Scotland is about to embark on a bold new journey in its fight against obesity and type 2 diabetes, as the National Health Service (NHS) prepares to roll out a radical low-calorie diet program across the country. Starting in January 2026, thousands of overweight Scots will be prescribed a regimen of soups and shakes, part of a scheme known as Total Diet Replacement. The initiative, reported on August 16, 2025, aims to reverse the tide of obesity and diabetes by replacing traditional meals with calorie-restricted alternatives, delivered straight to patients’ homes.
Obesity is one of Scotland’s most persistent health challenges, with roughly a third of the population classified as obese and another third overweight. According to the Daily Mail, about 300,000 people in Scotland are currently living with type 2 diabetes—a condition closely linked to excess weight and poor diet, and one that significantly increases the risk of heart disease, kidney problems, stroke, and nerve damage.
The new program is ambitious in both scale and scope. Over the next three years, around 3,000 patients newly diagnosed with type 2 diabetes will be enrolled. The plan is straightforward: for three to five months, participants will consume only specially formulated soups, shakes, or food bars, with a strict daily calorie limit of 900. After this initial period, normal foods will be gradually reintroduced, but with robust support. Patients will receive guidance through online consultations and an app that tracks food intake, weight, blood pressure, blood glucose, and exercise. The app also offers dietary advice and tips for maintaining weight loss in the long run.
The NHS Scotland describes the initiative as a “new, high impact technology that could improve patient outcomes and contribute to NHS renewal across Scotland.” The hope is that patients will lose up to ten percent of their body weight over the year-long plan. Even more striking, doctors are optimistic that 35 to 40 percent of participants will achieve remission from type 2 diabetes within the first year. A spokesman for the Scottish Government stated, “We anticipate that around 35 to 40 per cent will achieve remission from type 2 diabetes at the end of their first year on the programme, with a majority of patients benefiting from a clinically significant average weight loss of 10 per cent and reductions in blood pressure, all contributing to reduced risk of cardiovascular disease.”
Cost is a significant factor in this new approach. The Total Diet Replacement scheme is expected to cost £5.6 million for 3,000 patients—about £1,866 per person. This is notably less than the annual cost of popular weight loss injections such as Ozempic, Wegovy, and Mounjaro, which run around £3,000 per person per year. The NHS in Scotland currently prescribes a record 10,000 of these so-called “fat jabs” each month, as reported by the Daily Mail. These drugs, which suppress appetite and can lead to dramatic weight loss, have made headlines thanks to celebrity endorsements from figures like Oprah Winfrey, Whoopi Goldberg, Elon Musk, and Sharon Osbourne.
Yet, despite their effectiveness, these medications come with caveats. The benefits often persist only as long as the patient continues taking the drug, raising concerns about long-term dependency and escalating costs. In contrast, the soup-and-shake program aims to foster lasting lifestyle changes, equipping patients with the tools and habits needed to maintain a healthy weight without ongoing pharmaceutical intervention.
But not everyone is convinced that such schemes are a panacea. An opinion piece published in The Sun on August 16, 2025, sounded a note of caution, using the story of Amy Tapper—a 25-year-old who lost seven stone in a year with the help of Mounjaro injections—as a warning. While Amy’s transformation, from a size 26 to a size 18, is undeniably impressive, the columnist argued that her reliance on injections “for life” highlights a deeper issue. “There is a generation who are growing up knowing they no longer need to deal with portion control or restraint. They don’t need to worry about healthy eating or balanced nutrition to stay slim. Because they can turn to the wonderful fat jab. And stay on it for ever,” the article stated.
The piece praised the short-term effectiveness of weight loss drugs, calling them “a lifeline for millions,” but stressed that they do not address the root causes of obesity—namely, poor diet and a lack of education about nutrition. “The NHS must also make sure that patients learn healthy eating habits while they are on them. The Government shouldn’t be spending millions dishing them out so people don’t learn from their mistakes and stay on them for life,” the article warned.
To put the issue in perspective, the columnist compared Britain’s obesity rate of around 28 percent with Japan’s 4.5 percent. The difference, they argued, lies in government intervention: in Japan, healthy school meals and food education are mandatory, and employees must have their waists measured yearly at work. “Harsh and draconian, maybe, but which is worse? A big brother-style tape measure around your waist or an injection jabbed into it for life?” the piece asked, underscoring the societal dilemma.
Scotland’s new program seems to heed this advice, at least in part. By coupling meal replacements with education and digital support, the NHS hopes to foster healthier habits that will endure long after the program ends. The scheme’s digital platform will not only monitor patients’ progress but also provide ongoing coaching and encouragement. “We will measure impact by the number of patients recruited into this programme, the number who achieve remission and the number with clinically significant weight loss,” the Scottish Government spokesman explained.
Meanwhile, the UK government is taking additional steps to curb unhealthy eating habits. A ban on junk food adverts before 9pm is set to take effect in October 2025, aiming to shield children from the pervasive marketing of ultra-processed foods. The hope is that such measures, combined with programs like Total Diet Replacement, will help break the cycle of poor nutrition and rising obesity.
Still, the challenge is enormous. Decades of unhealthy habits have been passed down from generation to generation, and the columnist in The Sun warned that without a concerted effort to educate the public, “children of the future will grow up watching their mum inject herself for ever. They will think it’s their only option and become a Mounjaro Mum, too, one day. Then it will be an even bigger disaster.”
As Scotland prepares to launch its soup-and-shake experiment, the rest of the UK—and indeed, the world—will be watching closely. Can a combination of structured diet, digital support, and education succeed where drugs alone have struggled? The answer may shape the future of obesity treatment for years to come.
