Overweight and Long COVID: how a low-calorie diet can help

Posted On: 22nd January 2025

Whilst it has been more than four years since the COVID-19 outbreak, the impact of the pandemic is still being felt around the world. In Europe, it is estimated that more than 60% of those previously affected by the disease experience persistent, often severe symptoms months after the initial infection – a condition known as Long COVID.

Studies have found that obesity increases the risk of severe COVID and is also associated with long‐term post‐COVID symptoms. Obesity or overweight can make COVID worse as it can weaken the immune system response, impair lung function as well as cause general inflammation of the body – an overreaction of the immune system which can make COVID symptoms last longer. In addition, research has shown that vaccinated people with overweight are at higher risk of becoming very unwell  from COVID compared to vaccinated people of a healthy weight.

Earlier this month, researchers from the University of Glasgow published the results of the ReDIRECT trial. Funded by the National Institute for Health and Care Research (NIHR), this study investigated whether a remotely delivered structured weight management programme with total diet replacement (TDR) could improve Long COVID symptoms in people living with overweight.

The ReDIRECT trial included 234 adults with Long Covid and a body mass index (BMI) greater than 27 kg m2 (or >25 kg m−2 for South Asians) who nominated the Long Covid symptoms they most wanted to see improve, including fatigue, breathlessness and pain. The intervention group, consisted of 118 participants, who were provided with a 12-week weight loss programme with TDR (850 kcal per day), followed by structured food reintroduction and weight loss maintenance support.

Analysis of the results in 97 participants in the intervention group showed improvement of the primary outcome – which was based on the participant-selected dominant Long Covid symptom score – with no excess of serious adverse events. The mean weight loss in the intervention group was 10kg, which also led to meaningful reductions in blood pressure. As the researchers stressed, “given measured declines in blood pressure and known benefits of weight loss in reducing the risks for multiple other complications, the substantial intentional weight loss, if maintained, could have multiple other benefits for participants whose baseline BMI averaged around 35kgm2”.

As ReDIRECT was a complex intervention and had several limitations, the authors of the study recognised the need for further research. However, they noted that these “results which represent robust randomised trial evidence that remotely delivered dietary weight management which generates a mean of 10kg intentional weight loss, is both safe and effective in reducing the symptoms that matter most for people living with Long Covid and overweight”.

TDMR Europe works to help stakeholders, such as policymakers and healthcare professionals, develop a better understanding of slimming foods and aims to increase awareness of the research on the products. Businesses and organisations in the sector interested in finding out more can reach out to TDMR Europe at secretariat@tdmr-europe.com.

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Aris Myriskos

TDMR Europe Secretariat

Press and Media Relations Office