Total diet replacement programmes are effective for treating obesity

October 2, 2018, University of Oxford
Total diet replacement programmes are effective for treating obesity. Credit: Shutterstock

Replacing food with a diet of soups, shakes and bars starting at 810 calories per day alongside regular sessions with a counsellor is a safe and clinically effective way to treat obesity in primary care, finds a study from Oxford University researchers.

Total diet replacement programmes are not generally funded by the NHS in England but the authors of this study, published in the BMJ, suggest that there is now enough evidence for these programmes to be one of the treatments recommended for people who are obese.

The randomised controlled trial involved 278 adults in Oxfordshire who were substantially overweight and interested in losing . Participants were either offered a referral to a total diet replacement programme for 24 weeks or were enrolled into their GP practice's weight management programme, including advice and support to lose weight from a practice nurse.

Participants on the total diet replacement programme were asked to reduce their intake to 810 calories a day by replacing all food with specially formulated soups, shakes and bars in addition to milk, water and fibre supplements. These diet replacement products, which are designed to be nutritionally complete, were offered for eight weeks, followed by a gradual re-introduction of conventional food over a further four weeks. Participants were invited to attend regular meetings with a trained counsellor to develop techniques to help them follow the diet and later maintain their weight loss. From 12-24 weeks they were encouraged to continue to use one product a day to replace a usual meal.

After 12 months, these participants had lost on average 10.7kg (1 stone, 9lb) which was 7.2kg (1 stone, 1 lb) more than those enrolled into the GP practice programme. They also showed greater reductions in their risk of developing heart disease, stroke and diabetes. 45% of participants on the low energy programme had achieved a weight loss of 10% or more compared with just 15% in the GP practice programme.

The study's chief investigator Professor Susan Jebb, Professor of Diet and Population Health in Oxford University's Nuffield Department of Primary Care Health Sciences, said: "In the past we have worried that a short period of rapid weight loss may lead to rapid weight regain, but this study shows that nine months after the intensive weight-loss phase, people have lost more than three times as much weight as people following a conventional weight-loss programme."

Co-investigator Professor Paul Aveyard, a GP and Professor of Behavioural Medicine at the University of Oxford said: "Losing weight and keeping it off is hard and we know that people welcome support from their GP. This study shows that GP referral to a total diet replacement programme in the community is an effective intervention which GPs can confidently recommend, knowing that it leads to sustainable weight loss and lowers the risk of heart disease and diabetes. This model of care can be safely offered by GPs in routine ."

Dr. Robin Fox, a GP from the Bicester Health Centre who took part in the study, said: "Taking part in the DROPLET study has changed my practice. I saw for myself the results in my patients who enrolled and were assigned to the TDR programme. I'm now happy to advise my patients who would benefit from losing weight that they should consider TDR programmes as an option."

Co-investigator Dr. Nerys Astbury, Senior Researcher in Diet and Obesity at the University of Oxford's Nuffield Department of Primary Care Health Sciences, added: "This model of care, where patients are referred to a provider in the community for support, offers the potential for rapid roll-out at scale across the NHS and could help reduce the pressure on GPs in treating obesity-related disease."

Total diet replacement programmes are suitable for most people who are obese and wanting to lose weight. Those who suffer from certain medical conditions, or who are taking particular medications, may not be suitable and are advised to consult their GP before starting a programme. The study found no evidence that the total diet replacement programme increased the risk of adverse events which interfered with normal daily life.

The full paper, "Doctor Referral of Overweight People to Low Energy total replacement Treatment (DROPLET): pragmatic randomised controlled trial," can be read in the BMJ.

Explore further: Crash diets are highly effective – new evidence

More information: Nerys M Astbury et al. Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET): pragmatic randomised controlled trial, BMJ (2018). DOI: 10.1136/bmj.k3760

Related Stories

Crash diets are highly effective – new evidence

September 27, 2018
If you've ever tried to lose weight, you've probably heard that crash dieting isn't the best way to go about it. Although you may lose lots of weight initially, you won't be able to keep the weight off and may even end up ...

Four rules to avoid regaining lost weight

July 17, 2018
(HealthDay)—Have you reached your ideal weight? Congratulations! You're halfway to winning the weight loss battle.

When it comes to weight loss in overweight and obese adults with knee osteoarthritis, more is better

June 18, 2018
Researchers previously showed that overweight and obese individuals with knee osteoarthritis can reduce pain by 50% and significantly improve function and mobility with a 10% or more weight loss over an 18-month period. The ...

Women and men experience different benefits from low-calorie diets

August 8, 2018
A low-calorie diet causes different metabolic effects in women than in men, a new Diabetes, Obesity and Metabolism study suggests.

Lose fat, preserve muscle—weight training beats cardio for older adults

November 1, 2017
Weight training or cardio? For older adults trying to slim down, pumping iron might be the way to go.

16 week NHS programme to treat type 2 diabetes

January 11, 2018
An inexpensive, 16-week NHS lifestyle programme aimed at patients with type 2 diabetes can help to treat the disease.

Recommended for you

A holiday gift to primary care doctors: Proof of their time crunch

December 14, 2018
The average primary care doctor needs to work six more hours a day than they already do, in order to make sure their patients get all the preventive and early-detection care they want and deserve, a new study finds.

A co-worker's rudeness can affect your sleep—and your partner's, study finds

December 14, 2018
Rudeness. Sarcastic comments. Demeaning language. Interrupting or talking over someone in a meeting. Workplace incivilities such as these are becoming increasingly common, and a new study from Portland State University and ...

Study shows magnesium optimizes vitamin D status

December 14, 2018
A randomized trial by Vanderbilt-Ingram Cancer Center researchers indicates that magnesium optimizes vitamin D status, raising it in people with deficient levels and lowering it in people with high levels.

Teens get more sleep with later school start time, researchers find

December 12, 2018
When Seattle Public Schools announced that it would reorganize school start times across the district for the fall of 2016, the massive undertaking took more than a year to deploy. Elementary schools started earlier, while ...

Large restaurant portions a global problem, study finds

December 12, 2018
A new multi-country study finds that large, high-calorie portion sizes in fast food and full service restaurants is not a problem unique to the United States. An international team of researchers found that 94 percent of ...

Receiving genetic information can change risk

December 11, 2018
Millions of people in the United States alone have submitted their DNA for analysis and received information that not only predicts their risk for disease but, it turns out, in some cases might also have influenced that risk, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.