Low calorie diets to treat obesity and Type 2 diabetes

The NHS Long Term Plan makes a commitment to test an NHS programme supporting low-calorie diets for obese people with type 2 diabetes. These pilots build on the approaches of the Diabetes Remission Clinical Trial (DiRECT), and the Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET) trial, reflecting the evidence bases developed for both of these trials.

The low calorie diet pilots will test at scale both of these approaches that have been shown to put Type 2 diabetes in remission in those recently diagnosed with the condition. Patients will be prescribed a liquid diet of just over 800 calories a day for three months and then a period of follow up support, including periods of food reintroduction followed by weight maintenance. This approach will initially be piloted by up to 5,000 people.

Reviewing current work in this area

We are currently in the early stages of planning this work programme. As part of this, we have been hearing from commissioners across the country that have either:

  • already begun using low calorie diets / total diet replacement to treat obesity and/or put Type 2 diabetes into remission; or
  • begun planning to commission these services in the coming year.

(It is not too late to share your examples. If you have an example of implementing an approach which involves low calorie diets/total diet replacement, including those at the design, procurement or early implementation stage, then we want to hear from you. Please email england.diabetestreatment@nhs.net with details.)

We have also been hearing from suppliers that are developing new technologies and/or delivering support for those undertaking low calorie diets / total diet replacement. This understanding is now informing national thinking around the development and roll out of the pilots, providing insight into the innovations that are available in the current market and the effectiveness of different types of services on offer.

All of the examples that we have received are now helping to shape the conversation and planning for future implementation pilots. An Advisory Group, including broad membership from across diabetes, obesity, nutrition, research and patient expertise has been convened to help advise on the proposed implementation approach.

Future opportunities

Please sign up to the NHS Diabetes Programme bulletin for further opportunities to input as we go through the development process.