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Diabetes patients to be put on 800-calorie-a-day diet, says NHS England

Up to 5,000 type 2 diabetes patients will be prescribed a liquid diet of just over 800 calories a day for three months, to see if it puts them into remission, NHS England has announced.

The pilot will be run as part of the national diabetes prevention programme, which allows GPs to refer patients for support to help them lose weight, eat better and take up more exercise, and form part of the long-awaited NHS long-term plan.

However, GPs questioned whether such a low-calorie diet will produce effective results outside of a clinical setting, where patients are not so well motivated. 

In the announcement released by NHS England today, it also said that the national diabetes prevention programme will be doubled in size, to support around 200,000 people at risk of developing type 2 diabetes and help them lose weight.

NHS England said that this comes after the programme ‘proved even more successful than planned with patients losing on average 1kg more than expected’.

The scheme, first launched in 2016, was designed to delay or stop the onset of diabetes by providing lifestyle interventions.

Online versions of the programme will also be provided for patients who find it difficult to attend sessions because of work or family commitments, the announcement added.

Meanwhile, a new low calorie pilot is set to be launched next year, initially including around 5,000 people. This follows a Diabetes UK trial, in which almost half of participants who undertook a very low calorie diet achieved remission of their type 2 diabetes after one year, with a quarter dropping 15kg or more.

Diabetes UK chief executive Chris Askew said: ‘The first year results of Diabetes UK DiRECT study showed that – for some people with type 2 diabetes – an intensive, low-calorie weight loss programme delivered with ongoing support through primary care could put their condition into remission.

‘While this ground-breaking study continues to explore how long-lasting these benefits are, we are delighted that NHS England have been inspired by this work to pilot a type 2 remission programme through the NHS.’

But GPs warned that while the results were ‘encouraging’ in a clinical setting, they may not be replicated when patients are ‘less motivated’ to maintain the very low calorie diet.

Head of primary care and public health at Imperial College London Professor Azeem Majeed, a practising south London GP, said: ‘Although the study had encouraging results, we don’t know if the findings will be replicated outside the setting of a clinical trial, when patients may be less well motivated to maintain their very low calorie diet.’

He explained that while the new pilot will ‘provide data on how well these patients will comply with their diet, what their clinical outcomes are, and whether this programme should be rolled out more widely’, such targeted interventions need to be ‘combined with population-based measures that target the entire population’.

NHS England chief executive Simon Stevens said: ‘The NHS is now going to be ramping up practical action to support hundreds of thousands people avoid obesity-induced heart attacks, strokes, cancers and type 2 diabetes.

'The NHS long-term plan is going to give people the power and the support to take control of their own lifestyles - so that they can help themselves while also helping the NHS.'

However he added that 'this isn’t a battle that the NHS can win on its own' and called on the food industry to 'take action to cut junk calories and added sugar and salt from processed food, TV suppers and fast food takeaways'. 

Last month, the latest figures revealed that severe obesity in children aged 10 to 11 years had reached a record high.

This was despite the Government's obesity strategy, which was criticised by GPs and MPs who said they were 'extremely disappointed’ that the Government plan failed to adopt tougher measures.

Readers' comments (11)

  • ‘Nurse, mine is a large fish-supper, not this slop’.

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  • A nice 800 cal milkshake to wash their Greggs down with..

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  • Surely this should be Dietician led and not GP

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  • Is this really cutting edge research? Loose weight and stop having type 2 diabetes?
    Only way this will work is if the package includes a locked ward.

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  • Vinci Ho

    Would like to keep an open-mind. Let’s see what the outcomes of this pilot will show

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  • I am just so relieved to have left three years ago. I used to joke about GPs becoming 'botty wiping police' and visiting patients after they defaecate to check for proper cleaning in case they developed pruritus ani. Choosing to over-eat and under-exercise is not an illness, I realise it contributes to illness but maybe this is just a type of natural selection. The NHS is doomed.

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  • National Hopeless Service

    And when they get fed up of it they will eat cake again like most do. You can see the HBA1c trend from space.

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  • David Banner

    If dieticians supervise and patients purchase the products (they’re not buying food, so it’s cost neutral) then fine by me. If they are truly motivated they will happily cough up for the products and stick to the programme.

    BUT, if these products are put on (free) NHS prescription it will cost a fortune and eat up huge swathes of non existent GP time with barely any impact on the diabetic population.

    The real world is very different from the trial world. As others have pithily stated above, the vast majority will fail to comply with their liquid diet, but the massive demand for these “free” products will decimate NHS budgets.

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  • why can't a supermarket run these these programmes? they employ pharmacists, why not dietitians? easy access for most people, easy parking and education on food choices right on the doorstep. canada has such programmes whereby patients can go into a supermarket and learn how to read food labels and make healthy choices with a qualified dietitian. paid for by public health. patient self refers or referred by any type of medical practitioner or pharmacist. could be done on line for rural populations. there are many ways to do this without involving a GP.

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  • Please no! This isn't nothing new. They liquid diet will last 6 months then they will start eating the very stuff that pushed them there. Also what about the harms of a liquid diet and the costs.

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