Helen Gowers was Director of The Lifestyle Club (TLC) from June 2021 to March 2025, overseeing its development and rollout to over 100 GP surgeries. TLC is a health coaching service for adults with type 2 diabetes or prediabetes which comprises an 8-week structured education course and lifetime support. The approach is based on the low carbohydrate diet pioneered by the GP Dr David Unwin with his patient population at Norwood Surgery in Southport, where he achieves 50% drug free remission (1). The surgery has saved £420,000 on their diabetes drug budget since 2018 by using less medication.
TLC has helped over 1,600 NHS patients improve their diabetic control with many reducing medication and reporting improvements in energy levels, mood, indigestion, sleep, weight and blood pressure. The service is owned by Public Health Collaboration (PHC) a charity dedicated to creating a society where everyone can enjoy good metabolic health.
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TLC started as a pilot in 30 surgeries in 2021 and went on to be commissioned by 77 NHS surgeries across England. Clinicians signpost patients to the service and patients enrol on the 8-week programme to learn about insulin resistance, how different foods impact blood glucose levels and how a real food diet, lower in refined carbohydrate, can reduce hunger, enable weight loss and provide a sustainable way to address the condition. An important aspect is the continued support offered to participants after the course has ended through the TLC and PHC communities.​​​​
Helen collaborated with the University of Surrey to evaluate TLC outcomes both qualitatively and quantitatively. The study demonstrated 23% drug free remission rate with a cohort of participants from the Guildford area. Over the 6-month follow up period HbA1c fell from 57mmol/mol to 49mmol/mol with 46% achieving an HbA1c below 48mmol/mol, the threshold for type 2 diabetes diagnosis. Mean weight loss was 5.2kg, and median weight fell by 4.2kg which was statistically significant. Participants thought TLC was motivating and empowering and that health improvements and medication reduction were key motivators. Some found the low carbohydrate diet challenging in social interactions especially when there were rigid domestic routines or complex comorbidities. The paper has been submitted to a high impact journal and it is anticipated to be published later this year.
The QISMET accredited programme was awarded Silver Primary Care Project of the Year at the Health Service Journal Awards 2024. Helen is vice-chair of the PHC Scientific Advisory Committee. You can find out more about Public Health Collaboration (www.phcuk.org) and The Lifestyle Club (www.thelifestyleclub.uk) at their respective websites.
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References
1) Unwin D, Delon C, Unwin J, et al What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss BMJ Nutrition, Prevention & Health 2023;e000544. doi: 10.1136/bmjnph-2022-000544
