Remote Culinary Coaching Shows Sustained Weight Loss Benefits in Adults with Overweight and Obesity
Key Takeaways:
- A fully remote culinary medicine programme combining cooking and health coaching led to sustained weight loss over 12 months
- Participants experienced significant fat mass reduction without loss of lean body mass
- Improvements in diet quality, calorie intake, and cooking confidence were observed alongside weight changes
Study overview
A recent randomised controlled trial has found that a fully remote culinary medicine intervention can support meaningful and sustained weight loss in people living with overweight and stage I obesity. The programme combined practical cooking education with health coaching, offering a patient-centred approach to improving dietary behaviours and long-term health outcomes.
Conducted across two hospitals between May 2019 and September 2022, the study examined the one-year impact of this combined intervention on weight, body composition, and dietary habits.
Methodology
Participant characteristics
The study included 50 adults with overweight or stage I obesity. Participants had a mean age of 47.5 years, and 70% were female. The average body mass index was 30.7, with a mean total fat mass of 40.37%. All participants reported cooking fewer than five meals at home per week at baseline.
Intervention design
All participants initially received two nutrition education sessions focused on the Mediterranean diet. Following this, they were randomly assigned to one of two groups:
- Intervention group: Participants took part in a structured culinary coaching programme consisting of 12 weekly one-to-one tele-sessions, each lasting 30 minutes. These sessions integrated culinary skills training with health coaching principles and provided access to culinary medicine resources.
- Control group: Participants were given access to the same culinary medicine resources but did not receive coaching sessions
Outcome measures
Researchers assessed a range of clinical and behavioural outcomes at baseline, and again at 3, 6, and 12 months within a hospital clinical research setting:
- Body weight and height were measured by a registered dietitian
- Body composition was analysed using dual-energy X-ray absorptiometry (DEXA)
- Dietary intake was calculated using 4-day food records reviewed by a registered dietitian
- Diet quality was evaluated using a 14-item Mediterranean diet assessment tool
- Culinary attitudes and self-efficacy were measured using a validated questionnaire
The primary outcome was change in body weight at 6 months, with secondary outcomes including dietary intake, body composition, and behavioural measures.
Weight loss outcomes
Participants in the culinary coaching group achieved significantly greater weight loss compared with the control group at all measured time points:
- 3 months: -3.23% vs -0.71% (between-group difference -2.52; P = .016)
- 6 months: -4.2% vs -1.22% (between-group difference -2.98; P = .027)
- 12 months: -4.02% vs a weight gain of 0.28% (between-group difference -4.30; P = .021)
These findings indicate that the intervention not only supported early weight loss but also helped sustain these changes over a full year.
Changes in body composition
At 6 months, participants receiving culinary coaching demonstrated favourable changes in body composition:
- Average fat mass decreased by 1.86% in the intervention group
- In contrast, the control group experienced a slight increase in fat mass of 0.11%
- The between-group difference was 1.96 (P = .039)
Importantly, these reductions in fat mass occurred without any significant changes in lean body mass, suggesting that weight loss was primarily driven by fat reduction rather than muscle loss.
Dietary improvements
The intervention also led to measurable improvements in diet quality and energy intake:
- At 3 months, Mediterranean diet scores increased by 2 points in the intervention group compared with 0.38 points in the control group (net difference 1.62; P = .020)
- At 6 months, daily calorie intake decreased by 452 calories in the intervention group compared with 62.4 calories in the control group (net difference 390 calories; P = .015)
These findings suggest that the programme successfully influenced both food choices and overall energy consumption.
Behavioural and skill-based outcomes
Participants who received culinary coaching reported significant improvements in their confidence and ability to prepare meals:
- Self-efficacy in cooking techniques and meal preparation improved significantly at 12 months in the intervention group compared with the control group (P = .040)
No serious adverse events were reported during the study, indicating that the intervention was safe and well tolerated.
Interpretation and clinical relevance
The study authors highlighted the broader significance of these findings, stating:
“This study is an important step in considering CM [culinary medicine] interventions as an effective patient-centered nutrition strategy for weight loss.”
This suggests that combining practical cooking skills with behavioural coaching may offer a scalable and effective approach to supporting people living with overweight and obesity, particularly in remote or resource-limited settings.
Limitations
The study has several limitations, many of which were influenced by the COVID pandemic:
- High dropout rates after the first visit may have introduced attrition bias
- Some follow-up visits were conducted remotely, requiring participants to self-measure body weight
- Remote assessments limited the ability to collect body composition and other clinical data at certain time points
- Pandemic-related restrictions may have affected participants’ ability to cook at home
These factors should be considered when interpreting the findings.
Funding and disclosures
The study was led by Rani Polak at Harvard Medical School and Spaulding Rehabilitation Hospital in Boston and was published in Obesity.
Funding was provided by the US-Israel Binational Science Foundation and the National Institutes of Health Clinical Center. One author reported receiving royalties from a home cooking book and an honorarium from Wellcoaches.
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First UK Long-Distance Robotic Surgery Connects London Surgeon with Gibraltar Patient
Key Takeaways:
- A London-based surgeon has performed the UK’s first long-distance robotic cancer surgery on a patient in Gibraltar, marking a major milestone in telesurgery
- The procedure demonstrated minimal delay and high precision, suggesting remote surgery could expand access to specialist care in underserved regions
- Patients living far from specialist centres may benefit from reduced travel, lower costs and improved continuity of care
A landmark moment in remote surgery
A surgeon based in London has carried out what is believed to be the United Kingdom’s first long-distance robotic surgical procedure, operating on a patient located approximately 1,500 miles (2,400 km) away in Gibraltar.
Professor Prokar Dasgupta, a leading robotic urological surgeon, performed a prostate removal on 62-year-old Paul Buxton. Reflecting on the experience, he said it felt “almost as if I was there”, despite the geographical distance between surgeon and patient.
For Buxton, who is living with prostate cancer, the decision to participate in the procedure was straightforward. He described it as a “no-brainer” and an opportunity to become “part of medical history”.
Expanding access to specialist care
The development of long-distance robotic surgery is seen as a potential solution to longstanding challenges in healthcare access, particularly for people living in remote or underserved regions.
Such approaches could reduce the “vast expense and inconvenience” associated with travelling for specialist treatment, while enabling patients to receive care closer to home.
This milestone builds on previous advances involving UK-based surgical teams. Earlier work included a transatlantic robotic stroke procedure conducted over a distance of 4,000 miles on a cadaver – a body donated to science – which demonstrated that long-distance surgery was technically feasible.
A patient’s perspective
Buxton, originally from Burnham-on-Sea in Somerset, has lived in Gibraltar for four decades. As a British Overseas Territory, Gibraltar has limited healthcare infrastructure, with only one hospital – St Bernard’s Hospital at Europort. Patients requiring more complex care often need to travel abroad, commonly to the United Kingdom for NHS treatment if eligible.
Following his prostate cancer diagnosis shortly after Christmas, Buxton initially expected to join an NHS waiting list. However, he chose instead to take part in the remote surgery trial.
“A lot of people actually said to me: ‘You’re not going to do it, are you?’”
“I thought, I’m giving something back here,” he said.
Buxton also highlighted the practical advantages of the approach:
“If I hadn’t gone for the telesurgery in Gibraltar, then I would have had to have flown to London, I would have had to go on the NHS waiting list, get the procedure done and I would have probably been in London for three weeks.
“So I thought: ‘This is a no-brainer’.
“It is pioneering for Gibraltar, because you don’t need to leave Gibraltar.”
Following the operation on 11 February, he reported a positive recovery, stating he was “really well looked after” and “feeling fantastic”.
How the technology works
The procedure was conducted from The London Clinic using a robotic surgical system equipped with a high-definition 3D camera and four robotic arms. These were controlled remotely via a surgical console.
The connection between London and Gibraltar was enabled through fibre-optic cables, supported by a backup 5G link. The system achieved an extremely low latency, with a delay of just 0.06 seconds, allowing for precise and responsive control.
A surgical team in Gibraltar remained on standby throughout the operation to intervene if necessary, although the connection remained stable for the duration of the procedure.
The operation utilised the Toumai Robotic System and was delivered through a collaboration between The London Clinic and the Gibraltar Health Authority.
Looking ahead: scaling telesurgery
Professor Dasgupta emphasised the broader implications of the innovation:
“This gives us the opportunity to treat patients in remote areas and smaller communities by literally being able to take the best surgeon anywhere.”
The procedure forms part of an initial series of test cases. A second operation involving a 52-year-old patient in Gibraltar was carried out on 4 March, with a further procedure scheduled for 14 March.
The upcoming operation will be live-streamed to 20,000 leading urological surgeons attending the European Association of Urology congress, highlighting the global interest in this emerging field.
Reflecting on the future, Dasgupta added:
“I think it is very, very exciting, the humanitarian benefit is going to be significant.”
Alignment with broader surgical trends
This development sits alongside wider efforts to expand the use of robotic-assisted surgery within the NHS. Current ambitions include scaling up to 500,000 robot-supported operations annually by 2035.
While the NHS is prioritising local access to robotic surgery, advances in telesurgery suggest a complementary pathway – one that could extend specialist expertise beyond physical borders and reshape how surgical care is delivered globally.
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Study Finds Early Virtual Follow-Up Reduces Hospital Readmissions and Enhances Recovery
Key Takeaways:
- A UC San Diego Health telemedicine clinic reduced 30-day hospital readmissions from 20.1% to 14.9% among high-risk patients.
- The clinic provides rapid, virtual follow-up care after discharge, addressing medication access, care understanding, and specialist coordination.
- Findings suggest that virtual post-discharge care can improve health outcomes, cut costs, and enhance care equity.
Virtual care reduces readmissions in high-risk patients
A new study led by researchers at the University of California San Diego (UC San Diego) School of Medicine has found that a virtual transition of care clinic significantly reduces hospital readmissions among high-risk patients.
Published on 23 September 2025 in JMIR Medical Informatics, the study revealed that the 30-day readmission rate for patients seen in UC San Diego Health’s virtual transition of care clinic was 14.9%, compared with 20.1% in a benchmark group that received standard follow-up care.
“With our virtual transition of care clinic, we are providing patients with the right care, at the right place, at the right time,” said Dr Sarah Horman, lead author of the study and Professor of Medicine at UC San Diego School of Medicine. “With the convenience of meeting virtually, we’re able to reach patients much more efficiently.”
Tackling a national challenge
Hospital readmissions represent a major strain on healthcare systems across the United States, with an estimated annual cost of $17 billion. Recognising this challenge, UC San Diego Health clinicians and leadership launched the virtual clinic in 2021 to improve care coordination immediately following discharge.
The initiative supports clinical management and specialist referrals for people leaving hospital, aiming to reduce the likelihood of complications or unplanned readmissions.
How the virtual transition clinic works
The clinic operates with a team of 12 hospitalists, two medical assistants, one pharmacist, and an on-demand interpreter service. When necessary, visits were converted to telephone consultations to accommodate patients facing technical or connectivity barriers.
Each discharge triggers a standardised hand-off to the patient’s primary care provider and relevant specialists, summarising the reason for admission, ongoing care needs, and follow-up recommendations.
If a patient experienced issues post-discharge, the virtual care team expedited communication with the primary care provider to ensure timely in-person review.
Addressing barriers to follow-up care
“When telemedicine first began, there was concern it would further increase health disparities, especially in vulnerable patient groups,” said Dr Horman, who is also a hospitalist and affiliate faculty member at the Joan and Irwin Jacobs Center for Health Innovation at UC San Diego Health. “However, through our research, we have found the opposite as the virtual clinic reaches patients more effectively.”
Many individuals, she noted, struggle to attend in-person follow-up appointments due to transport issues or mobility limitations. “For example, many patients do not have access to transportation for in-person follow-up visits, so they will often skip them altogether, resulting in an increased risk of hospital readmission. For patients who did not have access to video visits, we coordinated telephone calls instead. In total, the no-show rate for these follow-up visits was less than 5%.”
Strengthening the post-hospital care chain
According to Dr Horman, the clinic targets three critical aspects of post-discharge care:
- Ensuring access to and availability of prescribed medications.
- Supporting patient and caregiver understanding of the care plan.
- Facilitating navigation between primary and specialist care.
“Our goal is to hardwire this linkage in the care chain between the hospital team and primary care in order to help expedite support during that very sensitive, post-hospital period of time,” she explained. “As a result, patient outcomes are improving while they recover at home and hospitals have capacity to take care of the next patient in need of critical care.”
Study scope and findings
The study evaluated more than 25,000 patients discharged from UC San Diego Health between 1 September 2021 and 17 September 2024. Of these, 2,314 were seen in the virtual clinic, while 23,129 received standard care.
Typically, patients see their primary care provider two to four weeks after discharge. However, under this programme, individuals at moderate or high risk were seen within one week.
“Our clinic is a one-time, virtual visit with a patient immediately after their hospital stay to ensure we’re doing all we can to mitigate risk,” added Dr Horman.
Data-driven patient targeting with the LACE+ index
The team used the LACE+ index to identify patients at high risk of readmission or complications. LACE stands for Length of stay, Acuity of admission, Comorbidity, and Emergency department visits. The “+” extends the model to include factors such as age, sex, and previous hospitalisations.
“The use of LACE+ underscores the importance of data-driven and patient-centric strategies in enhancing patient outcomes,” said Dr Horman. “By using this tool, we were able to target follow-up care to those most likely to benefit. This approach helped improve care transitions and reduce avoidable hospital visits.”
Future of the programme
UC San Diego Health’s virtual transition of care clinic continues to operate across Hillcrest and Jacobs Medical Centers, with expansion plans to include East Campus Medical Center.
Dr Horman noted that these findings demonstrate how telemedicine can contribute to broader goals of improving population health, enhancing patient experience, reducing healthcare costs, and advancing care equity.
The study’s co-authors include Milla Kviatkovsky, Edward Castillo, Patricia S. Maysent, Chad VanDenBerg, John Bell, and Christopher A. Longhurst, all from UC San Diego Health.
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