smart spending

The cost of losing weight

The Medifast option

Medifast advocates replacing the common three-square-meals structure with five prepackaged meals per day, consumed every 2.5 hours. The 70 different Medifast meals are limited in variety; options include mostly shakes, bars, soups, puddings and breakfast foods. Members are also encouraged to add a daily meal of lean meat and a side of salad greens plus vegetables.

"What we're basically doing is taking out all the guesswork, in terms of calorie-counting," says Paul Intlekofer, Medifast's chief marketing officer. "The choice is, 'What do you feel like tasting?' The brownie is the same as the maple syrup oatmeal," as far as calories go.

Medifast also offers health coaching through as well as Medifast Weight Control Centers in 20 markets for those members who live nearby. According to Medifast's website, the program's meals cost about $11 per day, or about $300 per month. For 2 months, the meals would set you back roughly $600 plus supplemental groceries.

The self-regulated alternative

Critics say some of these weight-loss programs don't have lasting effects because they don't teach consumers about nutrition. "What are you going to do when you get off the diet?" says Lisa De Fazio, a former dietitian at Kaiser Permanente who now serves as a consultant.

"It's a huge industry and, for some, it's a business making money off people's weakness for food." She advocates getting a consultation with a nutritionist, which costs between $75 and $100 per hour.

Of course, you can ditch a prescribed weight-loss program and launch a self-guided diet instead, which might involve the purchase of a diet book for between $15 and $25.

For the exercise part of the program, you can take walks and bicycle rides for free. Or you can sign up for a gym membership at about $40 per month. Such an independent program would cost less than $50 per month, plus grocery bills, of course.

The downside is that this self-regulated program requires more discipline to diet and little support, outside of the encouragement of family and friends. The weak-willed may find it too challenging.

"The environment we live in is really hard to manage," says Josefsberg. "You go to the pharmacy to pick up a prescription, and you pass 75 candy bars."

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