Low calorie diets to treat obesity and Type 2 diabetes

The NHS is delivering a new programme which provides a low calorie diet treatment for people who are overweight and living with Type 2 diabetes.

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 (no longer have diabetes).

The NHS and its partners Public Health England and Diabetes UK are now testing different models of providing this service when it is made more widely available on the NHS.

The pilot programme will initially be offered to up to 5,000 people in selected areas across England. The learning from the pilot will help to build knowledge and understanding about the use of of interventions such as this and the impact that they might have on the treatment of people living with Type 2 diabetes in future.

How it works

Eligible participants will be offered low calorie, total diet replacement products – for example, soups and shakes which add up to around 900 calories per day – for up to 12 weeks. During this time participants will replace all normal meals with these products.

Alongside this, participants will receive support and monitoring for 12 months including help to re-introduce real food after the initial 12-week period. Depending on where the service is being delivered, this support and monitoring will either be:

  • group* based
  • one-to-one*, or
  • digitally/remotely via an app, online or over the phone.

This support will provide participants with the help and advice they need throughout every stage of the programme.

Participants will also be closely supported by their local GP practice – for example if medicines need to be changed.

*Delivered online while social distancing guidelines are in place.

Where is the pilot taking place

The NHS Low Calorie Diet Programme is currently available in parts of the following areas across England, with different providers put in place by NHS England and NHS Improvement to deliver the service:

  • South Yorkshire and Bassetlaw
  • Humber Coast and Vale
  • Greater Manchester
  • North East London
  • North Central London
  • Bedfordshire, Luton and Milton Keynes
  • Derbyshire
  • Birmingham and Solihull
  • Gloucestershire
  • Frimley

Individuals who don’t live in an area where this service is currently being delivered will not be able to access the NHS Low Calorie Diet Programme at this time. However, to find out more about services available locally, individuals can discuss their individual circumstances with their GP or diabetes team at their next appointment.

Who is eligible and how to access the service

The NHS Low Calorie Diet Programme isn’t suitable for everyone and there are some eligibility requirements that people must meet to be involved. These include that individuals must:

  • be aged 18 – 65 years,
  • have a diagnosis of Type 2 diabetes within the last 6 years, and
  • have a BMI over 27 kg/m2 (or over 25 kg/m2 in people of Black, Asian or minority ethnic origin)

Individuals based in areas delivering the pilot will need to discuss other eligibility criteria and their individual circumstances with their GP or diabetes team at their next appointment in order to find out whether it is suitable for them.

Those who are not eligible for this service may wish to discuss their individual circumstances and the services which are available to them locally with their GP or diabetes team at their next appointment.

The studies

The NHS Low Calorie Diet Programme is based on two studies.

The Diabetes UK-funded ‘DiRECT’ trial saw almost half of those who went on a low calorie diet achieve remission of their Type 2 diabetes after one year. A quarter of participants achieved a 15kg or more weight loss, and of these, 86% put their Type 2 diabetes into remission.

A more recent trial of low calorie diets, called ‘DROPLET’, has demonstrated similar weight loss in people who were obese.

The details of the trials can be found here: