Published on: 19 February 2026

Obesity poses a formidable challenge globally, especially among ethnically diverse groups with significant comorbidities. Recent advancements in weight management highlight the potential of structured meal replacement low energy diets (MR-LED) as an effective therapeutic option. This summary explores the uptake and early outcomes of a MR-LED program implemented in South Auckland, New Zealand. The insights hold relevance for healthcare professionals engaged in metabolic health and weight management, with a particular focus on ethnically diverse populations facing severe obesity.

Bridging Gaps in Weight Management for High-Risk, Multi-Ethnic Populations

South Auckland represents a microcosm of obesity’s disproportionate impact on indigenous Māori, Pacific peoples, and socioeconomically deprived communities. Publicly funded bariatric surgery remains limited due to resource constraints, leaving many individuals without access to effective interventions. The introduction of the Te Mana Ki Tua (TMKT) specialist weight management service fills this critical gap by offering a structured, multidisciplinary MR-LED program.

The TMKT program primarily targets adults aged 18 to 70 years with a body mass index (BMI) of 35 kg/m² or greater, compounded by significant obesity-related conditions likely to improve with weight loss. This focus ensures that the intervention addresses those with the highest clinical need who have historically faced barriers to care. Notably, the program also includes young adults with type 2 diabetes and individuals deferred from corneal transplant surgery due to their weight.

Structured Meal Replacement Diets: A Clinically Effective Strategy

The core intervention consists of a 12-week MR-LED phase, which initiates the 12-month TMKT weight management journey. Participants consume low-calorie meal replacement products, carefully calibrated to meet protein requirements and supplemented with non-starchy vegetables or fiber. The regimen eliminates conventional food intake during this phase, promoting rapid and significant weight reduction.

Adjunctive obesity medications such as liraglutide are available based on individual response, especially for those not achieving expected weight loss milestones. Behavioral support, including group sessions and access to health psychologists, complements the dietary intervention, addressing psychological distress and enhancing adherence.

Impressive Early Outcomes in a Complex Cohort

Among the 128 participants who commenced the MR-LED program, the majority were individuals previously declined for bariatric surgery, predominantly from Māori and Pacific ethnic groups. The cohort exhibited complex health profiles, including an average baseline BMI near 50 kg/m² and a high prevalence of poorly controlled type 2 diabetes. Psychological distress was common, with many experiencing moderate depression and anxiety.

Despite these challenges, 72% completed the initial 12-week phase, achieving a mean weight loss of nearly 11 kilograms. This result aligns with or surpasses outcomes seen in less complex populations, demonstrating the intervention’s robustness. Furthermore, quality of life and psychological health scores improved significantly. Among those with type 2 diabetes, glycemic control improved, with a notable proportion achieving remission criteria without medication.

Retention Challenges and Strategies for Diverse Populations

While retention was substantial, attrition reached 28%, with younger adults and individuals from the young adult diabetes group showing higher dropout rates. Factors such as competing life priorities and cultural food practices may underlie these challenges. Transitioning from highly structured group formats to more flexible, individualized support could enhance engagement among younger and ethnically diverse participants.

The TMKT program’s multidisciplinary approach, including psychological support, appears instrumental in addressing the multifaceted needs of this population. Continued evaluation will refine strategies to optimize retention and long-term outcomes.

Implications for Healthcare Professionals in Global Muslim Weight Management

This evaluation underscores the feasibility and efficacy of MR-LED interventions within multi-ethnic, high-risk populations. For healthcare professionals working in global Muslim weight management contexts, these findings emphasize the importance of culturally sensitive, multidisciplinary care models that integrate meal replacement diets and behavioral support.

Providing free access to meal replacements and specialized clinical teams removes financial and structural barriers, fostering equitable care delivery. Additionally, the observed improvements in metabolic and psychological outcomes highlight the comprehensive benefits of MR-LED programs beyond weight loss alone.

Conclusion: Advancing Equitable, Evidence-Based Obesity Care

The TMKT service serves as a pioneering model demonstrating that structured meal replacement low energy diets can deliver meaningful weight loss and health improvements in complex, ethnically diverse populations. Despite high baseline comorbidity, participants achieved clinically relevant outcomes, validating MR-LED as a cornerstone in obesity management.

Healthcare professionals involved in global Muslim weight management should consider integrating structured MR-LED approaches tailored to cultural contexts and patient complexities. Such interventions promise to enhance access, effectiveness, and sustainability of obesity care worldwide.

Source: https://doi.org/10.1111/dom.70574

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