Meal replacement plans for type 2 diabetes remission

We're going to explore whether meal replacement plans can help you put your type 2 diabetes into remission.

What are meal replacement plans used for?

Meal replacement plans are short-term weight loss plans where you replace all, or some, of your meals with specially formulated food products. 

These are products like soups, shakes and bars. You can buy them from supermarkets, health food shops, and online. In some circumstances, meal replacement products are available through the NHS and health services too.

Depending where you get your soups and shakes from and what brand you use, they might be ready mixed or in powder form. 

There are two main types of meal replacement plans. 

Total diet replacement programmes (TDR)

With a total diet replacement programme you replace all food with soups, shakes and bars. Some people call them a ‘soups and shakes’ diet.

These soups, shakes and bars are designed to contain all the nutrients, vitamins, and minerals your body needs to work properly. Because of this, it’s not possible to make total diet replacement products yourself at home. And when choosing a plan, it’s important to check that the products are nutritionally complete before you purchase them. 

Most total diet replacement plans are a type of low-calorie diet. This is because the total calories consumed is 800-1200 calories a day. If a plan has a total daily amount of under 800 calories, it is a very low-calorie diet.  

For most people, a total diet replacement programme can be followed for periods up to 12 weeks.

In some areas of the UK, the national health service offers meal replacement plans as part of type 2 diabetes support programmes.  

Partial meal replacement plans

These plans are made up of a mix of ordinary food and specially formulated products like shakes, soups, porridge, bars and snacks. Most people swap their usual breakfast and lunch for these products and have a healthy balanced meal in the evening. 

Do total diet replacement plans work for type 2 diabetes remission?

Total diet replacement – replacing all meals with nutritionally complete 'soups and shakes' – is a key part of the weight management programme that's been shown to work to help many people put type 2 diabetes into remission. It's the first step of NHS remission programmes around the UK too. 

Research shows that total diet replacements can kick start weight loss by helping people lose weight quickly. This often motivates people to make the long-term changes to their diet that are needed for a total diet replacement plan to lead to type 2 diabetes remission. Total diet replacement plans are not a long-term diet approach.

For most people, a 'soups and shakes' diet should not be followed for more than 12 weeks. After this time, you need to slowly reintroduce ordinary healthy foods into your diet over a number of weeks. The next step is to continue with a healthy balanced diet with regular physical activity to help you keep off the weight you've lost. 

Support from your healthcare team helps

Whether you try a total diet replacement plan as part of an official NHS remission programme, or try it yourself using branded products you can buy from shops, support from your healthcare team is really important.

They can help you build healthy food and physical activity habits that you can stick to after you finish your total meal replacement plan.

People who have followed a total diet replacement plan as part of a remission programme tell us that this sort of support was crucial in helping them get into remission and stay there. 

"My routine was a shake in the morning, a soup at lunch time, a shake in the afternoon and then a soup at teatime.

We were gradually weaned back onto real food again by reducing the soups and shakes and building in real food.

Only then were we able to do some exercise, which was when I noticed I wasn't getting the same stiff joints which was a big bonus and I wasn't out of breath walking up the hill to house." – read more of Peter's story.

Do total diet replacement plans work for type 2 diabetes remission?

Partial meal replacement plans don't have the same level of research available as total diet replacements to say that they work for type 2 diabetes remission.

But we do know that weight loss is the key to remission, and partial meal replacement plans can help people lose weight.

Is a meal replacement plan right for me? 

Some people find meal replacement plans an easy and convenient way to lose weight quickly, while getting the nutrients their body needs. Lots of people who have used a meal replacement plan say they find it much easier than trying to calorie count their usual meals and snacks.

Safety considerations 

It's not safe to use meal replacement plans if you are:

• under 18 years old
• have eating disorders or mental health conditions
• are having cancer treatment
• have a heart condition
• pregnant, breastfeeding or have given birth in the last three months.

There are other health conditions that make meal replacement plans unsafe to try too. Speak to your healthcare team for more information.

Your healthcare team are the best people to ask

Restricting calories and making a big change to your diet like this can affect your diabetes as well as other health conditions, and any medications you take.

So, the best way to tell if a meal replacement plan is right for you is to get support from your GP or diabetes nurse. They can help you:

• decide whether a meal replacement plan is safe for you based on your weight and medical history.
• make appropriate changes to any medications you're taking.
• choose safe and nutritionally balanced meal replacement products.
• manage any side effects you might get while you're on the meal plan.
• think about what levels of physical activity you should be doing while on the plan.
• keep the weight off long after the meal replacement plan has ended.
• get support from other healthcare professionals, like a dietitian, if available. 

Choosing meal replacement products

Meal replacement products are regulated by law. This means they have to meet certain criteria to be considered safe. Get more information on how to pick meal replacement products that are safe.

Where can I go for more information?

NHS and health services

In some areas of the UK, health services offer type 2 diabetes remission programmes that use total diet replacement plans. 

Your healthcare team will be able to tell you whether an NHS remission weight loss programme might be an option for you.

• If you live in England and think a total diet replacement programme might be right for you, speak to your healthcare team about the NHS Path to Remission Programme. 
• If you're in Scotland, Wales or Northern Ireland, take a look at our support for type 2 remission guide for more information on what support is available in your area. 

Tips for choosing meal replacement products

We don't promote any brands of meal replacement products. But we know that some people may want to try meal replacement products available in shops and online. 

Meal replacement products for ‘weight control’ – what we call managing your weight – are regulated by law. There are rules around what needs to be in the products and what companies can say about the products.

Total diet replacement products

For a total diet replacement where the products are replacing all meals, the products should:

• provide between 800 calories and 1200 calories per day.
• provide at least 100% of the daily vitamins and minerals that the law says they should.
• contain at least 10g of fibre, but not more than 30g of fibre in total per day.
• contain no more than 125g of protein in total per day.
• provide enough of the essential fat which our bodies cannot make. But the daily products shouldn’t be made up of more than 30% fat.

Some brands that meet these rules are Optifast and Counterweight. 

Partial meal replacement products

For partial meal replacements where you swap one or more meals with a product, each product you swap one meal for should:

• provide between 200 and 400 calories per meal
• provide at least 30% of the amounts of vitamins and minerals that the law says, per meal
• contain least 500mg of potassium per meal
• contain no more than 30% fat per meal
• be made up of between 25% and 50% of protein per meal.

Some partial meal replacement that meet these rules are Almased, SlimFast Flavour Shakes, Tesco Slim shakes, Sainsbury Shape and Slim Meal Replacement Shakes, Almased meal replacement shakes, Tesco Slim meal Replacement Shakes and Exante meal replacement products. 

Before making any changes to your diet, speak to your healthcare team. They can give you more advice on these products and may be able to refer you to a dietitian.