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There is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m².

This programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care.

Feasibility study in primary care.

Patients with a BMI ≥40 kg/m² commenced a micronutrient-replete 810–833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months.

Of 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m², age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg …