A TEAM of NHS nurses is patrolling Scotland's streets to target pot-bellied members of the public and tell them how to lose weight.
Armed with measuring tapes to check waists and equipment to test blood pressure, the "Street Nurses" are policing busy shopping centres, supermarkets and community centres.
Any man with a paunch, or woman with an "apple-shaped" body whose wa
ist measurement is higher than recommended limits is given diet and lifestyle advice or referred to local slimming classes.
For women this would be a waist measurement of more than 32 inches and for men over 37 inches because middle regions larger than these are linked with an increased risk of heart disease, type 2 diabetes, bowel and liver cancer, and strokes.
The move is part of a scheme by NHS Ayrshire and Arran to target members of the public in its most deprived areas who might not normally visit their GP seeking help for their weight.
Under the scheme the nurses, wearing high-visibility waistcoats, set up portable tables and chairs in town centres to monitor passers-by. If they spot someone who looks overweight they will approach them and strike up a conversation about their health, inviting them to have a "rapid nursing assessment", which includes having their waist measured and their blood pressure checked.
Jackie Reid, one of the Street Nurse team, said members of the public were usually happy to discuss their weight if it meant getting some good diet and exercise advice.
Reid, a public health nurse, said: "We tend to pick places where people congregate, such as supermarkets. We just walk up and speak to people. We will be looking at the men with the paunches or women carrying external body fat who are an 'apple shape', as we know they are at higher risk of disease and cancer. If you are carrying core body fat around your middle, that's raising your cholesterol."
Overweight women can be referred to local Weight Watchers meetings, and men are sent to the NHS Ayrshire and Arran men-only weight loss club 'Slimmin Withoot Wimmin'. Locals can also attend cookery classes where they learn how to prepare healthy meals on a low budget.
Other measures include talking to the nurse about diet and lifestyle and how to include healthier food in their diets.
Those with dangerously high blood pressure are told about the problem and asked to give their permission for the nurses to write to their GP.
Shoppers are also asked about other aspects of their lifestyle and given advice on how to quit smoking or cut down on alcohol if they admit drinking more than the recommended weekly limits.
Reid said: "Because you are a nurse it opens doors. No one says we can't do it because they know we're nurses. People honestly aren't that shy. It's a bit of light-heartedness, but getting a serious message across.
People are generally OK about us talking about their weight. We are not judging them but giving them support."
Reid and her colleagues head out twice a month and have already targeted around 500 locals in the most deprived parts of many of the area's towns, including Irvine, Kilwinning, Kilbirnie, Ardrossan and Stevenston. The results of the scheme are being evaluated, and if it is successful it is likely that other health boards will follow suit.
Although NHS Ayrshire and Arran is understood to be the first health board to launch the initiative, support for such a move was first unveiled three years ago by Scotland on Sunday when then Health Minister Andy Kerr said NHS workers needed to go out into deprived areas to persuade overweight and obese people to visit their GP for help.
The scheme was welcomed by health experts.
Dr Colin Waine, chair of the National Obesity Forum, said: "If this is handled tactfully and sensitively it could make a contribution to reducing people's risk of all the diseases that are associated with obesity and this initiative is to be applauded.
"Its success will depend on how tactfully it's done. Some people will listen and others will choose to go their own way. No one knows the complete answer at the moment."
Mary Scanlon, Scottish Conservative health spokeswoman said: "There's no doubt there's a community of hard-to-reach patients who do not respond to calls for screening or use their GP."
Margaret Watt, chairwoman of the Scotland Patients Association, said: "Our health is our responsibility and we all know we must not smoke or drink too much or overeat. I think this scheme is fine so long as there are enough nurses in hospitals and doctors' surgeries where we need them."
Why measure waist circumference?Research has shown waist circumference can be a more accurate indicator than body mass index (BMI) alone of whether an individual is at risk of obesity-related illnesses.
While BMI, a calculation based on height and weight, gives a good indication of whether an average person is overweight it does not take into account body shape or body composition.
It is thought that carrying too much fat around your middle increases your risk of heart disease and certain cancers. For men, this comes in the shape of a 'paunch' and for women this is described as being 'apple shaped' rather than 'pear shaped'.
A waist circumference greater than 32in for women and 37in for men increases the risk of cardiovascular diseases, for example, heart attacks, strokes and diabetes.
