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My initial reaction to this headline was

what the fuck? That’s a terrible idea

And after reading it I feel the same way. We’ve already been through this in the 80s with the all liquid diet scams. The inevitable result is that you regain everything when you start eating normally again. The article itself even mentions this outright.

There’s a ton of nuance to this if weight loss is urgently needed and the diet is prescribed by a doctor. I just hope people don’t skim the headline and set themselves up for yet another round of futile diet scams.

This is not a great diet plan. Liquids aren’t as filling as solids, can be consumed quickly, and digested faster. Plus, this plan leaves you dependent on shake makers/brands instead of managing your own diet.

Also, diets don’t work, stop calling it that. Diets are temporary things. A real T2 mitigation plan will require permanent lifestyle and dietary changes, including some sort of exercise regimen and reducing carbohydrates intake and increasing fiber intake to promote fullness and help reduce cravings between meals.

Lastly, I wish these articles would stop suggesting you can reverse (as in cure) type 2 diabetes. There is no cure currently, only lifelong management and control.

Source: I’m a well managed type 2 diabetic for 12 years, in good health and fitness level.

So, while the results of the study are promising for some patients, more work needs to be done to ensure weight loss is maintained post-plan.

There's a great podcast called Maintenance Phase that's all about the diet industry's bullshit. They chose the title because once a dieter stops doing a diet, they return to the weight they were before (~80% of dieters according to this metaanalysis ). The diet is the maintenance phase. You can never stop.

This diet is a low calorie diet that keeps intake under 1000 calories. That's not healthy for the long term. This diet, like all diets, is crap.

Part of the difficulty in maintaining such extreme calorie restriction may lie in food choice and portion control. There is a challenge in eating enough of the correct foods to consume enough nutrients and remain full enough to avoid straying from the diet.

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Total diet replacement plans remove the element of choice for patients, making a diet easier to follow and increasing the chance that patients will stick with it.

The NHS soup and shake diet involves following a calorie restricted diet (800-900 kcal) of low calorie, nutritionally complete, total diet replacement products – made up, as the name suggests, of soups, shakes and bars – before reintroducing other foods, bridging progression onto a healthy maintenance diet, supported by coaches for 12 months.

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The results confirmed that total diet replacement plans can induce weight loss as well as a decrease in HbA1c. In some patients this was enough to induce diabetes remission. Great news indeed.

However, this is only one piece in a more complicated jigsaw puzzle. Not everyone who follows the plan will be able to reverse their diabetes. For example, even though the soup and shake diet restricts patient food choice as well as calories, sticking to a liquid only plan can still be difficult for some.

This diet is based on Dr. Roy Taylor’s research on Type 2 Diabetes, and its reversal. He and his team noticed that people with T2D have fat in their liver and pancreas. They confirmed this with a new MRI imaging technique that they developed. Regardless of body weight, if you have fatty liver/pancreas you have T2D or at least pre-diabetes. But, if your liver and pancreas are healthy, you can be overweight and not have T2D.

They call it the twin cycle hypothesis. Google it up, but short is this. If fat builds up in your liver, it starts a cycle that among other things causes the liver to send fat in to your pancreas, which starts another cycle in the pancreas, which feeds the liver’s cycle. As the pancreas gets more and more fatty, the insulin producing beta-cells begins to de-activate, which leads to T2D.

They wanted to test whether this hypothesis is true, and if so, is T2D reversible. How to do that? Their T2D test subjects must loose weight. What’s the fastest way to do that? Extreme caloric restriction.

They put their subjects on a diet consisting of 4 doses of meal replacement formula per day (800kcal/day). Their subjects noticed that it’s actually quite easy to stick to that diet after couple days.

The results of their studies is that if people loses enough fat to free their pancreas from fat, their pancreas can heal and return to normal, reversing T2D. But, there is always a but. If T2D has been going for too long (over 6 years in their studies), too many of the beta-cells have died, and full reversal of T2D is not possible.

Note: Extreme caloric restriction is very dangerous if you are on T2D medication. Do your own research and talk to your doctor. I tried to use correct terms so it’s easy to check the things.