Remission of type 2 diabetes was once thought impossible. But the landmark DiRECT trial showed it can be achieved, and it taught us that a cornerstone of remission is weight loss. The true challenge comes after: maintaining that progress in an environment that doesn’t always make it easy.
Since then, the NHS Path to Remission programme has taken this approach into routine care, offering real-world evidence of what works at scale. And now, GLP-1 medications are dominating headlines, promising rapid weight loss on a scale we’ve never seen before. But while the evidence is growing, so are the questions about long-term maintenance, about support, about access, and about what all this means for dietitians.
To help us navigate it, we’re joined by two experts at the forefront of remission care.
Dr George Thom works in Public Health at NHS Tayside, leading the type 2 diabetes prevention and remission service. He was part of the DiRECT research team and his PhD explored the challenges of weight loss maintenance.
Keren Miller is Clinical Expert Dietitian at Oviva, where she helped establish the national Type 2 Diabetes Path to Remission programme. With more than 20 years’ experience across NHS and digital health services, she’s played a key role in making remission support available at scale.
In this episode, we’ll explore what the evidence tells us about weight loss maintenance, how remission programmes are working in the real world, and where GLP-1s fit into the picture. We’ll also ask what this means for dietitians from supporting diet quality, to navigating patient expectations, to sustaining progress long term and what the future holds for obesity and remission care.
Show Notes
DiRECT Clinical Trial: https://www.directclinicaltrial.org.uk/
Oviva: https://oviva.com/uk/en/
Early findings from the NHS Type 2 Diabetes Path to Remission Programme: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00194-3/fulltext
Dr George Thom: https://www.linkedin.com/in/george-thom/
Keren Miller: https://www.linkedin.com/in/keren-miller-232756193/