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22 Oct

Total Diet Replacements work :

It’s official. Low energy total diet replacements work.

These are the very low calorie diets (VLCDs) where you replace all food for a short period of time with specially formulated soups, shakes and bars. Add in 750ml of skimmed milk, 2.25 litres of water or other low or no energy drinks and a fibre supplement and the total 810 kcal/day meets all your nutritional requirements.

These have been around some thirty years, I hear you say. Why the big fuss now?

Basically everyone’s talking about the results of the DROPLET trial (‘doctor referral of overweight people to low energy total diet replacement Treatment’), published in late September 2018 in the BMJ (1).

The study compared weight loss results from 278 overweight adults in Oxfordshire randomly trialling two methods. One group used a total diet replacement programme (TDR), the other used the ‘usual care’ offered by GP practices for people wanting to lose weight.

Both programmes included behavioural support, the first provided by the commercial company offering the TDRs, Cambridge Weight Plan UK, and the other provided by practice nurses.

The researchers not only found that people on the TDR lost more weight:

·         The TDR group lost, on average, 10.7kg

·         The ‘usual care’ group lost 3.1kg.

They also found they kept more of it off in the longer term. Twelve months on 10% or more weight had been lost by:

·         45% of the TDR group

·         15% of the ‘usual care’ group.

Now this doesn’t mean that people stayed on the TDR programme all that time. The TDR was only followed for 8 weeks, then normal food was reintroduced. From months 3 to 6 people were supported with weight maintenance.

One of the most interesting things about this trial and the report is that, not only is it reported in the BMJ, it very clearly indicates that all such diets offered are effective. If you’re not quite there yet, have a look at these direct quotes from the report:

  “Referral to a total diet replacement programme with support provided by a commercial provider is an effective intervention for the routine treatment of obesity.”

 “A TDR 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.”

Cambridge Weight Plan UK helped with the trial but of course you can come to Practically Slim:

·         We offer very low calorie total diet replacements, totalling 600-800 kcal/day

·         Our shakes, soups and bars are nutritionally complete and should be supplemented with water and other low energy drinks

·         We recommend they are used for a maximum of 12 weeks, in line with NICE guidance

·         We put a lot of emphasis on behavioural support and offer counselling in our weekly, friendly groups around the country

·         We don’t just do the essential goal-setting and problem-solving at these sessions. We offer behaviour-change techniques as well as specific behavioural advice based on our unique personality profiling

·         We also offer support whilst food is reintroduced, during the weight maintenance phase, and afterwards for as long as you like

·         We have detailed allergen information on all our products

·         We work with experienced and highly qualified personnel such as nutritionists and medical practitioners who oversee and support everything we do

·         Practically Slim meets all best practice standards following NICE guideline 43 (Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children).

We’re here for you. Because we’ve believed in this stuff all along and we have the know-how to help you lose your weight your way. Contact Heather@practicallyslim.com today to see how we can help you.

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 authorized 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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