Trial reportBMJ (Clinical research ed.)2018
Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET): pragmatic randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 12 syntheses or guidelines pooled it, 154 citations in OpenAlex.
- Preoperative low-energy diets for patients with a body mass index >30 kg/m2 undergoing non-bariatric surgery: pilot feasibility randomized clinical trial and a systematic review and meta-analysis of efficacy data.The British journal of surgery · 2026Pooled it
- Behavior change techniques in low-calorie and very low-calorie diet interventions for weight loss: A systematic review with meta-analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025Pooled it
- Pooled it
- Pooled it
- A systematic review of inequalities in the uptake of, adherence to, and effectiveness of behavioral weight management interventions in adults.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022Pooled it
- Identifying effective characteristics of behavioral weight management interventions for people with serious mental illness: A systematic review with a qualitative comparative analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022Pooled it
- Association between characteristics of behavioural weight loss programmes and weight change after programme end: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2021Pooled it
- The impact of adult behavioural weight management interventions on mental health: A systematic review and meta-analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2021Pooled it
- The Influence of Fasting and Energy Restricting Diets on Blood Pressure in Humans: A Systematic Review and Meta-Analysis.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2020Pooled it
- 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
- Efficacy of Intermittent or Continuous Very Low-Energy Diets in Overweight and Obese Individuals with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analyses.Journal of diabetes research · 2020Pooled it
- Management of overweight and obesity in primary care-A systematic overview of international evidence-based guidelines.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2019Pooled it
- Evaluating Whole Fruit Feijoa Powder for Type 2 Diabetes Risk Prevention: A Randomised Controlled Trial.Diabetes, obesity & metabolism · 2026Trial
- Effects of exercise and liraglutide on vascular health and inflammation during weight loss maintenance: a prespecified secondary analysis of the S-LiTE trial.Nature metabolism · 2026Trial
- Preoperative Weight Loss in Patients With Excess Weight and Colorectal Cancer: The CARE Feasibility Randomized Clinical Trial.JAMA network open · 2025Trial
- Remotely delivered weight management for people with long COVID and overweight: the randomized wait-list-controlled ReDIRECT trial.Nature medicine · 2025Trial
- Mobile-Based Platform With a Low-Calorie Dietary Intervention Involving Prepackaged Food for Weight Loss for People With Overweight and Obesity in China: Half-Year Follow-Up Results of a Randomized Controlled Trial.JMIR mHealth and uHealth · 2024Trial
- Efficacy, Safety and Acceptability of a Very-Low-Energy Diet in Adolescents with Obesity: A Fast Track to Health Sub-Study.Nutrients · 2024Trial
- Use of Cognitive and Behavioral Strategies During a Weight Loss Program: A Secondary Analysis of the Doctor Referral of Overweight People to Low-Energy Total Diet Replacement Treatment (DROPLET) Trial.Journal of the Academy of Nutrition and Dietetics · 2023Trial
- A high-protein total diet replacement alters the regulation of food intake and energy homeostasis in healthy, normal-weight adults.European journal of nutrition · 2022Trial
16 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test the effectiveness and safety of a total diet replacement (TDR) programme for routine treatment of obesity in a primary care setting.
designPragmatic, two arm, parallel group, open label, individually randomised controlled trial.
setting10 primary care practices in Oxfordshire, UK.
participants278 adults who were obese and seeking support to lose weight: 138 were assigned to the TDR programme and 140 to usual care. 73% of participants were re-measured at 12 months.
interventionsThe TDR programme comprised weekly behavioural support for 12 weeks and monthly support for three months, with formula food products providing 810 kcal/day (3389 kJ/day) as the sole food during the first eight weeks followed by reintroduction of food. Usual care comprised behavioural support for weight loss from a practice nurse and a diet programme with modest energy restriction.
main outcome measuresThe primary outcome was weight change at 12 months analysed as intention to treat with mixed effects models. Secondary outcomes included biomarkers of cardiovascular and metabolic risk. Adverse events were recorded.
resultsParticipants in the TDR group lost more weight (-10.7 kg) than those in the usual care group (-3.1 kg): adjusted mean difference -7.2 kg (95% confidence interval -9.4 to -4.9 kg). 45% of participants in the TDR group and 15% in the usual care group experienced weight losses of 10% or more. The TDR group showed greater improvements in biomarkers of cardiovascular and metabolic risk than the usual care group. 11% of participants in the TDR group and 12% in the usual care group experienced adverse events of moderate or greater severity.
conclusionsCompared with regular weight loss support from a practice nurse, a programme of weekly behavioural support and total diet replacement providing 810 kcal/day seems to be tolerable, and leads to substantially greater weight loss and greater improvements in the risk of cardiometabolic disease.
trial registrationInternational Standard Randomised Controlled Trials No ISRCTN75092026.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.