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 partner Diabetes UK are now testing different models of providing this service when it is made more widely available on the NHS.

The pilot programme is being offered in selected areas across England. The learning from the pilot will help to build knowledge and understanding about the use 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 are 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.

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:

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

The programme will also become available in the following areas from early 2022:

  • Black Country and West Birmingham
  • Bristol, North Somerset and South Gloucestershire
  • Kent and Medway
  • Lancashire and South Cumbria
  • Mid and South Essex
  • North East and North Cumbria
  • Nottingham and Nottinghamshire
  • Somerset
  • South West London
  • Sussex
  • West Yorkshire

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 (where individuals are from White ethnic groups) or over 25 kg/m2 (where individuals are from Black, Asian and other ethnic groups)

Individuals who live in an area where this service is being delivered will need to discuss their individual circumstances with their GP or diabetes team at their next appointment in order to find out whether it is suitable for them.

People who are not eligible for the NHS Low Calorie Diet Programme should discuss their individual circumstances and services that are available to them locally with their GP or diabetes team at their next appointment. Adults living with obesity who also have a diagnosis of diabetes or hypertension or both may be eligible for the NHS Digital Weight Management Programme – a nationally available 12-week online behavioural and lifestyle programme accessed via a smartphone or computer with internet access, following a referral from Primary Care or Community Pharmacy.

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: