Experts from our School to Lead £1.5m Research into NHS Low Calorie Diet Programme

It is estimated that 3.5 million people in the UK are currently living with a diagnosis of type 2 diabetes. In England, 26% of men and 29% of women live with obesity. Adults who live with obesity are seven times more likely to develop type 2 diabetes.

As part of its long-term plan to provide targeted support, and access to weight management services, for people recently diagnosed with type 2 diabetes with a BMI of 27 kg/m2  and above (or over 25 kg/m2 in people of Black, Asian or minority ethnic origin), NHS England and NHS Improvement has launched a pilot low calorie diet programme across 10 areas of the country to run over the next three years.

The programme is based on two large studies which showed that, as a result of going on a specially designed programme, people living with type 2 diabetes who were overweight could improve their diabetes control, reduce diabetes-related medication and, in some cases, put their type 2 diabetes into remission.

Eligible patients are provided with low calorie, nutritionally complete, total diet replacement products - including soups, bars and shakes - consisting of up to 900 calories a day, for up to 12 weeks. This is accompanied by 12 months of support to help patients re-introduce food and maintain their weight loss following completion of the period of total diet replacement, which is provided either in a group, one-to-one, or via digital technology.

Professor Ells explained: “Recent studies have shown that for some people who live with obesity and type 2 diabetes, a low calorie diet can help them lose weight, reduce their risk of heart disease, and put their diabetes into remission.

“Given the higher morbidity and mortality associated with COVID-19 infection observed in patients living with obesity and diabetes, there is increased national urgency to support these patients – whilst also meeting long-term plans for the NHS to significantly improve the health of our population, and reduce health inequalities and associated future costs to the NHS.

“It is therefore very important to assess the real-world implementation of the trial evidence. Translating tightly controlled clinical trials into routine delivery is a significant challenge. It is essential to have a rigorous programme of independent evaluation that provides clear feedback on how and why the programme was implemented, who it did and did not work for, and why.”

The team aims to find out:

• Whether the planned programme can work as well when delivered in practice as it has done in previous independent trials;
• What patients perceive to be the benefits and disadvantages of the programme;
• Whether or not the programme represents value for money;
• Which method of support (one-to-one, group or digital) is preferred by participants;
• What participants and staff involved in the programme think about it – including primary care referrers;
• Whether the programme is being delivered as it is intended (are all eligible patients being invited to receive the programme, and are they able to follow it as expected?).

They will carry out the research by gathering the views of staff involved in running and delivering the programme; running surveys for all participants; holding detailed conversations with a small sample of participants and asking them to take photographs or video diaries to document their experiences; examining the programme costs to determine its value for money; and investigating the feasibility of making the programme available widely across England.

The expert team is made up of academics from Leeds Beckett University, Sheffield Hallam University, Lancaster University, University of Leeds, University of York, and Teesside University. The team also includes an expert panel of patients living with obesity and type 2 diabetes – who have co-designed the study and will be involved in liaising with participants, collecting data, and helping to share the findings.

The research has received £1,502,156.92 of funding from the National Institute for Health Research (NIHR) Health Services and Delivery Research funding programme. It will run between November 2020 and October 2023.

Image supplied by Teesside University