Total Diet Replacement programmes cost effective in tackling obesity, says Oxford study

Replacing all regular meals with a low calorie diet of soups, shakes and bars, together with behavioural support, is cost-effective as a routine treatment for obesity, according to researchers from the University of Oxford.

Published today in the journal Obesity, the study is the first to estimate the long term health benefit and builds on the results of the DROPLET trial, which showed that ‘total diet replacement’ programmes (TDRs) are a safe and effective way to lose weight, with significant weight loss persisting to at least 12 months.

Nearly two thirds of adults in England are overweight or obese, increasing the risk of life-altering illnesses, such as type 2 diabetes, heart disease, stroke, and some cancers.

The NHS recently announced a pilot programme to offer a TDR programme to around 5,000 people with type 2 diabetes and has also committed to offering weight loss support for people with hypertension who are also obese.

The TDR programme is expected to cost an additional £13,000 for every year of life lived in full health which is gained as a result of the treatment. In the UK, healthcare interventions are generally considered cost-effective if they provide such a benefit for less than £20,000.

“The DROPLET trial showed that after 12 months people on total diet replacements lost on average 10.7kg (1 stone, 9lb), which was 7.2kg (1 stone, 1 lb) more than those only receiving the standard nurse-led programme of weight loss advice,” said co-author Dr Nerys Astbury, of the University of Oxford’s Nuffield Department of Primary Care Health Sciences.

Dr Seamus Kent, at the University of Oxford’s Nuffield Department of Population Health, said: “Studies like ours, which provide reliable estimates of the long-term impacts of weight management programmes on patients’ health and healthcare costs, are of real importance to enable the NHS to select the most clinically and cost-effective services for their patients."

Professor Susan Jebb, Professor of Diet and Population Health in University of Oxford’s Nuffield Department of Primary Care Health Sciences, Chief investigator of the DROPLET trial, said: “It is great to see the NHS Long Term Plan taking this research evidence and translating it into new clinical services for people who are obese. Our study provides great confidence that this programme is a cost-effective treatment, which could improve the health of large numbers of people who are affected by obesity.”