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11 Oct

Yes to meal replacement packs !!

If you’re looking to lose weight, Practically Slim have the diet for you.

Our range includes a nutritionally complete total diet replacement diet (TDR), similar to that successfully tested recently by a randomised controlled trial and reported in the British Medical Journal (BMJ) (1).

The BMJ highlights that, of two randomly selected groups of overweight adults referred by doctors, the group following the TDR diet lost more weight in the short and longer term compared to the group on a modestly restricted diet supported by GP practice nurses.

The Total Diet Replacement group lost 10.7kg on average, the ‘usual care’ GP practice group 3.1kg. For the first 8 weeks, the TDRs ate a max 810 calories a day, the ‘usual care’ group a little more. Both groups received regular counselling, one from the commercial TDR provider, the other from practice nurses.

At 12 months results were also better for the total diet replacement diet group. 45% had lost 10% of their weight or more, whereas only 15% of the ‘usual care’ group had. They also experienced reduced overall cardiovascular risk to a greater extent than the people in the ‘usual care’ group.

The study raises stark questions. Direct quotes from the British Medical Journal clearly point the way:

Why has a trial of this kind, of overweight adults in the community using commercial providers or the services of a GP practice nurse, not been carried out before?

“Most trials of these programmes have been small scale, and conducted in research settings or specialist obesity clinics.”

Why are doctors not doing more to help people who are overweight or obese?

 “Primary care doctors have the opportunity to offer treatments for obesity at the scale required …and are encouraged to screen patients and offer support for weight loss. Despite this, doctors rarely provide such support.”

 “Many primary care doctors are wary about supporting people who choose to use a TDR programme because they are unfamiliar with this approach or have concerns about the safety of such interventions. This trial should provide reassurance.”

Why do people think Total Diet Replacements are unacceptable to most people, are possibly unsafe, lead to rapid weight gain and are not recommended by guidelines?

We don’t know where that one’s come from but it’s well entrenched. The BMJ article specifically described this view as “a common but unsupported perception”. The rate at which weight was regained amongst those achieving 15% or more of weight loss was similar for participants in both groups. This very commonly repeated idea that regaining weight is related to the rate at which it’s lost “is not supported by experimental evidence.” There’s a mythbuster for you.

 The authors even go on to challenge current guidelines:

“Current clinical guidelines recommend that this type of diet is reserved for people in whom short term weight loss is a priority—for example, before bariatric or knee replacement surgery, and they are not recommended as routine weight loss interventions. This presumably reflects concerns that weight loss is short lived. This trial shows that TDR leads to greater weight loss at one year than an intervention based on usual food, nine months after the TDR phase of treatment.”

 Although some weight was regained by the TDR group between the end of the programme at 24 weeks and the final follow-up, this also occurred in the ‘usual care’ group.

 The BMJ article goes on to clearly state:

 “We found that weight loss did not vary by age, sex, socioeconomic status, or diabetes status, and together these factors suggest that this programme could be readily implemented and benefits realised across the population.”

 Their conclusion is clear:

A total diet replacement diet programme combining nutritionally complete formula food products with behavioural support seems to be acceptable, well tolerated, and leads to greater weight loss with larger improvements in cardiovascular risk than currently available weight loss programmes offered in primary care.

Note that the report refers to “a” total diet replacement dietprogramme, and does not confine its conclusion to the specific total diet replacement diet provider used in the trial. If you’d like to see results for yourself, why not contact us today and try our very own total diet replacement diet. 07970 252 647


We’re here to support you, with counselling, TDR and other diets, to lose your weight your way.

Note (1):


Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET): pragmatic randomised controlled trial


Nerys M Astbury, senior researcher,

1.       Paul Aveyard, professor,

2.       Alecia Nickless, clinical trial statistician,

Kathryn Hood, research assistant

3.       Kate Corfield, clinical trial administrator,

4.       Rebecca Lowe, research assistant,

5.       Susan A Jebb, professor

  Author affiliations: Nuffield Department of Primary Care Health Sciences at the    University of Oxford, UK


6.       BMJ 2018;362:k3760

7.       Standard Randomised Controlled Trials No ISRCTN75092026


BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3760 

(Published 26 September 2018)


© BMJ Publishing group Ltd 2018


The BMJ article quoted is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited.

Disclaimer notice

This Practically Slim article contains copyrighted material the use of which has not been specifically authorised by the copyright owner. It is used as part of Practically Slim’s efforts to advance understanding of issues of public health significance. We believe this constitutes a ‘fair use’ of the material and is in accordance with the license quoted above.

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