“Father, you have thinned!” Priest Paul Lomas, one of the participants on BBC’s Big Crash Diet Experiment show earlier this year became something of a sensation when he lost an incredible 20% of his body weight and put his type II diabetes into remission, dramatically improving his health and coming off much medication. Other participants in the programme had similar astounding results. But what about the health claims that they made? Can these be substantiated by more solid research? Are these results widely achievable?
The short answer is YES!
As a medical herbalist and nutritionist, I first became aware of these very low calorie diets (VLCDs) whilst studying for my degree at the University of Lincoln, back in 2009. As part of my course we had to thoroughly investigate various diets and evaluate their effectiveness, and the diet I chose to look at was a formula food VLCD very much like the one featured in the BBC programme. Back then I had already begun to take an interest in Type 2 diabetes, and its precursor which is known by many names: Metabolic Syndrome X, Insulin resistance, and pre-Diabetes to name a few. I wanted to research a way to control this using a dietary approach, and I was astonished with some of the early results I found.
There is a strong association with Syndrome X and non-alcoholic fatty liver disease – medically know as Steatohepatits. I discovered that this was being caused by an over-consumption of refined carbohydrates, and the poor liver unable to process the vast volumes of carbs being consumed, begins to form fat deposits which then cause congestion and worsens a list of other symptoms like elevated blood fats (cholesterol) raised blood pressure, tiredness, and increased inflammation.
You might have heard of the French delicacy called Foie Gras – this is made by force-feeding an unfortunate goose or duck on vast quantities of corn, leading to it have a fatty liver, which is then consumed as an expensive luxury. The same thing happens when humans over-consume refined carbs. Fat is also laid down in the pancreas and this is where the insulin we need to metabolise sugars is made. As the amount of fat increases, the efficiency with which insulin can be made is reduced, and finally (over time) type II diabetes occurs. Metabolic changes also occur at cellular level, so the insulin that is being produced works less effectively around the body, this is known as insulin resistance.
So how can these VLCD’s help so dramatically where regular diets are less effective? It seems that the rapid weight loss these diets generate are particularly effective in losing fat from the liver and the pancreas. Research carried out at Newcastle University again confirmed what I’d discovered a decade or so ago: Professor Roy Taylor used innovative magnetic resonance methods which supported his Twin Cycle Hypothesis – that Type 2 diabetes is simply caused by excess fat within the liver and pancreas, and he published these findings in 2014. The professor then went on to set up a trial where the use of VLCD’s was used to reverse symptoms. The trial, DiRECT (Diabetes Remission Clinical Trial), found that almost nine out of 10 people taking part who lost 15kg or more put their Type 2 diabetes into remission. The study also found that almost half of those were still off all their Type 2 diabetes medication with normal blood glucose levels after one year.
Fast forward to this year and the BBC’s programme had bought this into the spotlight. Dietary advice given for decades is being challenged, and VLCD diets which were once called “whacky and unsafe” have now suddenly gained a respectability which should have been recognised many years ago. Even the NHS is apparently investigating their use as a primary care treatment via GPs for reversing these chronic diseases. It was reported in September that the NHS is conducting a much larger study to see if this should be rolled out to tackle the nation’s obesity and diabetes epidemic.
However, an important factor is missing in both the Newcastle and the NHS research. This is the input from a specially trained consultant, offering one to one support. The latest study called “Doctor referral of overweight people to Low Energy Total Diet Replacement (DROPLET)” has just been published and this shows that these very strict diets require a lot of personal support, and it is not likely that the over-stretched NHS will have the manpower to offer this. This research shows that the best clinical outcomes are achieved by a collaboration between GP’s and a commercial provider of a VLCD like the Cambridge Weight Plan. The TV programme dramatically showed how tough these diets can be, and doing them home alone is a recipe for failure. Furthermore, many people have complicated medical issues and should not attempt to do this plan unaided or unmonitored.
This latest research which was published in the British Medical Journal on 27th September clearly demonstrates that GP referral to a commercial provider offering full support like weekly weight ins, one to one counselling, and sound nutritional advice following a stepped plan which reintroduces conventional food in a structured stepped plan was far more effective than the usual care offered by GP surgeries. The DROPLET study results show that with a VLCD and individual behavioural support, there was a 70% greater chance of losing weight and keeping it off after 12 months compared to the regular care for obesity that surgeries offer. Through regular contact and follow up, weight loss can be maintained well beyond this one year shown in the study.
Below are two photos of Father Paul Lomas featured in the BBC programme, before and after following the VLCD plan. He now happily supports the use and promotion of Cambridge Weight Plan.
— Martin Schoenbeck BSc (Hons) M.N.I.M.H. is a consulting medical herbalist and nutritionist working in Lincoln.
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