Professor Gary Frost shares best practice for weight loss maintenance at TDMR Europe’s webinar

Posted On: 25th May 2022

On 12th April at TDMR Europe’s online seminar “Diabetes Remission: Maintenance after weight loss with total diet replacement (TDR)”, health experts demonstrated that weight maintenance is possible after rapid weight loss with TDR and showed its crucial role in delivering diabetes remission  type 2 diabetes.

Professor Gary Frost (Chair in Nutrition and Dietetics – Imperial College London) participated in the webinar providing key-insights on the challenges and potential solutions related to successful weight loss maintenance and diabetes remission. Professor Frost stressed that biological, behavioural, and environmental factors conspire to resist weight loss and promote regain, and that effective treatment of obesity requires ongoing attention and support, and weight maintenance-specific counselling, to deliver better long-term weight management.

Presentation Slides Maintenance Of Weight Loss And Diabetes Remission Barriers And Solutions

Maintenance of weight loss and diabetes remission: barriers and solutions

Professor Gary Frost, Imperial College London, England

Long term weight loss and maintenance of weight loss over the life course remains a major unachieved goal (1).  Only 20% of people meet the criteria of long-term weight loss (10% of their initial body weight for one year) (2).  This disappointing statistic is common across all dietary profiles.  There are a number of common traits that are associated with maintenance of weight loss include positive emotional regulation such as low levels of dietary disinhibition and low levels of depression, dietary consistency, weight gain management and high contact with a councillor.  Unfortunately, evidence suggest that physiology starts to work against the maintenance of weight loss maintenance.  Energy balance starts to favour weight regain (1); appetite regulation favours a low appetite suppression tone (3).  In recent year my team have used some of these observations to design a method to nudge anorectic systems to prevent weight gain.  We had achieved this using a short chain fatty acid propionate.  Short chain fatty acids are produced by the microbiome in the human colon.  We have developed a method to deliver propionate to the colon and demonstrated positive effects on appetite regulation, hedonic wanting and liking of food and energy expenditure (4). It is possible such systems could impact on weight loss maintenance.

At the present time there is no high-quality evidenced based guidelines to enhance weight loss maintenance.  There is a number of good practice points that may enhance weight loss maintenance.

  1. Maintaining contact with professional support
  2. The use of corrective intervention
  3. Realistic but clinically important targets
  4. Physiological support
  5. Methods to support appetite regulation



  • Hall KD, Kahan S. Maintenance of lost weight and long-term management of obesity. Med Clin North Am [Internet] NIH Public Access; 2018 [cited 2022 Apr 12];102:183. Available from: /pmc/articles/PMC5764193/



  • Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med [Internet] 2011 [cited 2014 May 7];365:1597–604. Available from:


  • Chambers ES, Morrison DJ, Tedford MC, Frost G. A novel dietary strategy to increase colonic propionate production in humans and improve appetite regulation and bodyweight management. Nutr Bull 2015;40

If you would like to contact TDMR Europe to discuss the webinar or any other matter, please email

TDMR Europe organises educational seminars on TDRs and MRPs. Our events bring together industry stakeholders, academics, policymakers and others to review and raise awareness of the increasing evidence base within the scientific literature regarding the efficacy and potential of TDRs and MRPs to address effectively the challenge of obesity and related diseases in Europe. Find out more about TDMR Europe in our media pack and membership leaflet.