Overweight patients who are living with long Covid could benefit from a supported weight management programme to help alleviate symptoms, a new study suggests.

Researchers at the University of Glasgow found that a remotely delivered structured weight management program, supported by a dietitian and offering peer support, could improve a range of long Covid symptoms in people classified as overweight.

The study, known as the ReDIRECT trial, involved participants with long Covid symptoms persisting for over 12 weeks who were overweight. The researchers aimed to address symptoms that mattered most to participants, including fatigue, pain, and breathlessness, through weight loss management. The findings are published in Nature Medicine.

A total of 234 participants with long Covid and a body mass index (BMI) of over 27 kg/m² (or 25 kg/m² for South Asian participants) were divided into a control group (n=116) who received standard care and a weight management group (n=118). The latter group followed a dietitian-led, remote weight loss programme, which involved a total diet replacement (850 kcal per day for 12 weeks), followed by the reintroduction of regular food and weight loss maintenance support. The participants selected the long Covid symptom they would most like to see improved, and the researchers used questionnaires and visual analogue scales to assess any changes.

At six months, the intervention group showed an almost 40 per cent greater improvement in their nominated symptom than the control group. The improvement was more significant on average in the intervention group, but the range of outcomes varied more in the intervention group than in the control group, which improved less but in a more consistent pattern.

The researchers suggest that the study highlights the potential of exploring different therapeutic options in the absence of a disease-modifying treatment or cure for long Covid.

Dr David Blane, a senior clinical lecturer at the University of Glasgow’s School of Health and Wellbeing, said: ‘While it is difficult to assess the clinical significance of the health improvements in our study participants, there are promising signals that supported weight management could be a helpful part of a rehabilitation approach for some people living with long Covid.’

However, researchers need to conduct further studies since the mechanisms of action of the weight loss programme are uncertain and because the process is a ‘complex intervention’.

Emilie Combet, Professor of human nutrition, explained: ‘Long Covid is a complex condition, and ReDIRECT was a complex intervention, involving not only remotely-delivered weight management, but also dietitian and peer support. Further research is needed, as long Covid remains a significant public health concern affecting millions of individuals and families worldwide.’

A version of this article first appeared on our sister title Nursing in Practice.