NHS Low Calorie Diet FAQs

Hopefully, you’ll find the answer to your questions below.

Oviva is a leading provider of NHS services, combining the support of dietitians, diabetes specialist nurses, health coaches and psychologists with technology to make healthcare more convenient and accessible to all.
We blend behaviour change therapy with our unique technology and incredible team to support people to improve their health and better manage their conditions. We partner exclusively with the NHS to offer our programmes across the UK to participants for free. To put it simply, we help people lead healthier and happier lives.
Oviva have partnered with the NHS to deliver a programme for people who living with overweight and living with type 2 diabetes. In this 12 month programme, participants will be supported by their own Diabetes Specialist Dietitian and Health Coach to lose weight using a low calorie diet, improve their blood glucose levels, reduce their medications, and potentially put their type 2 diabetes into remission. Coaching can be carried out over phone/video calls, or via secure app messaging in the Oviva app. However, participants from South West London have the option of face to face care along with the use of our digital tools.
After confirming eligibility and discussing the service with your patient for the pathway please complete the referral form which is embedded into your clinical system and send to: ovivauk@nhs.net. Oviva can also support case finding to identify and invite eligible participants to join the programme. As part of the referral, the referrer must discuss any medication changes to take place on the first day of TDR and provide written confirmation of these changes to the patient and Oviva (please see the referral form for full information)
Upon starting the 12 month programme, patients will have the choice to be matched with their own personal coach or coach-led support group. Coaching can be carried out over phone, video calls or the Oviva app. They will have an initial consultation with a Diabetes Specialist Dietitian who will help them prepare for the journey ahead, creating a tailored plan. During the initial consultation, patients will find out more about the low calorie diet phase of the programme and their dietitian will be able to answer any questions that they may have.
Patients will then start the Low Calorie Diet using Total Diet Replacement (TDR) products which lasts for 12 weeks. After this, their dietitian and health coach will help them to reintroduce food over 4 weeks and help build new healthy habits. Patients will be able to use the Oviva app to track weight loss, log their food diary and read weekly resources to help build new healthy habits.
For the remaining 8 months of the programme, patients will work on sustaining these healthy habits to keep weight loss and improvements to their diabetes management, with regular support from their health coach. If they start to regain weight, they will also have the chance to do the refocus stage.
Patients will be able to use the Oviva app to track their progress, log their food, mood, activity and communicate with their coach. Throughout the 12 month programme, new learning modules and resources on Oviva Learn will be available for patients to read, watch and listen. This will provide them with information on how to help them with making long-term changes to their lifestyle.
No, and this is in line with what the research shows too, however patients who have done this programme and not managed to achieve this ultimate goal are still delighted to make healthy changes. They usually weigh far less than at the start of the programme and have improved blood glucose and blood pressure. They may even be on less prescribed medication.
Patients have commented that their health would have been far worse if they had not completed the programme. Remission is not the only measure of success.
Blood glucose and blood pressure monitoring equipment is provided by Oviva and sent directly to the patient. All the ancillaries required for the year long programme are provided too.
Participants are empowered and supported to take the measurements themselves. For any patients seen in person these measurements are taken at the face-to-face appointment. For those participants supported remotely, the measurements are taken in the comfort of their own home at a time agreed between the participant and their coach.
HbA1c should be checked at month 6 and at month 12. This helps ensure the safety of the participant who is likely to have made significant lifestyle and medication changes. It also helps to know if the intervention is producing the desired outcome, providing valuable feedback to those supporting the participant but also the participant themselves. Having these HbA1c results will also help primary care know if the participant can be coded as being in remission or not. (A reminder: remission is achieved when HbA1c is under 48mmol/mol on 2 separate occasions with a 6 month interval between while not on any diabetes medication).
The Oviva coach is responsible for identifying any adverse effects and events. Where appropriate, advice will be provided e.g. helping to alleviate constipation and appropriate clinical action will be taken, which may include alerting the GP for further action e.g. out of range blood pressure reading. The Oviva coach will write to the GP via nhs mail to alert the GP.
The participant is also empowered with a learning module titled ‘How to stay safe and what to do if you don’t feel well’. This includes clinical readings which are acceptable and which ones they should alert the coach to.
Every participant is able to pause the programme once for a maximum period of 4 weeks. Making lifestyle changes is challenging and we therefore acknowledge that it may be appropriate and in the best interest of the participant to take a pause from the programme. The GP will be informed if this is the case as it may be appropriate to restart some medication temporarily. Participants must restart after a maximum of 4 weeks and those unable to will be discharged back to their GP.
Special occasions are managed on an individual case by case basis. We take into consideration the type of occasion and the role of food within it, we consider the impact on the individual, their family, culture and faith. We also consider how long the occasion may last. A holiday may be managed differently to a wedding or Ramadan.
In some circumstances it may be a temporary reduction in the number of meal replacements to allow for a special meal, in other situations the timing of meal replacements may be considered. For some a 4 week pause may be most appropriate. The Oviva coach will work with the individual to agree the best strategy for the situation. Special occasions and learning how to manage them while managing new lifestyle choices is an important part of the year long programme.
Every patient is sent blood glucose monitoring equipment and the ancillaries required for the year-long programme. Those on antihypertensives at the start of the programme are sent blood pressure monitoring equipment. (If patients already have their own monitoring equipment we are happy to let them continue to use these devices that they are already comfortable with). In the initial intense phase of the programme where we expect many significant clinical changes (due to the dramatic change in intake and significant weight loss) we monitor these readings every week. As they move in to the sustain phase of the programme and become established within their ‘new normal’ the monitoring reduces to monthly but can increase if this is clinically indicated.
If any reading is of concern (either too high or too low) we will liaise back to the refer as soon as this is identified.
We follow the clear guidance set out by NHSE for this LCD remission programme. That includes ensuring appropriate medication adjustments are made on the day they start the total diet replacement. This helps to manage clinical risk from the start e.g. hypoglycaemia.
The programme is clinically lead by experienced healthcare professionals who are available to support both the patients and the clinical team looking after the patients.