One: Weight-Loss Miracle or Pyramid Scheme?

Maryland-based Medifast is one of the few weight-loss companies reporting year-on-year gains in its financial results in these dour economic times. Liquid protein drinks, raw foods, Scarsdale and Atkins — is the Medifast Meal Plan an amazing weight-loss product, or just another in a long list of fad diets?

Management boasts that it has been on the cutting edge of weight management offerings for almost 30 years, with an estimated 20,000 physicians nationwide having recommended Medifast as a treatment option to more than one million of their overweight patients. Medifast meals are formulated with low-fat protein and fiber, and are supposedly “clinically proven” to help users lose weight quickly — up to an alleged 20 pounds a month — through a process called ketosis, a metabolic state where the body is tricked into burning its own fat reserves.

Medifast uses both clinical research studies and retrospective analysis data from its Medifast clinics as the basis of its “clinically proven” claim. A review of the clinical studies provided by the company online and in regulatory filings, however, finds a troubling theme underlying most of the treatment protocols: simply, any one study examined was either too small (number of patients actually treated), or were too limited in sampling scope (patient ages, heath, etc.) to arrive at any unequivocal conclusions about the treatment efficacy.

For example, the clinical outcomes data most commonly referenced in Medifast literature — the “Multicenter Evaluation of Health Benefits and Weight Loss on the Medifast Weight Management Program” (conducted at the Johns Hopkins Weight Management Center) — is nothing more than a flawed, retrospective meta-analysis of Medifast Center participating patients with an overwhelming sampling bias: 83 percent and 90 percent of patients were female and Caucasian, respectively.

Arthur Frank, director of the George Washington University Weight Management Center, presciently noted in an online Barron’s interview back in 2006:

Any controlled-portion, formula diet, whether prepared by Medifast or Optifast or NutriSystem or even a GNC [vitamin] store will help you lose weight because they are easier to stay on and are intrinsically better because they take the individual out of the food decision-making process. You don’t necessarily need clinical tests to prove that.

In summary, flaws in study design invalidate the efficacy question: does the effect of dietary intervention with Medifast foods help patients to reduce body mass index (BMI) any better than other diet plans? And, as Frank brusquely said, “they’re all the same.” What then, accounts for the increasing popularity — as measured in sales — of Medifast products? Critics suggest the buzz behind the company has nothing to do with achieving the desired weight-loss goals or taste of Medifast meals-scrambled eggs, cheese puffs, or beef vegetable stew-and everything to do with the marketing behind the products.

Read part two for the case against Medifast’s financial success.