Month: June 2019

“While the total diet replacement is not a cure, it can put type 2 diabetes in remission, what happens after that is down to will power and lots of hard work in the gym to maintain the weight loss. In truth, it is a lifestyle change but one that for me has been worth it as I am no longer classed as diabetic, I have managed to reverse it.”

Joe McSorley provides an insight into a patient’s perspective and experience of meal replacement programmes (MRPs). Joe was diagnosed with Type 2 diabetes and took part in a 12-week meal replacement trial followed by food reintroduction and weight maintenance. So, what has he taken from the programme? We highlight a few key points.

• The biggest challenge is the start

Patients often find the idea of doing a total meal replacement programmes challenging but actually easier than expected and Joe was no different. However, as he remarks, “I found, because everything was laid out…I found that part of it easy because I had no decisions to make over what I was eating”.

• Slow and steady wins the race

Food reintroduction comes after the stage in which the patient has been consuming meal replacements and must be done stepwise over several weeks to allow the body to adapt to a more substantial diet. Joe notes that he introduced small, conventional meals on a gradual basis in order to give his body the smoothest transition possible.

• Exercise everywhere

Joe keeps up his weight management by walking, cycling and playing football – always making sure he has done a substantial amount of exercise each day. Joe’s top tip: consult with personal trainers, whose services are often included in gym membership fees and who can help people to devise a personal weight management programme that works for each individual.

• Portion control is key

Portion size plays an important role in weight management. Once people have begun to reintroduce conventional foods after the meal replacements, it is important to be aware of the nutritional characteristics of foods regularly consumed. Personal consultants are available with all MRPs, ensuring the patient has an awareness of portion control and nutritional value. Expert guidance on food reintroduction is provided by dieticians and specially trained nurses in health care settings and trained consultants in commercial settings to ensure support and education to advise on weight maintenance after finishing the MRP programme.

• More support is needed

Joe feels that the government needs to support sufferers of obesity and Type 2 diabetes by learning from studies such as the DiRect diabetes remission clinical trial and the DROPLET study, in order to understand how to effectively tackle obesity and diabetes. NHS England has already committed to piloting a Type 2 diabetes remission programme in 2019 similar to DiRect and NHS Scotland is busy rolling out programmes right now.

 

 

“We now treat obesity like all other chronic diseases, and we understand the value of meal replacement strategies which helps change the symptoms of hunger and lack of satiety in a subpopulation of people with the disease of obesity. For these people losing weight is effortless as the meal replacements addresses the underlying biology of the disease.”

Carel Le Roux, professor of metabolic medicine at University College Dublin, proposes in his interview that officially recognising obesity as a disease will change our understanding and approach to treating it. This, he argues, would allow medical professionals to examine obesity in separate stages: causes, symptoms, and complications. Once the symptoms of obesity are targeted, there is a greater chance of successful weight management.

So, what would be achievable if other countries were to officially recognise obesity as a disease? Portugal officially classified obesity as a chronic disease in 2014, but still remains the only country in Europe to do so. Doctors in the UK have been outspoken in their convictions that obesity should be designated a disease and should no longer be considered a lifestyle choice – they called on the government to enforce this reclassification so that patients can receive specialist care.

Classifying obesity as a chronic disease would allow the creation of formal policies to improve care in the medical field, so that preventative measures can be put in place. Le Roux also believes sufficient legislation is an essential step towards tackling the stigma of obesity, a statement echoed by the President of the Royal College of Physicians: “It is important to the health of the nation that we remove the stigma associated with obesity”. This stigma, Le Roux argues, only compounds the problem. Not everyone has control over their lifestyle; access to healthy food, exercise and information around nutrition has become something of a privilege.  Furthermore, many well-known conditions are lifestyle-related, such as heart disease, yet patients suffering from these conditions are not blamed to the extent that diabetes patients often are. Often not triggered by lifestyle factors, diabetes can be caused by health inequalities, genetic influences and social factors – all causes that are largely out of the patient’s control.

The decision to prescribe total meal replacement diets (TDRs) on the NHS is a positive sign that the medical field recognises obesity as a disease that can be treated and controlled by healthcare professionals. Professor Jonathan Valabhji, National Clinical Director of Diabetes and Obesity for the NHS in England said: ““Our work so far in this area has been producing really positive results and today’s announcement will allow us to go even further –  it will help patients who have Type 2 diabetes to achieve remission and importantly, help more of those who are at risk to not get it in the first place.”

Le Roux’s approach to TDRs is very simple: If a patient is responding well to a diet approach, it is beneficial to continue; if a patient does not seem to respond well, then the medical professional may look at modifying the diet or considering alternative options. Members of TDMR Europe take care to carry out extensive consultations with people who wish to lose weight in order to design a tailored weight management programme that works for them. In choosing the right option, different factors should be taken into account: the amount of weight to lose, the general health and fitness of each individual and the cost-effectiveness of the proposed solution, as well as personal preferences

TDMR Europe is delighted to announce it has partnered with Innovations in Food Europe conference 2019. ACI’s Innovations In Food Europe conference will take place in London, UK on the 23rd and 24th of October 2019.

The conference will discuss new policies and regulations in the food industry, how to keep up with changing demands and trends, addressing opportunities in the market brought by lifestyle changes, as well as how to thrive in the industry as both a start-up, or a larger company. These are all very current topics and should be a great asset to players in the food & beverage industry.

>> View Agenda <<

TDMR Europe members are entitled to a discount on registration.  For more information and discount registration please contact Mayar Raouf on +44 (0)20 7463 0698 or mayar.raouf@whitehouseconsulting.co.uk.

“Formula diets, as currently designed, have proved extremely safe and effective in helping people to lose substantial amounts of weight, and gaining remission of type-2 diabetes. Almost nine out of 10 people with type-2 diabetes were still in remission, not diabetic and not needing medications, a year later if they lost 15kg.”

Professor Mike Lean, professor of human nutrition at the University of Glasgow and consultant physician at Glasgow Royal Infirmary, discusses the DiRECT diabetes remission clinical trial, a research study investigating whether offering an intensive programme of weight loss with TDR and weight maintenance could help place with Type 2 diabetes into remission. The first study of its kind, it has to the potential to revolutionise the way Type 2 diabetes is managed in the future.

The trial aimed to assess how many people can become non-diabetic through a 15kg weight loss. All participants were followed for at least two years, to see how many remained in remission and how that related to their weight. The latest findings revealed that more than a third of people with Type 2 diabetes who took part in the intensive weight management programme (starting with TDR) were in remission two years later. These results build on the initial findings, which showed that 46% of patients were in remission after twelve months.

Professor Lean emphasised that it’s a well-known fact that diabetes remissionis strongly linked to weight loss and maintenance. Remission of diabetes allows patients to stop taking anti-diabetes drugs, improving their quality of life and saving on treatment costs. The drugs themselves can cause side-effects, and cost healthcare services in the UK around £800m per year. For people who can achieve a long-term remission, the effect upon their future health and wellbeing is expected to be very beneficial.

Inspired by the results of the DiRECT study, NHS England has committed to piloting a Type 2 diabetes remission programme in 2019, and NHS Scotland is rolling out programmes right now. These studies have the capacity to investigate on a larger scale and provide more evidence to support weight management programmes for achieving diabetes remission. But the DiRECT trial itself has much more to give. Some participants of the original study are being followed for another three years, and more research is being done into the cost-effectiveness of the programme. A significant challenge will be to distinguish between responders (those who achieved remission) and non-responders (those who did not) and develop ways to help those who struggle to achieve and maintain diabetes remission.

For more information on the DiRECT trial go to: https://www.directclinicaltrial.org.uk/

For more information on Professor Mike Lean’s presentation, please contact TDMR Europe.

TDMR Europe is delighted to announce that it is partnering with Food Matters Live 2019, an event which aims to bring together a curated exhibition with hundreds of exhibitors and speakers and thousands of visitors from across the global food, drink and nutraceutical industry. It is a unique event dedicated to creating cross-sector connections focused on the future of food, drink and sustainable nutrition.                                                           

TDMR Europe was previously featured in Food Matters Live Table Talk newsletter, with a video in which our member Rob Rona discusses the new regulations for total diet replacement products and the important role trade associations play in both guiding and enforcing legislation. To see the video please click here.

Food Matters Live 2019 returns to ExCeL, London on 19–20 November. Follow

@FoodMattersLive #FoodMattersLive2019