An intensive low-energy diet programme, similar to the NHS Type 2 Diabetes Path to Remission, significantly improved eating disorder symptoms in people with type 2 diabetes and excess weight who were at risk of developing eating disorders, according to a University of Oxford study published today in The Lancet Psychiatry.
Participants enrolled in a total diet replacement (TDR) programme, experienced significant improvements in eating disorder symptoms which persisted six months after the programme finished when participants had regained some weight. This directly addresses a research gap highlighted by recent National Institute for Health and Care Excellence (NICE) guidance on the use of ‘Low-energy and very-low-energy diets for adults’ in Overweight and obesity management, which noted a lack of evidence on the psychological impact of restrictive diets.
"As a dietitian, I've seen firsthand how both eating disorders and type 2 diabetes can impact the quality of people's lives," said lead author Dr Elena Tsompanaki, a registered dietitian who led the study as part of her doctoral research at the Nuffield Department of Primary Care Health Sciences, University of Oxford. "Our findings challenge the assumption that weight loss programmes worsen eating disorder symptoms in vulnerable people , potentially opening up important treatment options that many patients might have previously been denied."
The researchers recruited 56 participants with type 2 diabetes (diagnosed within the last six years), overweight or obesity, and existing eating disorder symptoms identified via a validated questionnaire (called Eating Disorders Examination Questionnaire or EDE-Q). Half were assigned to receive a low-energy (~860 kcal/day) TDR programme with behavioural support for six months – similar to the NHS Path to Remission programme while the control group received usual diabetes care from their GP. It assessed four types of symptoms: restraint eating, eating concerns, shape concerns, and weight concerns.
Read the full story on the Nuffield Department of Primary Care Health Sciences website.