{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:32:09Z","timestamp":1787027529745,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      Structured meal replacement low energy diets (MR\u2010LED) are effective in obesity management, but evidence for individuals of minority ethnic groups or those with BMI &gt;35\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and significant comorbidities is limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We evaluated the early effectiveness of a weight management program delivered by a multidisciplinary team within a specialist weight management service. We enrolled three groups: those who had been declined bariatric surgery, young adults with type 2 diabetes (T2D), and people awaiting corneal transplant who had their procedure deferred due to their weight. Individuals were primarily treated with a 12\u2010week MR\u2010LED. Adjunctive obesity medications were available under pre\u2010specified criteria. The present study reports outcomes following the 12\u2010week MR\u2010LED, which was the first phase of a 12\u2009month programme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 1172 people screened, 482 met inclusion criteria and 128 commenced MR\u2010LED. Most participants (111\/128, 87%) had previously been declined bariatric surgery; 11\/128 (9%) were young adults with T2D and 6\/128 (5%) were awaiting corneal transplant surgery. Ninety\u2010three individuals (73%) were from Pacific or indigenous M\u0101ori ethnic groups. The cohort had mean (SD) baseline weight of 145.0 (38.6) kg (BMI 49.9 (11.3) kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ); 94 (73%) had T2D on treatment, with a mean HbA1c of 67.6\u2009mmol\/mol (11 young adults and 83 from the bariatric surgery declined list). Psychological distress was common with 41% and 30% having moderate depressive and anxiety symptoms, respectively. Ninety\u2010two people (72%) completed the 12\u2010week MR\u2010LED, achieving a mean (SD) weight loss of 10.9 (7.8) kg. Young adults with T2D were less likely to complete the programme. Among people with diabetes, 63\/94 (67%) completed the 12\u2010week intervention, with 21\/63 (33%) achieving an HbA1c &lt;50\u2009mmol\/mol on no diabetes medication. Psychological and quality of life scores improved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A 12\u2010week MR\u2010LED intervention delivered in a specialist service achieved clinically meaningful weight loss and improved metabolic and psychological outcomes in a high\u2010risk, multi\u2010ethnic cohort living with higher body weight.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70574","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T01:46:43Z","timestamp":1771552003000},"page":"3924-3932","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uptake and early outcomes of a meal replacement intervention in an ethnically diverse adult population living with obesity and significant comorbidity"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8444-4201","authenticated-orcid":false,"given":"James","family":"Shand","sequence":"first","affiliation":[{"name":"Department of Medicine Faculty of Medical and Health Sciences, The University of Auckland  Auckland New Zealand"},{"name":"Te Mana Ki Tua, Specialist Weight Management Service Counties Manukau Health New Zealand, Te Whatu Ora  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Brosnahan","sequence":"additional","affiliation":[{"name":"School of Medicine, Dentistry and Nursing University of Glasgow  Glasgow UK"},{"name":"Counterweight Ltd.  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Statistics Faculty of Science, The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0043-2423","authenticated-orcid":false,"given":"Rinki","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medical and Health Sciences, The University of Auckland  Auckland New Zealand"},{"name":"Te Mana Ki Tua, Specialist Weight Management Service Counties Manukau Health New Zealand, Te Whatu Ora  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0176-8"},{"key":"e_1_2_8_3_1","unstructured":"World Health Organisation.Obesity and Overweight; Geneva Switzerland: World Health Organisation; 2025 [cited 2025 November 25].https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight"},{"key":"e_1_2_8_4_1","unstructured":"Ministry of Health.Obesity Statistics. 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