Study results

Remotely delivered weight management for people with long COVID and overweight: the randomized wait-list-controlled ReDIRECT trial

Emilie Combet, Laura Haag, Janice Richardson, Caroline E. Haig, Yvonne Cunningham, Heather L. Fraser, Naomi Brosnahan, Tracy Ibbotson, Jane Ormerod, Chris White, Emma McIntosh, Catherine A. O’Donnell, Naveed Sattar, Alex McConnachie, Michael E. J. Lean & David N. Blane

Nature Medicine 31, 258–266 (2025)

The trial, funded by the National Institute for Health and Care Research (NIHR) in response to the COVID-19 pandemic, involved participants with Long Covid symptoms lasting more than 12 weeks and with overweight. Participants nominated the Long Covid symptom they most wanted to see improve (including fatigue, breathlessness, pain), before beginning a six-month intervention which included a structured weight management programme with total diet replacement (for 12 weeks), followed by food reintroduction and weight loss maintenance support.

The results of the ReDIRECT trial – led by the University of Glasgow and published in Nature Medicine – found that a digitally-focussed, remotely-delivered structured weight management programme was effective in reducing the Long Covid symptoms that matter most to participants.

Long Covid is a complex condition and the ‘mechanisms of action’ of the intervention are uncertain. To inform and evaluate further interventions, an inclusive approach to treatment is needed which incorporates the personal experiences and preferences of people living with Long Covid. The study worked closely with patient representatives from Long Covid Scotland, an interaction which was critical in shaping the research from design to analysis.

Baseline characteristics of ReDIRECT study participants

The baseline characteristics show that symptoms linked to LC and overweight are diverse and complex. The study being “remote” means that recruitment was rapid and across the UK, yet certain groups (e.g. men and those from ethnic minority groups) were under-represented. Read the open access (free of charge) paper here:

Baseline Characteristics in the Remote Diet Intervention to REduce long-COVID Symptoms Trial (ReDIRECT) 

Haag L, Richardson J, Haig C, Cunningham Y, Fraser H, Brosnahan N, Ibbotson T, Ormerod J, White C, McIntosh E, O'Donnell K, Sattar N, McConnachie A, Lean M, Blane D, Combet E. 

NIHR Open Res 2024, 4:7

ReDIRECT Study Protocol

We have published our study protocol for the ReDIRECT Study on NIHR Open Research. The protocol describes the study in detail and is open access (free of charge).

The remote diet intervention to reduce Long COVID symptoms trial (ReDIRECT): protocol for a randomised controlled trial to determine the effectiveness and cost-effectiveness of a remotely delivered supported weight management programme for people with Long COVID and excess weight, with personalised improvement goals [version 1; peer review: 1 approved, 1 approved with reservations]

Haag L, Richardson J, Cunningham Y, Fraser H, Brosnahan N, Ibbotson T, Ormerod J, White C, McIntosh E, O'Donnell K, Sattar N, McConnachie A, Lean M, Blane D, Combet E. 

NIHR Open Res 2022, 2:57

Study Protocol supplementary material

Study Protocol SPIRIT Checklist