Cut the Waist

Cut the Waist

Illustrative photo for 'Cut the Waist'
'Cut the Waist aims to raise the profile of an important public health message' - Dr Andrew Brewster, Director of Cut the Waist

An introduction to Cut the Waist

My name is Dr Andrew Brewster and I work as a full-time GP in Reading, UK. I have a specialist interest in obesity, type 2 diabetes, and the link between these two conditions. I have a strong commitment to healthcare professional education in order to help improve patient care, with an emphasis on optimising management of type 2 diabetes through a knowledge of obesity medicine, and prevention of type 2 diabetes via achievement of modest weight reduction goals for those at risk of developing this condition.

In addition to promoting Cut the Waist as an important public health message, I am involved in the following related work:

  • Visiting Research Fellow at Reading University and Clinical Director, Reading University Certificate in Obesity Management Course
  • Editorial Board Member, Diabetes and Primary Care
  • Lecturer, University of Surrey Diabetes Course

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

Barometer - Health improvement, risk reductionIn 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 obesity and type 2 diabetes, the importance of waist circumference and ways to support patients in their efforts to manage their weight, reduce their waist circumference, and reduce their risk.


Andrew Brewster