Previous studies with LED/VLED with TDR have indicated that compliance is between 70-80%. The patients in both the TDR and exercise groups will have regular contact with investigators to encourage compliance and offer support. The standard care group will also receive weekly telephone calls to encourage compliance to suggested lifestyle changes. Participants will be offered £50 compensation for completing each of the three assessments, which will take approximately 3-4 hours. However, those patients in the TDR arm that do not achieve a loss of >4% body weight at week 1 and 10% at week four will be considered non-compliant and excluded from the study.