ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- A systematic review of UK-based long-term nonsurgical interventions for people with severe obesity (BMI ≥35 kg mJournal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2020Pooled it
- Weight losses with low-energy formula diets in obese patients with and without type 2 diabetes: systematic review and meta-analysis.International journal of obesity (2005) · 2017Pooled it
- Remotely delivered weight management for people with long COVID and overweight: the randomized wait-list-controlled ReDIRECT trial.Nature medicine · 2025Trial
- Personalized nutrition in type 2 diabetes remission: application of digital twin technology for predictive glycemic control.Frontiers in endocrinology · 2024Trial
- Trial
- Antihypertensive medication needs and blood pressure control with weight loss in the Diabetes Remission Clinical Trial (DiRECT).Diabetologia · 2021Trial
- Clinical and metabolic features of the randomised controlled Diabetes Remission Clinical Trial (DiRECT) cohort.Diabetologia · 2018Trial
- The Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial.BMC family practice · 2016Trial
- Impact of and Comparative Outcomes for Digital and In-Person Interventions for Complex Obesity in a Diverse Urban Population.Endocrinology, diabetes & metabolism · 2026Article
- Article
- Effect of time-restricted eating regimen on weight loss is mediated by gut microbiome.iScience · 2024Article
- Challenges in the care and treatment of patients with extreme obesity.Archives of endocrinology and metabolism · 2024Review
- Using trials of caloric restriction and bariatric surgery to explore the effects of body mass index on the circulating proteome.Scientific reports · 2023Article
- Predicting weight loss success on a new Nordic diet: an untargeted multi-platform metabolomics and machine learning approach.Frontiers in nutrition · 2023Article
- A Normalized Real-Life Glucose Profile After Diet-Induced Remission of Type 2 Diabetes: A Pilot Trial.Cureus · 2022Article
- Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT.Frontiers in endocrinology · 2022Article
- Effects on body weight, eating behavior, and quality of life of a low-energy diet combined with behavioral group treatment of persons with class II or III obesity: A 2-year pilot study.Obesity science & practice · 2021Article
- Nocturnal eating but not binge eating disorder is related to less 12 months' weight loss in men and women with severe obesity: A retrospective cohort study.Clinical obesity · 2020Article
- Heterogeneity in the uptake, attendance, and outcomes in a clinical trial of a total diet replacement weight loss programme.BMC medicine · 2020Article
- Article
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Authors and funding
13 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m(2).
aimThis programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care. DESIGN AND
settingFeasibility study in primary care.
methodPatients with a BMI ≥40 kg/m(2) commenced a micronutrient-replete 810-833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months.
resultOf 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m(2), age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of ≥15 kg at 12 months, six (7%) had a 10-15 kg loss, and 11 (12%) had a 5-10 kg loss. The indicative cost of providing this entire programme for wider implementation would be £861 per patient entered, or £2611 per documented 15 kg loss achieved.
conclusionA care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of ≥15 kg for one-third of all patients entering the programme.
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