Faculty of Life Sciences and Education, University of South Wales, Lower Glyntaff Campus, Pontypridd, CF37 1DL, UK.
Department for Health, University of Bath, Bath, BA2 7AY, UK.
BMC Public Health. 2020 Feb 25;20(1):249. doi: 10.1186/s12889-020-8252-5.
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.
Semi-structured interviews were conducted with 18 men with a BMI over 25 kg/m including those who had, and had not, attended group-based or one-to-one weight loss services. Interviews were analysed using thematic analysis.
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.
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.
男性参与商业和英国国民保健服务（NHS）的减肥服务的比例很低，很少有研究报告为什么会这样。然而，有证据表明，确实参加减肥计划的男性往往会减掉与女性一样多，甚至更多的体重。本研究旨在探讨男性在英国主流减肥服务中的体验和期望，这些服务是在医生推荐后提供的，特别关注障碍和激励因素。
对 18 名 BMI 超过 25kg/m2 的男性进行了半结构化访谈，其中包括参加过和未参加过基于小组或一对一的减肥服务的男性。采用主题分析法对访谈进行分析。
确定了两个主题；“恐惧作为改变的动力”（1）和“对现有减肥服务的态度”（2）。在主题二内，确定了两个子主题；“女性主导的服务”和“现有服务对男性不兼容”。研究结果表明，由于医疗诊断或推荐，恐惧是促使男性参与减肥服务的一种机制。这通常是由于意识到其他人因体重而健康状况不佳的经历而增强的。性别失衡和对现有减肥服务的态度阻碍了男性参与或持续参加课程。这种不平衡导致男性在使用减肥服务时感到自我意识、羞耻和感知到耻辱。这些经历强调了提供与男性偏好一致的服务以促进参与的重要性。
医疗诊断或推荐是男性参与减肥服务的强大动力，因为这会引起不减肥的负面后果的恐惧。男性认为减肥服务是女性化的空间，在这些空间中，他们感到自我意识和不自在。因此，男性被阻止参与，并认为他们的选择有限。讨论了对服务设计和委托的影响。让男性参与研究、服务设计和评估是提高他们参与度和减肥效果的关键。
