The NHS has announced an expansion of its Soup and Shake diet plan to thousands more Type 2 diabetes patients.
The weight loss programme will be a central plank of a new health service drive to tackle diabetes. It will be rolled out across England over the next 12 months, having been previously only been available on a trial basis in some English NHS areas since 2020.
It comes after research found losing weight can increase the chances of a patient going into remission from Type 2 diabetes. The Diabetes Remission Clinical Trial (DiRECT) findings have provided hope to those who have to take medication to manage their blood sugar levels, and face other health issues as a result of obesity. Follow up data from NHS England has further underscored the potential benefits of the plan.
Earlier in April, Diabetes UK warned of a “rapidly escalating” crisis after cases of diabetes in the country topped five million for the first time. An NHS survey at the end of 2022 found a quarter of adults in England are classified as obese.
While quick weight loss diets are often frowned upon by dietitians, they are recommended when they are followed in conjunction with professional medical advice. In the case of the NHS diet plan, it sees GPs and dietitians work closely with patients to help them lose weight.
So how does the Soup and Shake diet work, what kind of food and drink do you consume - and what is the NHS expected to say?
What is the NHS Soup and Shake diet plan?
The NHS Soup and Shake plan involves replacing meals with soups and shakes for a period of three months.
It is available for free in several NHS areas for people aged 18 to 65 who have been diagnosed with Type 2 diabetes in the last six years and have a body mass index (BMI) over 27 (or over 25 in people of Black, Asian or minority ethnic origin). While this sort of diet is not revolutionary in itself, the wider package the meal replacement products come with, is.
NHS clinicians and coaches give participants support through virtual one-to-one appointments, online help and groups. After the three month diet period comes to an end, patients are then handed a programme that reintroduces healthy, nutritious food and continue to receive advice.
How can you get the NHS Soup and Shake diet plan?
At present, the diet programme is only available at 21 NHS sites in England. Here is a full list of the areas where you can access the plan:
- North East and North Cumbria
- South Cumbria and Lancashire
- West Yorkshire
- Nottingham and Nottinghamshire
- Black Country
- North Somerset and South Gloucestershire
- Mid and South Essex
- South West London
- Kent and Medway
The NHS announcement made at the Diabetes UK Professional Conference on Wednesday (26 April) revealed the treatment will be extended across the rest of England by March 2024. It will be available to anyone who has been diagnosed with Type 2 diabetes in the last six years.
To receive the treatment, you have to have been diagnosed with Type 2 diabetes in the last six years, be aged 18 to 65-years-old, have a BMI of 27 or above (25 or above if you’re from an ethnic minority), and get referred by your GP. Similar programmes are available on the NHS in Scotland, while Northern Ireland and Wales are piloting soups and shakes plans.
NHS England also offers a digital weight management programme, which is a 12-week online scheme that can be accessed on a smartphone or computer through this NHS website link.
What impact has the NHS Soup and Shake diet plan had?
More than 4,500 people with Type 2 diabetes have been taking part in a trial of the NHS soups and shakes diet programme since September 2020.
Initial results published in January 2022 showed that, on average, each participant lost 7.2kg (1st 1lb) after a month and 13.4kg (2st 1lb) after three months. Follow up data from 2022, that was published on 26 April, showed average weight loss to be 11kg (1st 10lb) over a full 12-month programme.
NHS England said data from a study of participants taken three months after the programme ended suggests that those who follow the plan are able to keep the weight off over time. Previous clinical data has shown that roughly half of people who lose weight on similar diets were able to achieve remission from their Type 2 diabetes after 12 months.
“We know this weight loss will go a long way to help people stay well and avoid preventable illness, and for many will also mean they can put Type 2 diabetes into remission,” said Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity. “This is also the latest example of the NHS rapidly adopting the latest evidence-based treatments to help people with Type 2 diabetes live well. With research showing that obesity causes more severe illness from Covid-19, as well as other serious diseases, there has never been a more important time to lose weight.”
The treatment could also stand to ease the financial burden on the NHS by billions of pounds if it is scaled up. Diabetes is estimated to cost the health service 10% of its budget every year, with the condition responsible for one in 20 prescriptions written by GPs. Some of those who have been on the NHS Soup and Shake programme have spoken out about how the diet helped them.
Nadeem Akhtar, 49, from Sheffield, has lost more than 19kg (over 3 stone) since starting the plan and has put his Type 2 diabetes into remission. “I lost my mum to diabetes, which was devastating. It really showed me just how destructive this disease can be and I really didn’t want to go down the same path,” he told the PA news agency.
“Being on the plan is the best thing I’ve ever done for myself and my family. It was hard at first, but my health coach was so understanding and really helped me through the difficult times and keep up healthier habits.”
Karen Bradbury, 50, from Derbyshire, started the programme in 2021 after her nurse warned her she would have to go on daily medication if she couldn’t lower her blood sugar levels. “I have battled with my weight on and off over the years and was diagnosed with Type 2 diabetes,” she said. “Since being on the low calorie diet programme, I have felt totally supported by the practitioners and all the tools available.
“I’ve learnt loads about Type 2 diabetes and how to manage stress and habits with food. I feel so much healthier. I have lost 5st 3.5lbs (over 33kg) and my blood sugar levels have nearly halved – which meant I didn’t have to start medication.”
Ms Bradbury has also enjoyed other health benefits as a result of the diet plan. “My energy levels have increased substantially, and I am now swimming three to four times a week and walking every day,” she revealed.
“I used to wake up to 10 times a night to use the bathroom, I was thirsty all the time, exhausted and generally felt unwell. Now I sleep soundly all night and feel less tired during the day. My mental health has also improved. I feel better and I’m living better for me and my children. I’m so grateful that I was offered this opportunity.”
If you live in England, meet the criteria and want to enroll on the NHS Soup and Shake plan, you should contact your GP.
What does diabetes research show?
According to the latest results of the five-year Diabetes Remission Clinical Trial (DiRECT), losing weight and keeping it off could reverse diabetes. Diabetes UK, which funded the study, said it could prove to be “life-changing” for the millions of people who have the condition.
Obesity is a key driver of Type 2 diabetes, with research suggesting that obese people are up to 80 times more likely to develop the condition than those with a healthy body mass index (BMI) of 22 or less. But, by losing weight through medically-supported, nutritionally complete, low-calorie diet plans, some participants in the DiRECT trial managed to come off their diabetes medication.
Of the 298 people who took part, half received regular diabetes care and another half were put on a diet plan that was supported by health professionals. Some of the latter group received the Soup and Shake diet for several weeks before being supervised on how to better balance their meals.
At the end of the original two-year study, 95 of the 149 people on the weight-loss programme agreed to take part in an extension study lasting three years. This new data shows that, of this group of 95 people, 48 were in remission from Type 2 diabetes at the start of the extension study, and almost a quarter (23%) of these were still in remission three years later having lost an average of 8.9kg (1st 6lb).
The proportion of patients who were in remission five years after the original study started was more than three times greater than the control group, who received standard care. Those who did not remain in remission had regained the weight they had previously lost.
Professor Roy Taylor from Newcastle University, who co-led the study, said: “The DiRECT five-year follow-up shows that the rapid weight-loss programme brings about considerable weight loss at five years with low-intensity support. The most important question now is how the follow-up programme can be even more successful at an affordable cost.”
Additional reporting by PA