Nutrition Therapy for Weight Loss — What Works & What Doesn’t

Weight-loss medications like semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) have become widely discussed in recent years. While these treatments can be effective, experts emphasize that diet still serves as the foundation for weight management.

At the European Association for the Study of Diabetes (EASD) 2025 Annual Meeting in Vienna, researchers shared compelling insights on which nutrition strategies deliver real results—and which approaches don’t live up to expectations.

Why Nutrition Still Matters

Even though injectable drugs are gaining traction, they are not always available to everyone. Side effects, cost, and access issues mean that many people still need reliable, non-drug weight-loss methods.

Physicians also encourage pairing medication with lifestyle changes, making diet and nutrition therapy an essential part of long-term health strategies. The latest studies provide strong evidence about which eating plans work best.

5:2 Meal Replacement Shows Promise

Freepik | standret | Physicians stress that medication must be combined with effective diet and nutrition for long-term health success.

A standout finding came from China, where researchers tested a 5:2 intermittent fasting meal replacement plan. Adults with early type 2 diabetes who followed this structure experienced greater improvements in weight loss and blood sugar control compared to those prescribed metformin or empagliflozin.

The trial, called EARLY, took place in nine centers and measured body composition along with abdominal fat distribution. Results showed:

1. Significant drops in BMI and waist circumference
2. Lower waist-to-hip and waist-to-height ratios
3. Reductions in body fat percentage
4. Noticeable decreases in abdominal fat and subcutaneous fat

The structured replacement system seemed to support adherence. As Dr. Dongni Yu from Beijing Hospital explained, the routine provided both safety and measurable success. However, she noted that the study had limits, such as its smaller sample size and short timeframe.

Time-Restricted Eating vs Dietetic Guidance

In Australia, researchers compared time-restricted eating (TRE) with individualized dietetic guidance (IDG). Participants were either given a nine-hour eating window or one-on-one nutrition consultations.

After four months, both groups experienced modest weight loss of about 2–3 kg, but no significant difference appeared in blood sugar levels (A1c). Although the progress wasn’t dramatic, many participants maintained their weight loss even after the support phase ended.

Dr. Evelyn Parr, who led the trial, highlighted that TRE might still work well for people unable or unwilling to seek dietetic counseling. Some participants who started with TRE became curious about healthier food choices later, showing that it may serve as a steppingstone toward sustainable changes.

Mediterranean Diet vs. AGHE

Another study compared the Mediterranean diet with the Australian Guide to Healthy Eating (AGHE) over an eight-week period in participants without diagnosed metabolic disease.

The findings favored the Mediterranean diet, with those following it showing significant improvements, including a reduction in waist circumference, lower body fat percentage, improved fasting insulin levels, and an increase in lean muscle mass.

The AGHE diet provided general benefits, but the Mediterranean approach demonstrated more pronounced improvements in markers linked to diabetes prevention and obesity risk. Researcher Robel Hussen Kabthymer explained that incorporating Mediterranean principles into national guidelines could enhance public health outcomes.

Why Some Strategies Fail

Not every nutrition therapy produced impressive results. For example, the Australian trial revealed that time-restricted eating did not deliver stronger outcomes than personalized dietary guidance. These findings suggest that while TRE can be convenient and accessible, it might not always achieve significant metabolic changes without additional support.

Similarly, researchers noted that short-term studies can make therapies appear more effective than they may be in the long run. Weight loss maintenance often requires ongoing support, structured plans, and lifestyle adjustments beyond diet alone.

Broader Implications for Weight Management

The research highlighted that while new medications capture public attention, nutrition therapies remain critical. For individuals without access to expensive drugs, diet-based strategies offer affordable, sustainable, and safe alternatives. Even for those on weight-loss medication, nutritional changes enhance results and help prevent relapse once treatment ends.

Experts emphasized that successful programs usually combine several factors:

1. Structure that guides consistent behavior
2. Flexibility for different lifestyles
3. Ongoing support from health professionals
4. Cultural adaptation for regional diets

The Role of Patient Preference

Freepik | Personalized diet plans, professional guidance, and support are the reliable route to sustainable health goals.

Another key insight was the importance of personal choice. Some individuals prefer strict structures like meal replacements, while others thrive with flexible plans like TRE or Mediterranean diets. Allowing patients to select an approach they can realistically follow increases long-term success.

At the conference, one attendee suggested merging approaches. For example, integrating dietitian guidance with time-restricted eating might produce stronger results than either method alone. Researchers agreed this could shape future studies.

Where the Evidence Points Next

The findings from EASD 2025 underline the need for continued global research into nutrition therapy. Small trials provide promising directions, but larger, longer-term studies are essential to confirm which strategies truly transform health outcomes.

Researchers are also interested in how technology can support adherence. Mobile apps, text message check-ins, and digital coaching are being tested to keep participants engaged and motivated over time.

A Sustainable Path to Weight Management

While weight-loss drugs can be helpful for some, nutrition therapy provides accessible, drug-free strategies for improving health. Approaches such as the 5:2 meal replacement plan in China and the Mediterranean diet in Australia have demonstrated notable benefits, while time-restricted eating may support some individuals in making positive changes.

By tailoring dietary strategies to individual needs, incorporating support systems, and learning from cultural differences, health professionals can help people achieve sustainable progress. Structured, evidence-based nutrition therapy, combined with consistency and proper guidance, offers a reliable route to long-term health and weight management.