Exploring the influences on men's engagement with weight loss services: A qualitative study.

Abstract

Background: Engagement of men with commercial and UK National Health Service (NHS) weight loss services is low, and few studies report on why this may be. However, evidence shows that men who do participate in weight loss programmes tend to lose as much, or more weight than women. The present study aimed to explore men’s experiences and expectations of mainstream weight loss services in the UK, following referral from a medical professional, particular in relation to barriers and motivators. Methods: Semi-structured interviews were conducted with 18 men with a BMI over 25kg/m 2 including those who had, and had not, attended group-based or one-to-one weight loss services. Interviews were analysed using thematic analysis. Results: Two themes were identified; Fear as a motivation for change (1) and Attitudes towards existing weight loss services (2). Within theme two, two subthemes were identified; ‘Female dominated services’ and ‘Incompatibility of existing services for men’. The findings suggest that fear, as a result of a medical diagnosis or referral is a mechanism for motivating men to engage with weight loss services. This was often augmented by awareness of other people’s experiences of poor health due to their weight. The gender imbalance and attitudes towards existing weight loss services deterred men from engaging with or continuously attending sessions. This imbalance resulted in feelings of self-consciousness, shame and a perceived stigma for men using weight loss services. These experiences highlighted the importance of providing services which align with men’s preferences to promote engagement. Conclusions: A medical diagnosis or referral serves as a strong motivator for men to engage with weight loss services by invoking fear of negative consequences of not losing weight. Men perceived weight loss services to be feminised spaces, in which they felt self-conscious and out of place. As a result, men were deterred from engaging and considered their options were limited. Implications for service design and commissioning are discussed. Involving men in research, service design and evaluation is key to improving their engagement and weight loss.

Preventing weight gain in adults: A systematic review and meta‐analysis of randomized controlled trials

“…Similarly, men are often underrepresented in community based chronic disease prevention programs that promote healthy eating and regular exercise, with a lack of male program leaders, spousal or partner involvement and time and travel constraints due to employment commitments all cited as common recruitment barriers 94 . Qualitative evaluation of barriers to engagement reported by men include perception of weight management programs being female‐dominated and designed for women with male under‐representation creating a minority effect and inhibiting participation 95 . Conversely, the increased number of studies in women seen here may be due to the emphasis of women as a high risk group for accelerated weight gain across the reproductive life course (i.e., preconception, pregnancy, inter‐pregnancy, postpartum and menopause) 24 .…”