NHS 'Soup and Shake' Diet Targets Diabetes Crisis in Overweight Patients

A New Approach to Tackling Obesity in Scotland

Scotland is taking a bold step in its fight against obesity by introducing a groundbreaking initiative that involves prescribing low-calorie soups and shakes through the National Health Service (NHS). This move aims to address one of the country’s most pressing health challenges, which has been exacerbated by rising rates of overweight and obese individuals.

The new program, known as Total Diet Replacement, is designed for patients who have recently been diagnosed with type 2 diabetes. These individuals will receive calorie-restricted meals that replace their usual breakfast, lunch, and dinner. The daily intake will be limited to a maximum of 900 calories, and these meals will be delivered directly to their homes for a period of three to five months.

Following this initial phase, patients will gradually reintroduce normal food into their diet while receiving guidance on healthy eating through online consultations and an app. The goal is for participants to lose up to 10% of their body weight over the course of a year. This weight loss is expected to lead to lower blood pressure and a reduced risk of various diseases. Additionally, medical professionals are hopeful that up to 40% of participants will achieve remission from type 2 diabetes within the same timeframe.

The NHS has described this initiative as a “new, high-impact technology” that could significantly improve patient outcomes and contribute to the overall renewal of healthcare services across Scotland. Obesity remains one of the most serious health issues in the country, with approximately one-third of the population classified as obese and another third considered overweight.

Type 2 diabetes affects around 300,000 people in Scotland, a condition often linked to obesity. Poorly managed blood sugar levels can increase the risk of heart disease, kidney disease, stroke, and nerve problems. In recent years, the NHS has conducted small-scale trials of Total Diet Replacement, which is also available through private clinics. Starting in January, around 3,000 patients nationwide will be enrolled in the National Digital Type 2 Diabetes Remission Programme.

Participants will receive meal replacements such as soups, shakes, or food bars, which will be delivered directly to their homes. An app will track food and drink intake, weight, blood pressure, blood glucose levels, and exercise, providing dietary advice and tips on maintaining long-term weight loss. Patients will also have access to online support from a health coach.

In recent years, doctors have turned to semaglutide-based treatments like Ozempic, Wegovy, and Mounjaro, which suppress appetite and can lead to significant weight loss. High-profile individuals, including Oprah Winfrey, Whoopi Goldberg, Elon Musk, and Sharon Osbourne, have publicly discussed their use of these medications. Recent data show that the NHS in Scotland now prescribes a record 10,000 of these so-called “fat jabs” each month.

However, a year's supply of these injections costs approximately £3,000 per person. There are concerns that the benefits may only last as long as the patient continues taking the drug. In contrast, the soup and shake program is expected to be more cost-effective and sustainable. The scheme is projected to cost £5.6 million for 3,000 patients, translating to a one-time cost of about £1,866 per individual.

The Scottish Government has stated that the program will support 3,000 people newly diagnosed with type 2 diabetes over the next three years, with the first group recruited in January 2026. It is anticipated that 35 to 40% of participants will achieve remission from type 2 diabetes at the end of their first year on the program. The majority of patients are expected to experience a clinically significant average weight loss of 10%, along with reductions in blood pressure, all contributing to a decreased risk of cardiovascular disease.

The success of the program will be measured by the number of patients recruited, those who achieve remission, and the number experiencing clinically significant weight loss. This initiative represents a major shift in how Scotland approaches the management of obesity and type 2 diabetes, offering a potentially transformative solution for patients and the healthcare system alike.