Four drinks a day over eight weeks can help those at risk of heart disease, says study
Obesity can be successfully tackled, at least in the short term, by giving up real food for formula meals for eight weeks, which removes temptation and any need to make difficult decisions about what to eat, a new study has found.
The research, by the former government obesity advisor Professor Susan Jebb of Oxford University and colleagues, was designed to see whether a crash diet of just 810 calories a day – provided by four formula drinks – would help people whose obesity is putting them at high risk of health problems such as heart disease and type 2 diabetes.
It is the sort of meal replacement diet that people wanting to lose weight have used since the 1970s, but it has not been recommended for obesity. Jebb and colleagues wanted to find out whether it might be a suitable intervention for GPs to offer on the NHS.
Their study, launched in a poster at the European Congress on Obesity in Vienna, looked at the effects in 278 adults, recruited through 10 GP practices in Oxfordshire. Half of the participants were put on the formula diet – provided by the Cambridge Weight Plan, which funded the study – and received regular counselling and support, which the researchers said was a critical part of the programme. The others had regular care, which involved weight advice from the practice nurse.
Those on the plan lost an average of 10kg over a year, which for 73% was at least 5% of their body weight, and for 45% it was 10%. Those in the other group also lost weight but significantly less – 32% lost 10% of their bodyweight.
Nerys Astbury, manager of the trial called Droplet (doctor referral of overweight people to low energy treatment), said removing food from the lives of people with obesity was liberating.
“People reported that they didn’t feel hungry. I think these people are overweight because they have an unhealthy relationship with food. We take food out of the equation,” she said.
Obesity is caused by many things, but in particular by the unhealthy environment, where fattening food is cheap, all around us and constantly promoted. That made portion control hard. “You just want one more biscuit or one piece of cake,” she said.
After eight weeks, ordinary food was gradually reintroduced. Weight loss was at its greatest at six months, and then people slowly put weight on again. The effects of all diets tend to wear off. Astbury said all those in the trial would probably return to their original weight within a couple of years. But the period of lower weight was good for their health. They might want to go on the programme again later on.
Jebb said the programme probably worked for a variety of reasons. The formula meals were filling because they were high in protein and fibre. The break from usual habits and chance to establish new ones was helpful and losing a lot of weight quickly was motivating. “Dieting is hard and boring and a short sharp programme may be easier to stick to than a long slow one,” she said.
She hoped the NHS might fund the programme for people who are clinically obese, if it proved to be cost-effective. “Meanwhile we can at least reassure people who are willing to self-fund that there is good evidence it is clinically effective. It adds to the portfolio of interventions we can offer to people – it won’t suit everyone, but it increases patient choice,” she said.
While this trial used the Cambridge Weight Plan, others that are similar include Lighter Life, Optifast and Counterweight Plus, said Astbury.