World Diabetes Day: Addressing the risk factor of obesity more important than ever

Posted On: 13th November 2023

Taking place on 14th November, this year’s World Diabetes Day (WDD), organised by the International Diabetes Federation, is focused on raising awareness of the risk factors for developing type 2 diabetes (T2DM) to help prevent the condition and highlighting the impact of diabetes-related complications as well as the importance of having access to the right information and care to ensure timely treatment and management.

The global prevalence of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population. In Europe, while, the prevalence of diabetes appears to have stabilised in Nordic countries, it has continued to go up in southern European countries as well as in central and eastern Europe. These upward trends reflect an increase in associated risk factors, such as being overweight or obese.

The European Parliament’s resolution on the “Prevention, management and better care of diabetes in the EU”, introduced on World Diabetes Day 2022, stresses the importance of preventing obesity, emphasising that the condition is “one of the major determining risk factors for developing type 2 diabetes”. Nevertheless, in the EU, we haven’t yet seen any policy initiative to help people that already have obesity and T2DM improve their health.

On the UK side, the success of the English National Health Service’s (NHS) “soups and shakes” diet programme has demonstrated that weight loss with total diet replacement (TDR) is a cost-effective solution to tackle obesity and improve T2DM. According to the latest data, over 2,000 people have improved their health through the programme with participants losing an average of 13kg in three months, which was maintained at six months. The NHS TDR programme was based on several scientific studies, including the PREVIEW, DROPLET and DiRECT trials, showing the effectiveness of this product in weight loss and T2DM prevention and remission in people with obesity.

In the PREVIEW trial TDR delivered an average 10.3 kg weight loss in 8 weeks and the study demonstrated the crucial role that such weight reduction can play in diabetes prevention. Undertaken in a primary care setting, the DROPLET trial has shown similar weight loss results and T2DM improvement.

The latest results of DiRECT showed that, in the three-year extension of the study, nearly a quarter (23%) of participants who were in remission from T2DM at two years in the original trial remained in remission at five years. The original DiRECT study ran for two years and saw almost half of those (46%) who went on a low-calorie diet with TDR achieve remission of their T2DM after one year and 36% at two years. A quarter of participants achieved a 15kg or more weight loss, and of these, 86% put their T2DM into remission.

Interviewed by TDMR Europe Chair, Professor Anthony Leeds, Professor Mike Lean who led the DiRECT trial together with Professor Roy Talyor, said on EAWAZ TV that the formula diet that was used “was very carefully designed to give all the vitamins and minerals” and emphasised that “the diet is perfectly safe”. “Participants lost 15-20 kg in about eight or 10 weeks…eight or nine out of 10 were no longer diabetic in that short time” stressed Prof Lean.

Discussing weight maintenance after weight loss with TDR in the DiRECT trial Prof Lean said “after having lost that weight the next phase is to maintain that weight loss, gradually replacing meals one by one until they are back up to hopefully three main meals a day. In some cases, patients elected to use a meal replacement for one of the main meals, using a low-calorie meal replacement in the long term as a way of controlling their total calorie intake. That isn’t absolutely necessary but it’s certainly one strategy which is effective”.

With T2DM and obesity rates in Europe reaching a record-high, governments across the continent need to introduce weight loss programmes in healthcare to tackle these conditions effectively. It is equally important to ensure that such health initiatives will be based on sound science and consider all options available, including the use of TDRs.

More information on the use of TDR for weight loss and diabetes remission and prevention is available here.

You can find more information on diabetes remission and maintenance after weight loss with TDR here.

A list of studies in which weight loss was achieved with TDR can be found here.

TDMR Europe works to help stakeholders develop a better understanding of formula diet foods and aims to increase awareness of the scientific evidence showing the effectiveness of these products in tackling obesity and improving related comorbidities. Find out more here.

Aris Myriskos, TDMR Europe Secretariat