This program is for adults living in the United Kingdom who would like to prevent type 2 diabetes or who have type 2 diabetes and want to manage and reverse the condition.

Counterweight® Plus, a community-based, weight-loss program, is designed to help prevent, manage and/or reverse type 2 diabetes.

A cluster randomized controlled trial (RCT) across 49 primary-care practices in England and Scotland found that 24% of participants in the intervention group achieved and maintained a weight loss of 15 or more kilograms (kg) at 1 year compared to 0% of control participants. At 1 year, 46% of intervention participants and 4% of control participants achieved diabetes remission. At 2 years, significantly more intervention participants had a weight loss of at least 15 kg (11% vs. 2%) and had remission of diabetes (36% vs. 3%) compared to the control group. Posttest results from one RCT conducted among participants with difficult-to-treat asthma and obesity demonstrated significantly greater improvements in asthma control, quality of life, and weight loss in the intervention group, compared to the control group, over 16 weeks of treatment. Results from several single-group studies indicate significant weight loss up to 24 months and significant improvements in body composition, blood pressure, triglycerides, diabetes remission, diabetes distress, quality of life, well-being, self-esteem, and depression at 12 months.

Counterweight Plus intends to encourage behavioral changes that support and enhance weight loss and weight-loss maintenance. The following options are available:

• Type 2 diabetes prevention – participants are supported by a dietitian in changing their behaviors, losing weight, improving blood glucose levels, forming new habits, and improving overall health to prevent and lower the risk of type 2 diabetes.
• Type 2 diabetes remission – participants are supported by a dietitian as they combine meal replacements with behavior change to lose weight, improve blood glucose levels, reduce use of medications, and possibly move type 2 diabetes into remission.

The program is delivered in the following three phases:

• Stage 1: Total diet replacement – participants eat calorie-controlled porridge, soups, and shakes and receive support from their dietitian to reach personal weight loss and health goals;
• Stage 2: Food reintroduction – participants gradually reintroduce foods into their diet while building healthy habits, receive personalized advice from their dietitian, learn how to plan and prepare healthy meals, increase daily activity, and learn skills and strategies to maintain progress; and
• Stage 3: Weight-loss maintenance – each participant’s progress is monitored, and they receive long-term support from their dietitian, including tips; recipes; motivation; support; and advice about nutrition, exercise, sleep, stress management, and behavior change.

The original Counterweight program was created in 2000. Counterweight Plus was used in the Diabetes Remission Clinical Trial (DiRECT), which is the world's largest study of type 2 diabetes remission funded by Diabetes UK. The program is currently available in Cornwall Isles of Scilly; Shropshire, Telford and Wrekin; North West London; Suffolk and North East Essex.

This program is facilitated by Counterweight dietitians. Information on training was not located. Please use details in the Contact section to learn more.

Considerations for implementing this program include understanding this program is currently only available in the United Kingdom, acquiring buy-in and commitment from participants, and ensuring participants have access to the program’s mobile app.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing Counterweight Plus, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

This program lasts 1 year. The total diet replacement stage is 12 weeks and includes 7 appointments; the food reintroduction stage lasts 2 to 8 weeks and includes 6 appointments; the weight loss maintenance stage is 6 months and includes 6-18 appointments.

According to Xin et al. (2020), the intervention is predicted to be more effective and cost saving in adults with type 2 diabetes compared with standard care due to healthcare cost savings from periods of remission from diabetes and its complications. There is a mean total lifetime cost savings per participant of £1337, and the intervention becomes a cost-saving within 6 years.

To move Counterweight Plus to the Effective category on the Clearinghouse Continuum of Evidence at least one external evaluation must be conducted that demonstrates sustained, positive outcomes lasting at least two years from the beginning of the program or at least one year from program completion. This study must be conducted independently of the program developer.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals.  Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu

You may also contact Counterweight by phone 020 3026 8800 or visit https://www.counterweight.org/pages/get-in-touch

https://www.counterweight.org/pages/type-2-diabetes