Date: 01 June 2016
Category: Obesity in men
In our medical obesity clinic, there are significantly greater numbers of women than men referred, despite high levels of obesity in men. We find often find that a recent health scare, such as diagnosis of diabetes or a fatty liver, has motivated the men to think about losing weight and improving their health.
The clinic is aimed at patients with severe and complex obesity, is jointly run by a dietitian and physician, and is accessed via GPs and the community based Leeds Weight Management service. In our initial assessment, we look at the history of weight gain. Many men report that a reduction in activity was a factor; with the local interest in rugby and football, many may have played the sport (with several weekly training sessions) but then had to stop through an injury, work commitments or a change in family circumstances. This decrease in activity (along with continuing to eat and drink the same) has often contributed to weight gain over the years.
We find that men are less likely to have tried formal diets, such as attendance at slimming clubs, diets through the local GP practice or very low calorie diets, compared with women. They tend to say that they have ‘watched their diet’ or their partner has encouraged them to watch their calorie intake. Men often try to increase their activity to help with weight loss.
Although they are less likely to have attended slimming clubs, many state that they have found the group sessions run by Leeds Weight Management very helpful. In the Leeds Weight Management group, all attendees have a significant amount of weight to lose and most have significant comorbidities in contrast to the usual members of slimming clubs. Men have reported that this makes them feel more comfortable about attending, even though it is a mixed group. The Leeds Weight Management sessions focus on healthy eating, including portion sizes, goal setting and also being more active. All attendees have access to local leisure centres at reduced cost.
As the men have been through a community weight programme before referral onto our clinic, most will have started to address portion sizes, decrease snacking and trying to be more active. This focus continues in our clinic. Some will report that they are doing a significant amount of exercise, but it is important to get the correct balance so activity can be maintained. We have had a small number of men who have attended slimming clubs; one was so successful that he is now a group leader!
The clinic focuses on improvement in comorbidities, in addition to weight loss. Currently advice is on an individual basis and we will encourage men to continue with self-monitoring and setting small achievable goals. Some men will use apps on their smartphones to monitor their diet and activity.
We are currently expanding our clinic and will be working more closely with Leeds Weight Management. This may give the opportunity to develop men only groups in combination with leisure centres.
New NIHR research supports much of what we are doing – for example, confirming the factors that encourage men to seek help with their weight, and providing an example of a programme that uses an interest in sport to support weight loss. We will be thinking about how we can implement these findings, and those from current research projects, in practice.
In our medical obesity clinic, there are significantly greater numbers of women than men referred, despite high levels of obesity in men.
Consultant Dietitian in Adult Obesity