WHETHER YOUR BLOOD pressure is on the upswing or your stomach’s always wrecked, one of the first things your doctor might ask is, “What’s your diet like?” They’ll probably tell you to cut back on greasy takeout and eat more vegetables, then come back in a month for a quick check-in.
This guidance is so vague, it almost feels pointless. Cut back … forever? Eat more … how?
The “food is medicine” movement wants to eliminate that confusion: Proponents believe doctors should be better educated about nutrition, and sick patients should receive an Rx for groceries and healthy meals. The idea is, by making high-quality food easier to access, our healthcare system will be better equipped to prevent—and even treat—disease.
Prescribing medically tailored meals (MTMs) is one way to go about this: Dietitians personalize prepared meals to meet the needs of people with chronic health conditions. The goal is to improve their health and quality of life while also cutting down on medical bills.
Research suggests this concept could do a lot of good. A 2025 study published in the journal Health Affairs estimates that a national MTM program would save the U.S. a whopping $32 billion in healthcare costs. So far, the benefits—fewer symptoms, less frequent hospital visits, better odds of living longer—are most promising for people with HIV/AIDs, diabetes, heart failure, cancer, and kidney disease, but scientists have only scratched the surface, says Seth Berkowitz, MD, MPH, the section chief for research at UNC School of Medicine. (Dr. Berkowitz investigates the health outcomes of medically tailored meal interventions.)
While you may have only recently heard of medically tailored meals, the Food Is Medicine Coalition (FIMC) has been fine-tuning them for decades, says executive director Alissa Wassung. Its nonprofit agencies partner with chefs and dietitians across 25 states to deliver medically tailored meals, medical nutrition therapy, and nutrition counseling to people living with cancer, diabetes, heart disease, the list goes on. The people the agencies serve receive meals for free, thanks to state and federal programs and philanthropic donations.
It seems like a no-brainer: If you give people healthy meals, surely they’ll get healthier. But the current state of MTMs is not without growing pains. Recently the space has become crowded and confusing. Dozens of ambitious start-ups have boarded the food-is-medicine train. They, too, deliver prepared meals marketed as dietitian-approved and medically tailored, sometimes for no or low cost with health insurance.
In theory, having more MTM providers would be a great thing. It’d mean that more people could use a much-needed service that’s sparse or nonexistent in many parts of the country. But grassroots advocates worry that some for-profit companies are using misleading marketing tactics and skimping on quality.
“When they start using the term ‘medically tailored’ without specific standards and definitions, it really does dilute the entire movement,” says Jean Terranova, senior director of policy and research at Community Servings, a FIMC-accredited agency that delivers MTMs in Massachusetts and Rhode Island.
Plus, the scientific community still needs more research to understand when these meals make a true difference in people’s health. (There’s not yet a federally recognized nutrition standard for “medically tailored.”) And certain meal providers have already been called out for delivering pricey, processed junk.
‘Medically tailored’ or meh?
DR. BERKOWITZ SUSPECTS that many start-ups are responding to the genuine need for more meal providers across all states. But the most solid data on MTMs is based on grassroots organizations that have built their practices over many years with feedback from their local communities. FIMC agencies pioneered the blueprint for MTMs nearly 40 years ago as a response to the HIV/AIDS crisis. Replicating their wins is a tall order in a fast-paced, tech-driven landscape.
Case in point: A report from STAT News, which found that Homestyle Direct—an Idaho-based company that recently rebranded itself as an MTM service—actually shipped subscribers not-so-healthy frozen meals. One “diabetes-friendly” option included a Jimmy Dean sausage breakfast sandwich that packed nearly 1,000 milligrams of sodium. Yet the company has the potential to make millions, in part by billing taxpayer-funded Medicaid programs. “That’s exactly what you don’t want to see,” Terranova says.
The STAT News report also scrutinized other meal-delivery companies that bill Medicaid, including Mom’s Meals, for its pureed cheeseburgers (yum?) and oatmeal cream pie, and Magic Kitchen, for its biscuits and gravy.
FIMC published its first public-facing MTM requirements in 2024. The 32-page document is their “commitment to excellence,” Wassung says. It outlines best practices for integrating full-time dietitians, assessing clients’ needs, and meal preparation.
Accredited agencies, a designation that’s currently only offered to nonprofits, should meet the following criteria.
- They should not serve or deliver “ultra-processed” foods or dishes that contain artificial sweeteners, high fructose corn syrup, or preservatives.
- They should prioritize using “as many fresh ingredients as possible” and offer them ways of baking, braising, and sauteing rather than frying.
- The food should arrive fresh and lend itself to freezing or reheating.
- It needs to taste good, too. (Yes, they actually conduct taste tests.)
“We’ve invested significantly in research,” Terranova says. So if newer companies aren’t striving for the standards that led to the impressive results in that research, “we’re afraid that could reverse the trajectory of the policy wins,” she explains. That concern has only grown as the federal government zeroes in on “efficient” spending. “We’re seeing potential cuts to Medicaid,” Terranova says. “We want to make sure we’re not straying from interventions that work.”
So, it’s a tricky situation. Profit-driven companies can make, market, and price their meals however they’d like. For those that have the option to bill Medicaid, what constitutes a “medically tailored meal” varies by state, some of which have shockingly loose requirements. And it raises worthwhile questions about oversight.
“True, fair competition can be a good thing in many cases,” says behavioral scientist Justin B. Moore, PhD, a professor of public health sciences at Wake Forest University School of Medicine who has researched MTMs. “But I do think [the competition is] muddying the water.”
A Gut Check
NO START-UP HAS perfected MTMs, but some have shown a decent effort. Take Epicured, a New York-based company that specializes in low-FODMAP meals, which are sometimes better tolerated by people with digestive conditions like irritable bowel syndrome (IBS) and Crohn’s. The plan involves nixing dairy, wheat, legumes, and certain fruits and vegetables, so it can be tough to follow.
Epicured announced a partnership with Mount Sinai in 2019, propped by a large financial investment from the health system. Laura Manning, MPH, RD, clinical nutrition manager at Mount Sinai Hospital, is one of the dietitians who works with Epicured to develop the criteria for its “therapeutic” menu items, which include pad Thai, chicken bacon lasagna, and lamb ragu pasta. She says patients who have benefited the most are actually in their 20s and 30s—they’re working crazy hours and “too busy to figure out how to cook all this stuff.”
When a patient with GI issues is referred to Manning for a low-FODMAP diet, she’ll sit down with them for an hour to learn about their current diet and lifestyle. She’ll ask questions like, “How do you prepare your meals? What does that look like in a day? Do you enjoy cooking?” She wants to give them helpful information about how their diet could mess with their gut, but also an actual plan—when it makes sense, she’ll recommend starting with Epicured.
You don’t need to sit down with a dietitian to buy Epicured’s meals, though the company and the experts we spoke with highly encourage that step. You can just go to its website, select what looks good, and hit “checkout”—final price pending on insurance. The company says the meals arrive freshly prepared, chilled, and ready to eat or heat. (Worth noting: Epicured only offers the elimination phase of a low-FODMAP program. It’s in the final stages of creating meals for the reintroduction and personalization phases—not something you can truly pull off without the guidance of a clinician.)
Others operate similarly: Performance Kitchen and ModifyHealth, for example, partner with various health insurance providers that may include dietitian support, but also allow you to peruse their menus and purchase meals yourself. You’ll find diabetes-focused, heart-healthy, kidney-friendly, GLP-1-support, and low-FODMAP options—plus a bunch geared toward overall wellness, like vegetarian and Mediterranean dishes.
Cutting Through the Food Noise
UNFORTUNATELY, ALL THESE complexities means that the burden falls on you to figure out what’s legit, says Abby Langer, RD, a Men’s Health nutrition advisor and the owner of Abby Langer Nutrition. She thinks it’s a little shady that so many of these companies don’t directly name who they partner with to make their meals—or spell out the nutrition requirements they abide by.
Which brings us back to the question of quality. Some companies seem to stack up on the nutrition front, while others serve up calorically dense options not unlike the ultra-processed foods that the “Make America Healthy Again” movement is cracking down on. Some ship frozen meals while others deliver them fresh. Some require a meeting with a dietitian or a referral from a clinician, while others let you “add to cart” instantly. Some give off mystery meat vibes while others look impressively gourmet. Most of them are expensive, hovering around $10 to $20 a plate, not including shipping costs. (It goes even higher. At Epicured, sea bass, broccoli, and potatoes will run you $32 with delivery fees.)
“If you’ve got the means or insurance, awesome. But most people don’t have the means or the insurance, which implies that health disparities will increase,” Moore says. “If only people with money can get these things and people without money cannot, the gap between them will increase. From an ethical standpoint, it’s terrible.”
And then there are questions about end game. “Consider the long-term viability of these programs,” Langer says. “Are you going to order meals forever? Are you learning what kind of meals are appropriate so you can eventually make them yourself?” Moore agrees: “It doesn’t get at behavior change, at motivations.”
However, Manning thinks of the service as a stepping stone for her patients. “If they see it in front of them, prepared in a way they haven’t thought of before, it can inspire them to continue to eat this way,” she says. They probably won’t lean on Epicured meals forever—once they get through the elimination phase of the low-FODMAP plan, she helps them slowly reintroduce specific foods to pinpoint their GI triggers. Eventually, instead of ordering three meals a day, for example, they may order a few per week, or whatever fits their lifestyle.
Ultimately, it’s too soon to tell how this all shakes out. “I don’t think it will be the case that no start-ups can do this. Of course, I think some can learn,” Dr. Berkowitz says. “On the other hand, there could be some learning curves over the next five to 10 years as more try to get involved, scale it, and bring these interventions to more people.”
We’ll leave you with this: If you have insurance (or the financial means) and want to try a medically tailored meal service, it may be worth a shot—but only if it’s transparent about who’s designing and cooking the meals, the nutrition specs of each dish, and how it upholds quality. Otherwise, you risk opening up your diet to something you shouldn’t have to consume anymore of: B.S.
Alisa Hrustic is a health writer and editor. She was previously the executive editor at SELF and deputy editor at Prevention.com. Her work has been featured in Women’s Health, Men’s Health, Oprah Daily, National Geographic, and other national publications.