My initial reaction to this headline was
what the fuck? That’s a terrible idea
And after reading it I feel the same way. We’ve already been through this in the 80s with the all liquid diet scams. The inevitable result is that you regain everything when you start eating normally again. The article itself even mentions this outright.
There’s a ton of nuance to this if weight loss is urgently needed and the diet is prescribed by a doctor. I just hope people don’t skim the headline and set themselves up for yet another round of futile diet scams.
I think the NHS can do better now than private industry scams from 40 years ago, especially with the knowledge we’ve gained in the last 40 years. You really shouldn’t conflate the two.
I think the NHS can do better now than private industry scams from 40 years ago
I don’t mean to sound confrontational at all, but sincerely, why do you think that? Correct me if I’m wrong but there isn’t any evidence that government programs in general have ever been effective in reversing the obesity epidemic. Our medical knowledge has increased over the last 40 years yes, but nonetheless worldwide obesity has been on the rise and is accelerating.
Not to suggest that we should just give up, quite the opposite. All I mean to say is that yes of course an 800 calorie total meal replacement shake system results in short term weight loss. With predictable regain when patients eventually stop. We’ve been through all of this before. As I said the nuance here will be with the medical supervision, but the extreme damage to the general public’s perception of weight loss caused by decades of misleading and contradictory information cannot be overlooked.
I just don’t want people to see these preliminary results and then go off thinking they should try a cabbage broth diet for a few weeks, or some other such silliness. I don’t really see how the two can be un-conflated in the absence of specific cautionary messaging.
Sorry but you’re conflating a lot.
This was about diabetes, not obesity. While there is overlap and they cover that, this was specifically about an intervention to reverse diabetes.
Second this is an intervention, aka a specific dietary program for diabetes. To compare that to worldwide obesity is comparing two extraordinarily different things. Worldwide obesity is likely from unhealthy processed foods that people choose to eat. This is an intervention to fix that. You can’t compare those to shoo away the medical knowledge we have about interventions/programs.
So on to interventions/programs: Our knowledge of pretty much everything is vastly better than it was before. We understand macronutrients better, micronutrients better (vitamins, minerals), the entire biochemistry of the body - but especially about diabetes. Not only did we not know this 40 years ago, the ad-driven private industry didn’t care about it.
Private industry wants to sell a product, they don’t care about anything else. Like if you think private industry actually cared about solving diabetes 40 years ago, I got news for you: They don’t give two shits. All they want to do is sell stuff. They can do the jazz hands but then they will wipe their hands clean with ‘part of blah blah blah’. They truly do not care one iota.
NHS is a government agency that is actually trying to solve a problem. They are tasked to solve the problem. They want to solve the problem. Dare say, they need to solve the problem. NHS doesn’t care about profits or market share. They care about solving the problem. Entirely different motivations, goals, structures, and definition of success.
And we do have the results:
Research on the effectiveness of the diet to manage diabetes initially began with promising results from randomised control trials. The diet was then rolled out to larger scale trials in clinical practice, implemented via the NHS.
The results confirmed that total diet replacement plans can induce weight loss as well as a decrease in HbA1c. In some patients this was enough to induce diabetes remission. Great news indeed.
The people selling slimfast were not doing randomised control trials, because again they don’t care. Simply not what they care about. They care about fancy TV ads and making profit.
NHS does do control trials to actually test, and get actual results. Because they are tasked with actually solving the problem.
Yes they caveat it:
However, this is only one piece in a more complicated jigsaw puzzle. Not everyone who follows the plan will be able to reverse their diabetes. For example, even though the soup and shake diet restricts patient food choice as well as calories, sticking to a liquid only plan can still be difficult for some.
Psychological issues with food, such as emotional eating, aren’t necessarily fully addressed by the programme, so – even for those who’ve followed the plan successfully – once the 12 months have finished, if the patient returns to their usual eating habits then they’ll regain weight and the diabetes could return.
But notice that 12 month followup? That’s something you won’t get with private companies selling ‘slimfast’. But we are getting that with this intervention. Again, different motivations.
In conclusion, be skeptical if you want. It’s always good to question. But don’t do this reflex conflation with ‘slimfast’ bs from 40 years ago. Don’t shoo away modern, scientific programs that have results, because of some private industry product bs from 40 years ago that never cared in the first place. VERY different things.
Sorry, but you’re simply incorrect about the facts. Pretending that this isn’t explicitly about weightloss when the article says as much in plain language makes me question whether or not you’re participating in this discussion in good faith. Yes it is in the context of treating diabetes, specifically the type caused by obesity, and the goal of the replacement diet is to address the obesity.
And I would once again ask for specific evidence about the effectiveness of government sponsored obesity interventions in the last 40 years. “They actually want to address the problem” is not evidence that they have done so or will anytime soon. The point of contention here is not their motivation or trustworthiness, but their effectiveness. Insisting that we “better understand the entire biochemistry of the body” is also not evidence of an effective obesity intervention.
Also extremely disingenuous to “shoo away” this point by saying they “actually get results”, when the only “results” you have provided are pasted paragraphs from this very article which only references short term testing on total meal replacement diets (which is not new information) that also acknowledges it hasn’t worked in the long term (which is also not new information).
I will say once again as I have said in literally every comment in this thread, since much of your criticism of my point seems to be dependent on ignoring this, that the problem here is not in what someone and their doctor decide to do together to treat their obesity. It’s a problem of public messaging and context. We simply can’t have headlines going around implying that shake and soup diets have achieved some advanced status considering the damage similar diet schemes have caused and continue to cause. The messaging needs to be done very carefully because we live in the real world where sensationalism can cause real harm.
It is literally explicitly about diabetes. Diabetes tends to overlap with obesity and they talk about it a bit, but it is literally explicitly about diabetes. The study if you follow the links is “Type 2 diabetes: etiology and reversibility”.
And yes I gave the results that they found. Why are you acting like that’s bad?
Messaging? Sure we can criticize click bait headlines, but sorry to say you are the one that jumped to 40 year old products and conflated them. And I’m the one saying don’t do that. I think I’m out of this conversation. I think I’ve explained it well enough.
I’m genuinely amazed that the hill you chose to die on is whether or not the weight loss studies, that specifically targeted obese patients, which measured their results in weight loss, with the stated goal of reversing diabetes via addressing obesity, are in fact about addressing obesity.
Studies, btw, not study. Lots of interesting stuff in this article if you actually bother to read it. Some of them even have obesity in the title, if that’s really the only important thing to you.
Anyway, your continued refusal to answer the question you are directly being asked is noted, as is your repetition of the false assertions I have already addressed. I wholeheartedly support your initiative to leave this conversation. Cheers
This is not a great diet plan. Liquids aren’t as filling as solids, can be consumed quickly, and digested faster. Plus, this plan leaves you dependent on shake makers/brands instead of managing your own diet.
Also, diets don’t work, stop calling it that. Diets are temporary things. A real T2 mitigation plan will require permanent lifestyle and dietary changes, including some sort of exercise regimen and reducing carbohydrates intake and increasing fiber intake to promote fullness and help reduce cravings between meals.
Lastly, I wish these articles would stop suggesting you can reverse (as in cure) type 2 diabetes. There is no cure currently, only lifelong management and control.
Source: I’m a well managed type 2 diabetic for 12 years, in good health and fitness level.
So, while the results of the study are promising for some patients, more work needs to be done to ensure weight loss is maintained post-plan.
There’s a great podcast called Maintenance Phase that’s all about the diet industry’s bullshit. They chose the title because once a dieter stops doing a diet, they return to the weight they were before (~80% of dieters according to this metaanalysis ). The diet is the maintenance phase. You can never stop.
This diet is a low calorie diet that keeps intake under 1000 calories. That’s not healthy for the long term. This diet, like all diets, is crap.
Part of the difficulty in maintaining such extreme calorie restriction may lie in food choice and portion control. There is a challenge in eating enough of the correct foods to consume enough nutrients and remain full enough to avoid straying from the diet.
…
Total diet replacement plans remove the element of choice for patients, making a diet easier to follow and increasing the chance that patients will stick with it.
The NHS soup and shake diet involves following a calorie restricted diet (800-900 kcal) of low calorie, nutritionally complete, total diet replacement products – made up, as the name suggests, of soups, shakes and bars – before reintroducing other foods, bridging progression onto a healthy maintenance diet, supported by coaches for 12 months.
…
The results confirmed that total diet replacement plans can induce weight loss as well as a decrease in HbA1c. In some patients this was enough to induce diabetes remission. Great news indeed.
However, this is only one piece in a more complicated jigsaw puzzle. Not everyone who follows the plan will be able to reverse their diabetes. For example, even though the soup and shake diet restricts patient food choice as well as calories, sticking to a liquid only plan can still be difficult for some.
This diet is based on Dr. Roy Taylor’s research on Type 2 Diabetes, and its reversal. He and his team noticed that people with T2D have fat in their liver and pancreas. They confirmed this with a new MRI imaging technique that they developed. Regardless of body weight, if you have fatty liver/pancreas you have T2D or at least pre-diabetes. But, if your liver and pancreas are healthy, you can be overweight and not have T2D.
They call it the twin cycle hypothesis. Google it up, but short is this. If fat builds up in your liver, it starts a cycle that among other things causes the liver to send fat in to your pancreas, which starts another cycle in the pancreas, which feeds the liver’s cycle. As the pancreas gets more and more fatty, the insulin producing beta-cells begins to de-activate, which leads to T2D.
They wanted to test whether this hypothesis is true, and if so, is T2D reversible. How to do that? Their T2D test subjects must loose weight. What’s the fastest way to do that? Extreme caloric restriction.
They put their subjects on a diet consisting of 4 doses of meal replacement formula per day (800kcal/day). Their subjects noticed that it’s actually quite easy to stick to that diet after couple days.
The results of their studies is that if people loses enough fat to free their pancreas from fat, their pancreas can heal and return to normal, reversing T2D. But, there is always a but. If T2D has been going for too long (over 6 years in their studies), too many of the beta-cells have died, and full reversal of T2D is not possible.
Note: Extreme caloric restriction is very dangerous if you are on T2D medication. Do your own research and talk to your doctor. I tried to use correct terms so it’s easy to check the things.
