A recent study published in the British Medical Journal has shown the combination of total dietary replacement (TDR) with behavioural support led to significantly greater weight loss maintained at twelve months when compared to modest energy restriction and regular weight loss support.

The primary outcome measure of The Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET) was weight change at 12 months. Trial Participants in the TDR group lost significantly more weight (10.7kg) than those in the usual care group (3.1kg).

This finding adds to the growing body of evidence TDR programs are an effective weight loss approach. Previous studies conducted in specialist obesity clinics and research centres have shown weight loss at one year to be greater with TDR than comparative support programs. Their use has also been effective in Diabetes management where TDR and behavioural support have been shown to achieve not only weight loss, but Diabetes remission maintained by 50% of study participants after one year.

What is total dietary replacement?

TDR are nutritionally complete meal replacements formulated to provide 100% of daily intake requirements. Their nutritional completion means they can be used to replace all meals. A TDR plan provides energy intake of around 800kCal per day where up to five meals (3 main and two mid meals) are replaced with a shake, bar or soup and generally two serves of non-starchy vegetables.

The restricted intake creates an energy deficit and rate of weight loss greater than what can be achieved with a nutritionally complete full food plan. For this reason, TDR are administered under clinical supervision. The doctor monitors the effect of weight loss on medications and blood results whilst the dietitian provides nutritional symptom management and dietary counselling.

One of the main concerns with rapid weight loss is weight will be regained once the weight loss period is complete. This latest research is showing that harnessing patient compliance at the beginning of a weight loss program when the commitment to losing weight is highest results in increased weight losses early, that with ongoing support can be maintained over the longer term.

TDR & behavioural support

There is also belief the use of meal replacements reinforces a diet cycle (see diagram below) approach to weight resulting in weight regain often in excess of the initial weight loss. The dieting cycle often traps people who are trying to lose weight. It is precipitated by repeated failed attempts at restricting food intake, per the following diagram. What’s missing from this cycle is behavioural support.

Changing our relationship with food is no different to changing other behaviours that have become habitual. It takes time, it’s difficult and uncomfortable. We have to go through a process of change within which there will be setbacks that have to be dealt with. Changing the way we choose to respond to our thoughts, feelings, environmental and social triggers can be extremely challenging. For many, food has played a supportive role – providing relief - albeit temporary, from stress, exhaustion or other discomforts.

A TDR plan simplifies food choice. They provide a portion controlled meal option. The amount and frequency of food intake needed to achieve and maintain a healthy weight is reset.

TDR have been shown to be an effective tool for use in weight management. They optimise weight loss when the potential for weight loss is greatest. They provide the patient with space to begin build healthier food habits based on mindful, intuitive eating in response to hunger and satiety signals.

They also allow for a gradual transition back to a full food as the weight loss goal is approached. This can occur in combination with an increased understanding of the foods and portions that are supportive of weight maintenance.

Medically supervised TDR and behavioural support programs are an effective weight loss approach for overweight and obese individuals who are motivated to achieve and maintain a healthy weight as part of a healthy lifestyle.

Is this you?

LifeShape LED

At LifeShape Clinic we believe that the correct meal replacement used under the supervision of qualified health professionals can be a great short-term weight loss tool.

LifeShape Clinic have their own comprehensive range of meal replacements as part of their programs. LifeShape LED™ is a nutritionally complete meal replacement designed in conjunction with our medical team. The range provides all of the protein, carbohydrate, fat, vitamins and minerals you need as part of your LifeShape meal plan and comes in a range of bars, shakes and soups.

Reference:
Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET): pragmatic randomised controlled trial
Published 26 September 2018
https://www.bmj.com/content/362/bmj.k3760