Te Kāika DiRECT

Tā mātou e tūhura ana

What we are investigating

Take | Issue

Obesity is one of the main risk factors for type 2 diabetes, heart disease and certain cancers. Aotearoa New Zealand has amongst the highest rates of obesity in the world, so we need more options for helping people who want to lose weight.

There is international evidence that a new Dietitian-supported intervention, known as the DiRECT protocol, of total meal replacement, followed by a weight-loss maintenance phase, is effective for long-term weight loss. Additional benefits include remission of type 2 diabetes and a reduction in the risk of related conditions such as heart disease, chronic kidney disease, retinopathy, nephropathy and lower limb amputation.

However, the feasibility or acceptability of this intervention has not yet been considered in Aotearoa New Zealand.

Whāinga | Aim

The purpose of this study is to consider the feasibility and acceptability of using the DiRECT protocol in Aotearoa New Zealand.

Huarahi i whāia | Approach

This is a randomised controlled study of 40 participants with obesity, and either prediabetes or type 2 diabetes, who are looking to lose weight. The study is being conducted within Te Kāika, a primary care provider in Dunedin.

Participants will be randomised to either one year of gold-standard usual care (dietetic counselling, grocery vouchers to afford healthy foods, and free gym membership) or a three-month programme of rapid weight loss via total meal replacement, followed by nine-months of weight loss maintenance support.

The trial will measure both quantitative outcomes (such as body weight, lipids and blood glucose control) and qualitative outcomes (such as the experiences of study participants, whānau and primary care providers).

Funding acknowledgement

This project also receives funding from:

The Ministry of Social Development and Pūtahi Manawa | Healthy Hearts for Aotearoa New Zealand.

Research presentation: A DiRECT approach to weight loss in Aotearoa
Healthier Lives Kōrero Tahi 2024: equity and beyond (13-14 February 2024)

Knowledge exchange

Whakawhiti Mōhiotanga

Video | kōnae whakaata

Healthier Lives Kōrero Tahi 2024: equity and beyond (13-14 February 2024)
- - - - A DiRECT approach to weight loss in Aotearoa (22 min)
Professor Mike Lean - presentation at Edgar Diabetes and Obesity Research 20th anniversary event (November 2023) (39 min)
Doctor Kim Ma'ia'i - presentation at Edgar Diabetes and Obesity Research 20th anniversary event (November 2023) (10 min)