Researchers followed people with type 2 diabetes who participated in an intensive weight loss program called Counterweight-Plus for 5 years. Participants lost an average of 6.1 kg (about 13 pounds) and 10% of them went into remission—meaning their diabetes essentially disappeared. The study found that the program actually saved the healthcare system money over time because fewer hospital visits and medications were needed. Even though some people’s diabetes may return eventually, the weight loss and health improvements lasted, making this an effective and affordable treatment option.
The Quick Take
- What they studied: Whether an intensive weight loss program called Counterweight-Plus could help people with type 2 diabetes lose weight, go into remission (have their diabetes disappear), and whether it would save money for the healthcare system.
- Who participated: People with type 2 diabetes who enrolled in the DiRECT study and followed the Counterweight-Plus weight management program for 5 years. The study tracked their weight loss, diabetes status, healthcare costs, and quality of life.
- Key finding: After 5 years, participants lost an average of 6.1 kg and 10% achieved diabetes remission. The program saved approximately £2,091 per person in healthcare costs over 5 years, mainly through fewer hospital visits and reduced medication needs. These savings covered the cost of the program itself.
- What it means for you: If you have type 2 diabetes, this program may help you lose weight and potentially reverse your diabetes, while also reducing the overall cost of your healthcare. However, results vary by person, and some people’s diabetes may return over time. Talk to your doctor about whether this approach is right for you.
The Research Details
This was a long-term cost-effectiveness analysis that followed real people with type 2 diabetes over 5 years. Researchers tracked two groups: one that received the Counterweight-Plus weight loss program (which included meal replacement shakes, structured eating plans, and regular check-ins with healthcare providers) and a comparison group receiving standard diabetes care. The study measured how much weight people lost, whether their diabetes went into remission, how much healthcare they used (doctor visits, hospital stays, medications), and how their quality of life changed.
The researchers then used mathematical models to predict what might happen over a person’s lifetime, assuming that people who achieved remission might relapse within 10 years. They calculated all the costs involved—including the program itself, doctor visits, medications, and hospital care—and compared them to the health benefits gained, measured in quality-adjusted life years (a way of combining how long people live with how well they live).
This type of analysis helps healthcare systems decide whether a treatment is worth the investment by comparing its cost to the health benefits it produces.
Understanding whether a treatment saves money is just as important as knowing whether it works. This study shows that even though the weight loss program costs money upfront, it pays for itself through reduced healthcare needs. This information helps doctors and patients make informed decisions and helps healthcare systems decide which treatments to offer.
This study is based on real-world data from an established clinical trial (DiRECT), which makes it more reliable than theoretical predictions alone. The researchers used actual healthcare costs and quality of life measurements from participants. However, the study relies on mathematical models to predict what happens beyond 5 years, which introduces some uncertainty. The study assumes that people who achieve remission will relapse within 10 years, which may or may not happen for everyone.
What the Results Show
Over 5 years, participants in the Counterweight-Plus program lost an average of 6.1 kg (about 13 pounds) and 10% achieved diabetes remission. The program cost £1,691 per person to deliver over 5 years. However, the program saved £2,091 per person in other healthcare costs, meaning it paid for itself and saved an additional £400 per person.
The biggest savings came from fewer hospital admissions. People in the program spent less time in the hospital, which is expensive. Additional savings came from fewer doctor visits and lower medication costs for blood pressure and diabetes management. On average, healthcare costs were about £480 per person lower each year in the intervention group.
Beyond just saving money, people in the program reported better quality of life. The program produced 0.043 quality-adjusted life years per person over 5 years, which means people lived better-quality lives. When researchers projected these results forward over a person’s entire lifetime, the program was estimated to save £496 per person while producing 0.08 additional quality-adjusted life years.
The study found that most of the intervention costs occurred in the first 2 years, with relatively little additional cost in years 3-5. This suggests that once people establish new eating habits and lose weight, maintaining the program becomes less expensive. The quality of life improvements associated with diabetes remission were significant, even for the 90% of people whose diabetes didn’t go into complete remission but who still lost weight. The program also appeared to reduce mortality risk in people who achieved remission, providing additional long-term health benefits beyond what was measured in the 5-year period.
This 5-year analysis builds on earlier 2-year results from the same study, which also showed cost-effectiveness. The longer follow-up confirms that the benefits persist and that the program remains cost-effective over time. This aligns with other research showing that structured weight loss programs can improve type 2 diabetes outcomes, though this study provides stronger evidence about the financial benefits. The finding that the program saves money while improving health is particularly important because many healthcare interventions cost money without producing savings.
The study relies on mathematical models to predict what happens after 5 years and over a person’s lifetime, which introduces uncertainty. The researchers assumed that people who achieve remission will relapse within 10 years, but this may not happen for everyone—some people may maintain remission longer. The study doesn’t provide information about the sample size or how many people participated, which makes it harder to assess how broadly these results apply. The program studied involved face-to-face appointments with healthcare providers, which is more expensive than remote delivery options that are increasingly being used. Results may vary depending on a person’s age, overall health, and ability to stick with the program.
The Bottom Line
If you have type 2 diabetes and are overweight, ask your doctor about structured weight loss programs like Counterweight-Plus. The evidence suggests these programs can help you lose weight, potentially reverse your diabetes, and reduce overall healthcare costs. The program works best when combined with commitment to dietary changes and regular follow-up with healthcare providers. Even if your diabetes doesn’t go into complete remission, weight loss alone provides significant health benefits. (Confidence level: Moderate to High—based on 5-year real-world data, though individual results vary)
This research is most relevant for people with type 2 diabetes who are overweight or obese and interested in intensive weight loss. It’s also important for healthcare providers and insurance companies deciding which diabetes treatments to offer and support. People with type 1 diabetes or those who cannot commit to dietary changes may not benefit as much. Pregnant women and people with certain medical conditions should consult their doctor before starting any weight loss program.
Weight loss typically begins within the first few weeks of the program. Diabetes remission may take several months to achieve and occurs in about 1 in 10 people. Healthcare cost savings accumulate over time, with the program paying for itself within about 5 years. Quality of life improvements can be noticed within weeks to months as weight decreases and energy increases.
Want to Apply This Research?
- Track weekly weight (same day, same time each week), blood sugar readings if available, and number of diabetes medications taken. Set a goal of losing 5-10% of body weight over 6 months and monitor progress toward this target.
- Use the app to log daily meals and track adherence to the meal plan provided by your healthcare provider. Set reminders for scheduled healthcare provider appointments and medication times. Record energy levels and how you feel each day to monitor quality of life improvements alongside weight loss.
- Create a dashboard showing weight trend over time, medication changes recommended by your doctor, and quality of life scores. Compare monthly progress against your initial baseline. Share reports with your healthcare provider at regular check-ins to adjust the program as needed and celebrate milestones like 5% and 10% weight loss.
This research describes the effectiveness and cost-effectiveness of the Counterweight-Plus weight loss program for type 2 diabetes. Individual results vary significantly, and not everyone will achieve diabetes remission. Before starting any weight loss program or making changes to diabetes medications, consult with your healthcare provider. This information is not a substitute for professional medical advice. People with type 1 diabetes, pregnant women, and those with certain medical conditions should not undertake weight loss programs without medical supervision. The financial savings described are based on UK healthcare costs and may differ in other countries or healthcare systems.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.