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

The research study led by Te Kāika Health's Dr Kim Ma'ia'i and Otago's Associate Professors Andrew Reynolds and Justine Camp has shown the benefits of a primary care-led weight management programme in Ōtepoti, Dunedin. The programme dramatically improves outcomes for people living with type 2 diabetes and obesity overseas, but had never been considered in Aotearoa. 

"This is more than a diet – it's about resetting habits and being more aware of what we eat," said Reynolds. "What was special about Te Kāika DiRECT is that it was 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 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 considered both the effectiveness of the intervention and its acceptability. Participants in the trial — which included 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."

As well as finding the approach acceptable, participants had significant results following the structured plan: three months of total meal replacement, followed by food reintroduction and supported weight loss maintenance. Participants on the structured plan lost 6.9kg more body weight than those receiving Dietetic support alone. The weight reduction was still there at 12 months, with participants working with the Dietitian also starting to lose weight (2.3kg) as well by then. 

A nationwide trial, if successfully funded, 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.