Te Kāika DiRECT: Local Innovation in Diabetes and Obesity Care Shows Promising Results

The critical study led by Te Kāika Health and Associate Professor Reynolds has shown that locals in Ōtepoti, Dunedin, have embraced a primary care-led weight management programme that has had success internationally. The programme dramatically improves outcomes for people living with type 2 diabetes and obesity. The Te Kāika DiRECT trial exemplifies the kind of community-driven, equity-focused research that is at the heart of Pūtahi Manawa and was highlighted at an indigenous heart health conference in Sydney earlier this year.

"This is more than a diet – it's about changing lives," said Reynolds. "What's special about Te Kāika DiRECT is that it's rooted in primary care and driven by community needs. It shows what's possible when whānau, clinicians, and researchers work together."

The pilot programme, Te Kāika DiRECT, trialled a structured weight loss approach already successful in the UK to determine its acceptability and effectiveness in Aotearoa. The initiative was born from the voices of Te Kāika Health patients, many of whom were seeking better ways to manage their weight and health, dissatisfied with existing options.

The trial participants— 40 individuals — shared overwhelmingly positive feedback. One participant noted, "You see results quickly, and those results motivate you to keep going." Another participant appreciated the focus on sustainable change: "This study's just allowed me to hone in on that long-term lifestyle change as opposed to quick fixes."

Te Kāika Health, a Māori-led health provider serving 5,200 predominantly Māori, Pacific, refugee, and low-income whānau in South Dunedin, collaborated with researchers from the University of Otago on this patient-driven project. The research team, including Associate Professor Andrew Reynolds, Associate Professor Justine Camp, and Dr Kim Ma'ia'i, represented a poignant partnership of Māori, Pacific, and Pākehā researchers.

Participants had significant results following a structured plan: three months of total meal replacement, followed by food reintroduction and supported weight loss maintenance. An average weight loss of 6.9kg after three months, with most of the weight still off after 12 months, far outpaced those receiving standard care, who lost just 0.8kg in three months and 2.3kg after a year.

A nationwide trial, if successful, could reshape how diabetes and obesity are managed across New Zealand, offering a scalable model rooted in community care. 

The trial was funded by Pūtahi Manawa, the Ministry of Social Development and Healthier Lives and was completed in 2024.