How to succeed on a total diet replacement programme

If you’re obese or severely obese and suffering from health complications linked to your weight, you could consider a total diet replacement (TDR) programme. This involves replacing all foods with specially formulated products such as soups, shakes and cereal bars, providing between 800–1200 calories per day.

Only follow a very low calorie diet if a GP has suggested it to you. If they feel it is right for you, they will help you choose one that includes regular meetings with a specially trained counsellor or health professional. They will explain how to use the meal replacement products and help you stick with the programme. They should also support you as you reintroduce foods to your diet, and help you develop healthy eating habits.Very low calorie diets are not a long-term weight management strategy and should only be used as part of a wider plan.

Will you benefit from a total diet replacement programme?

This intensive form of dieting helps you lose weight fast, but it does not suit everyone. It's designed for adults who are obese (BMI 30–40) or morbidly obese (BMI over 40) and remain overweight despite making healthy changes to their diet and lifestyle. However, those with a BMI of 27 or higher who also have related health problems may also benefit from it. If that doesn’t include you but you’re still overweight, try a less rigorous diet.

Why is it so important to lose weight if you are very overweight or obese? Obese people are more likely to develop Type-2 diabetes and are at risk of developing other health problems, including heart disease. If you’re insulin-resistant or pre-diabetic, losing weight will help reduce your diabetes risk. If you have Type-2 diabetes, recent studies indicate that losing weight may put you into remission.

A TDR is not for you if you are under 18, taking anti-obesity medication, having cancer treatment, have a heart condition and particularly if you have had a heart attack or a stroke in the past three months or are taking MAOI medication. It is also unsuitable if you are pregnant, breastfeeding or have given birth in the past three months. If you have any medical condition or are taking medication it is particularly important that you speak to your doctor before starting a TDR. If you drink alcohol well above the recommended safe limits or use non-prescription drugs a TDR is not suitable.

If you are taking medication to treat diabetes or high blood pressure it is also particularly important that you discuss your suitability for a TDR with your doctor before starting the programme.

How do you prepare for success?

Your chances of success are greatly improved if you’re prepared. Ask yourself ‘Am I ready for this?’. Think about whether there are things happening in your life that are going to make following a TDR particularly difficult – perhaps stressful events such as moving house. But if your weight is damaging your health, don't leave it long before starting, and don’t make excuses; clear the decks.

Keep a note of your progress

If your motivation starts to decline, looking back at how much weight you've lost could really help you stick to the programme, so always keep a diary of your progress.

Remove temptation from your kitchen

Spring-clean your kitchen. If you live alone, get rid of all foods. If you share a kitchen, separate your products into their own cupboard; this will be especially effective if you don’t have to cook for other people. If you are buying foods for the family, it’s a good idea to shop online, as you’ll be less tempted to buy things for yourself.

Ask for support from friends

It’s important to have support from friends, family and work colleagues while you are on a TDR; be specific with them about what they can do. It could be something as simple as saying ‘could you come for a walk with me in our lunch break?’ or ‘rather than going for a drink this weekend could we do something that doesn’t involve food and drink?’. Explain why losing weight is important to you.

What should you know before trying a TDR?

If your BMI drops to 25, stop your TDR. Otherwise, you can follow a TDR continuously for up to 12 weeks. In addition to the foods provided, you must consume plenty of water. Aim for 3 litres/5¼ pints of water spread out through the day; it doesn’t matter if it’s bottled, tap, still or fizzy. If you don't like the taste of your tap water, invest in a water filter.

How will you feel?

Let’s be honest, losing weight is difficult, so it’s important to keep in mind why you’re doing it and remember the health benefits. In the first couple of days you might feel tired, dizzy, irritable and listless and find it difficult to concentrate. These symptoms will get better. You will of course feel hungry, but your body will adapt.

Confusing thirst and hunger

Drinking plenty of water or other healthy calorie-free fluids can reduce these side-effects and help you avoid misinterpreting thirst as hunger.

Emotional eating

Boredom, stress, anxiety and loneliness are common triggers for eating. Remember that cravings are often transitory, lasting 3–5 minutes, so distract yourself; phone a friend or go for walk. It’s also a good idea to keep busy. Tiredness can make it harder to stick to a TDR, so be sure to get plenty of sleep.

Do you need supplements?

You should get all the nutrients you need from the products. The programmes can be low in fibre, which can increase your risk of digestive problems such as constipation, so it’s also a good idea to take a fibre supplement. Your pharmacist will be able to advise which is best for you.

What can you eat when you finish the programme?

When you have reached a BMI of 25 or have been on the diet for 12 weeks, whichever comes first, start to introduce foods slowly, reducing the number of meal replacement products you use each day. This period usually lasts four to eight weeks. It’s important that you keep the weight off, so be careful not to revert to your old eating habits. Continue to avoid processed carbs, such as biscuits. Weigh yourself regularly, at least once or twice a week, and consider returning to the TDR for a week or more if your weight starts to increase.