Rates of obesity and related health problems such as type 2 diabetes are skyrocketing in the UK and the US.
On both sides of the Atlantic around three quarters of middle-aged men are overweight or obese.
The impact of this is not only physical health issues – being overweight causes a great deal of stigma in our body beautiful obsessed societies of today.
There has been some movement in terms of acceptance of all shapes and sizes for women, and a general support for women to make healthy changes to diet and lifestyle.
But while exercise and protein-packing is marketed to men, counting calories and dieting is generally seen as a girly domain – even though men are more likely to be obese.
Cutting calories and eating salads has been marketed as a woman’s domain
‘Weight loss is commonly defined as a feminine concern which some men find difficult to relate or react to,’ Rob Hobson, Healthspan head of nutrition, says.
‘In some cases, embarking on weight loss can be especially tricky when in the presence of male peers, which can create an environment that puts pressure on men to retain their ‘real’ male identity.
‘Living up to the cultural script of masculinity can impact on weight loss efforts and also influence decisions to seek help and advice, which may have a huge impact on long-term health as symptoms of disease take longer to be diagnosed.’
Stigma and men’s dieting
For men, even considering changing what they eat can be a stumbling block.
In Gary Barlow’s raw and honest autobiography A Better Me, he illustrates just how hard it can be for men to change their eating patterns. In response to ordering a salad, Gary was jeered ‘What? What’s wrong with him? Salad? Are you gay?’
This lack of social support is a significant barrier to change.
Countless research studies demonstrate the transformative benefits of encouragement from those around us, and conversely the detrimental effect of being surrounded by people who stigmatize health-promoting behaviors such as healthy eating.
It can be incredibly hard for me to admit that they want to lose weight and are usually only open about their struggles once they’ve shed the pounds.
This is because being overweight is also stigmatized – leaving men in an impossible catch-22 of wanting to shed pounds but not be perceived as ‘dieting’.
This is one reason why men tend to control their weight through exercise rather than diet.
But not being able to talk about their struggles can obviously affect men’s mental health. There has been wonderful coverage and discussion of men’s mental health in recent years with regards to depression and suicide prevention, but less so on issues of body image and self-esteem.
It’s OK to get fit, but not diet
Here is a typical case that I see in my practice:
Middle-aged man, often quite fit, sporty and happy with their body at school and beyond. It’s only when the years creep up and life gets a bit more demanding (work plus kids plus friends plus aging parents, etc.) that the pounds insidiously pile on.
This may seem rather cruel – just when life is at its fullest, health niggles start to rear their heads. Usually, this leads to a short-term ‘fitness’ goal – 10k run, triathlon, amateur boxing match for charity, etc.
These goals are often reached relatively easily. With the training lasting at most a few months, focus is razor-sharp. The exercise feels good and it’s effortless to negotiate the time at the gym with partners (‘it’s for charity!’).
Dr Meg Arroll says there has been wonderful coverage and discussion of men’s mental health in recent years with regards to depression and suicide prevention, but less so on issues of body image and self-esteem
In fact, the admiration from fiends and family is almost as good as seeing changes in body shape.
However, after the event there is no structure in place to maintain healthy changes. Fed-up spouses again want so help at home (no benevolent excuse now), colleagues have moved onto another topic of conversations and to be honest, it’s all rather anticlimactic.
Then what happens? Old patterns of behavior kick right back in. A heavy sigh of relief is expressed as meetings once again include wine and a side of chips. Yet, there is a niggling feeling that the middle will start spreading again.
Why? Diets are marketed to women.
Even our ads for diets exclude men – for example the only men in the famous Diet Coke ads are picture perfect.
In fact, soft drink brands have invented new versions (Coke Zero, Pepsi Max) that purposefully exclude the word ‘diet’ from their names. Because diets are for girls.
The tipping point
What I also see quite often is a health scare trigger that can drive weight loss.
Labour MP Tom Watson recently revealed that after hitting a whopping 22 stone, developing Type 2 diabetes, and reading about politicians dying in their 50s, he knew he needed to make a substantial change to his diet and lifestyle.
Having a young daughter too was a motivating factor for a healthier routine from the former ‘Tommy two dinners’, who sought out research and evidence in order to change his health for good.
This is the tipping point for meaningful health change, which consists of a combination of factors rather than just not just one.
This is important as a health scare is sometimes not enough on its own to instigate behavior change.
Heavy criticism is heaped on people with so-called ‘lifestyle conditions’ but without truly understanding what’s driving this behavior, it can rarely be changed.
The tipping point if often powerful enough to help men overcome the shame and guilt associated with overweight and obesity – but really, we need to help men make these changes before ill-health develops by reducing the stigma around dietary changes.
The solution – combining men’s competitive nature with meaningful health changes
In general, only 2-5 percent of weight loss is maintained over time. As we age, our metabolism slows so even with the same amount of physical activity, it can be nigh-on impossible to prevent the creeping waistline unless dietary changes are made.
Combining diet, exercise and a good understanding of individual eating psychology is essential for maintaining a healthy weight long-term. Innovative approaches such as the SuperWellness Challenge harness both men and women’s competitiveness within a workplace and use this edge to catapult health and wellbeing.
The SuperWellness program combines nutritional education with the principles of coaching and behavioral psychology, so that even after the initial competition is finished, participants have the knowledge and confidence to keep going with their new healthy habits.
Major companies such as P&O Ferries and AMCOGiffen (principal contractor to Network Rail) have seen huge benefits to their workforce, with the former having reduced sickness absence from 7 percent to 0.07 percent following the program. Which goes to show, that there are ways to help even diet-adverse men get healthier.