Part of the Waste the Waist research team at the study launch: From left to right – Dr Afroditi Stathi, Daniel Messom, Dr Colin Greaves, Margaret Francis; Dr Gordon Taylor, Lisa Austin.

The intervention team: left to right:  Afroditi Stathi; Trilby Breckman, Mike Wheeler, Maxine Denham; Steve Beere; Colin Greaves; Chris Kay; Kirsty Stewart; Fiona Gillison. Photo (with permission) by Dr Paul Bennett.

Waste the Waist

'Waste the Waist': A single site randomised controlled trial of a primary care based lifestyle intervention for people with high cardiovascular risk.

A single site trial, led by Dr Colin Greaves of the Peninsula Medical School’s Primary Care Research Group will run from November 201 to March 2013. This study is designed to evaluate a new approach to weight loss and physical activity in people with increased cardiovascular risk and is funded by the National Institute for Health Research (NIHR), the Department of Health's national health research funding scheme.

The Waste the Waist study is a collaboration between the Peninsula Medical School in Exeter, the University of Bath, Deakin University in Australia and NHS Bath & North East Somerset (BANES) - the study has received funding of £240,000 from the NIHR.

Waste the Waist is based on the highly successful LIFE! Programme which has benefited thousands of people in Melbourne, Australia. It is the latest state-of-the-art programme for supporting weight loss and a healthier lifestyle and mirrors the recommendations of the recently released European guidelines for the prevention of type 2 diabetes (to which the Peninsula Medical School was a contributor). It aims to encourage and support at risk individuals to implement behaviour change, resulting in positive alterations to their lifestyle in areas such as physical activity and diet. The study will work in partnership with NHS B&NES GP practices and will involve 100 NHS patients .

Previous studies have shown that those with cardiovascular conditions such as heart disease and diabetes can make a huge difference to their rates of recovery by making even small positive changes to their lifestyle. The more changes in diet and physical activity they make, the better the results – among people at risk who made just four or five lifestyle changes the rate of progression to type 2 diabetes was reduced to zero per cent.

The single site pilot study will evaluate the Waste the Waist programme to ensure that the methods and procedures for assessing its impact will work as intended. For example, the pilot study will monitor ways to ensure that individuals do not drop out of the programme for preventable reasons, such as poor communication of the level of effort required. Once the study is complete, the team plans to conduct a large trial to assess the impact and value for money of the programme.

NHS patients selected by their GP will be invited to take part in the pilot study from 15th November 2010.

Dr. Colin Greaves, Senior Research Fellow in Primary Health Care at the Peninsula Medical School and who is the chief investigator for the Waste the Waist study, commented: "The developed world is, potentially, heading towards crisis as the result of the impact of lifestyle-related disease – and sitting at the top of the list are type 2 diabetes and cardiovascular disease. If lifestyle interventions can be proven to deliver sustained changes in weight and physical activity, the potential savings to healthcare budgets are immense. It is estimated that diabetes now accounts for up to 18 per cent of total healthcare expenditure in Europe and costs an estimated £9 billion per year in the UK. Getting a programme such as Waste the Waist to work will mean that it can be implemented across the UK as a value for money option for local health authorities, resulting in fewer at risk individuals developing lifestyle-related disease and reductions in cost to health care providers. We are excited to be working with colleagues in Bath and Australia to make this happen."

Dr Afroditi Stathi, Lecturer in Exercise Psychology at the University of Bath and co-applicant in the Waste the Waist study commented "The Waist the Waste project is a great example of how scientific knowledge can be exchanged among researchers and practitioners around the globe. There is a universal need for more effective ways for supporting weight loss and healthy lifestyles and we are excited to collaborate with our colleagues in Peninsula Medical School and Deakin University."

Lisa Austin and Dr Gordon Taylor from Bath University added: "This represents an exciting collaboration between Bath and North East Somerset NHS and the University of Bath and the Peninsula Medical School, which has the potential to deliver tangible health benefits to the local population."

Dr Pamela Akerman, Acting Joint Director of Public Health, NHS Bath & North East Somerset & Council, said: "NHS B&NES is delighted to be working in partnership with Bath University and the Peninsula Medical School to pilot the waste the waist programme. We recognise how important it is to identify people who are at risk of developing diabetes and cardiovascular disease as early as possible and help them to make the necessary lifestyle changes. We play an important role in supporting people to manage their weight by being active and eating a healthy diet and look forward to the results of the pilot.

"The pilot will work alongside practices who are offering NHS Health Checks. This is a national programme which aims to identify people aged 40-74 who may be at risk of developing cardiovascular disease, diabetes or kidney disease, in order to offer support or treatment to help them reduce their risks ."

It is predicted that one in 10 Europeans aged 20-79 will have developed diabetes by 2030. Its reach is growing – once a disease of old age, diabetes is now affecting adolescents and children and the highest increase is in the 30-40 year old age group. Diabetes now accounts for up to 18 per cent of total healthcare expenditure in Europe and costs an estimated £9 billion per year in the UK.

Information about the National Institute for Health Research, the Department of Health's national health research funding scheme, is available at www.nihr-ccf.org.uk/site/programmes/rfpb/default.cfm

An article has now been published

  • Gillison F, Greaves CJ, Stathi A, Ramsay R, Bennett P, Taylor G, Francis M, Chandler R. "Waste the waist": the development of an intervention to promote changes in diet and physical activity for people with high cardiovascular risk. British Journal of Health Psychology 2012;17(2):327-45.