Director, Cut the Waist
An introduction to Cut the Waist
My name is Dr Andrew Brewster and I'm a GP in Reading. I have a specialist interest in Type 2 diabetes and obesity, as well as a commitment to developing services for patients with an emphasis on preventative medicine.
In addition to promoting Cut the Waist as an important public health message, I am involved in the following related work:
- As Clinical Director of the Reading University Certificate in Obesity Management Course
- As an advisory board member of the Thames Valley Local Diabetes Research Network
- As a lecturer both nationally and internationally on diabetes and obesity related topics
- As a lecturer locally for the Warwick Certificate in Diabetes Care Course and Insulin Conversion Course in Reading
The philosophy behind all of my work, including Cut the Waist, is that appropriate education and training of fellow healthcare professionals, along with development of appropriate patient services, will improve care and ultimately reduce the burden of ill-health related to obesity.
An emphasis on waist circumference
Cut the Waist places particular emphasis on waist circumference, because waist circumference rather than BMI is the simplest clinical measurement which identifies people whose weight is distributed centrally. The identification of central weight distribution is important as it is associated with a tendency to accumulate high-risk internal fat stores.
A significant limitation of BMI measurement is that it provides no information about distribution of body fat; BMI is therefore a rather blunt tool which can under-estimate risk in circumstances where individuals may have a relatively normal body weight yet increased waist circumference.
Irrespective of BMI category, people with a large waist are at increased risk of developing type 2 diabetes, high blood pressure and cholesterol problems, all of which can lead to heart disease.
Barometer intervention for at-risk patients
In dealing with my own at-risk patients in clinical practice, I have developed a two-stage expert patient intervention:
- An importance session, making patients aware of the impact of weight on health
- A confidence session, helping patients to realise that it can be done!
This intervention - called "BAROMETER" - aims to motivate patients, through appropriate education and resources, to bring about lifestyle and behaviour change, resulting in long-term waist and weight reduction. I am committed to working with other agencies to develop intelligent approaches to working with patients to tackle obesity and to emphasize prevention of obesity-related disease within the National Health Service.
Over time, I hope that this website will become a useful resource for information about the importance of waist circumference and ways in which it can be reduced. To that end, I will be updating it with articles, information and links to other sites, as well as news about the Cut the Waist campaign itself.
Yours
Andrew Brewster