Researching men’s experiences of living with obesity

Today, we are launching our study looking at experiences of losing and gaining weight among men living with obesity. The report ‘Living with Obesity’ involved the collection and analysis of almost 30 hours of in-depth interviews with 29 adult men currently living with obesity within the East of England and extensive engagement with directors, commissioners and providers of weight management services.

The findings build on Healthwatch Essex’s expertise in lived experience research to provide an insightful and well-informed evidence base for improving weight management services and our understanding of living with obesity more generally.

The report highlights how sustained weight loss depends on more than diet and exercise, including emotional support and doing purposeful weight loss activities together. It also reveals the impact of how various stages of a man’s life can affect weight gain and the importance of identity and how weight cycling can evoke extreme shame in some of the participants, having damaging consequences for a person’s wellbeing.

Research Manager and author of the report, Dr John Day, said: “An important part of our work highlights the role played by masculinity in creating socially constructed constraints to accessing services and the stories we’ve heard from participants have shown that fluctuations in bodyweight were commonly experienced by men who attended commercial weight loss management programmes. These programmes, by overlooking the turbulent and delicate identity adjustment the men were immersed in, fell short of adequately preparing them for experiencing weight regain.

“Distressing encounters with weight regain and harrowing memories of attending commercial weight management programmes cemented some men’s deep-rooted fears that they lacked the self-discipline to permanently lose their unwanted bodyweight and were destined to eventually return to the ‘old habits’ which had led to the development of obesity.

“Extremely aware they were living in an obesogenic society, men who articulated such fears found themselves in a predicament whereby they were no better off in respect of their desired bodyweight, but worse off in terms of their sense of self-worth and overall wellbeing than when they set out on their journey to lose weight.

“We have already received support in terms of the need for this work from Integrated Care Systems, Essex County Council, the UK Obesity Empowerment Network, people living with obesity involved in the respective All-Party Parliamentary Group, and research groups at the Universities of East Anglia and Western Australia. Now the report is complete, we intend to translate this support into real-world impact.

“Following on from the presentation I gave for Suffolk and North East Essex ICS on supporting people living with obesity, I have also consulted with the UK Obesity Empowerment Network to provide insight into how they might go about achieving greater voice and representation from men. Based on the executive summary of the report we have already shared with stakeholders, Essex County Council have confirmed implications from the work will be used to inform the future design of weight management services. We have also made the Department of Health and Social Care aware of the report, which is timely given their announcement last week that new weight management services are going to be launched.

“Although, arguably, the most meaningful impact of the report might be its potential to change the way readers think about obesity. The rich data included in the report illustrate how participants developed obesity, which was often through a complex set of social circumstances that directed and constrained the men’s behavioural options, as opposed to the common, incorrect and harmful assumption that obesity is the outcome of unrestrained personal choice, irresponsibility and laziness.”

The report outlines the following implications that could inform developments and transformations to weight management services and policy:

  • The type of social support arising from collective action in weight loss strategies with other men and women is more engaging for men than the female-centred group discussion element of conventional weight management programmes.
  • To increase the involvement in and adherence to weight management programmes amongst men living with obesity, service providers might look to incorporate weight loss practices relevant to physical activity or diet into their programmes.
  • While regular sport participation is often associated with a healthy childhood and the development of a sporty identity, it appears that amongst men, the most popular sports they devote time to during childhood, upon which their identities are based, are not sports which are conducive to regular participation throughout adulthood.

Dietary advice and interventions amongst men in the UK who have recently finished or are about to end their regular participation in football and rugby could act as a preventative strategy against the development of significant weight gain and obesity.

  • There is need for greater recognition of the life course context in which weight gain and the development of obesity take place within public health policies, via the various social expectations experienced by men as they encounter and negotiate the adult life course. Early adulthood, becoming a father, the peak of working life, and career progression appear to be pivotal stages in life when men are more likely to gain weight.
  • Due to being in the constantly unsettling scenario of facing the omnipresent stigma of living in an obese body, when encountering unanticipated life events men are already in an unstable predicament, which can trigger behaviours that promote a vicious circle of weight gain and depression. Therefore, the lived consequences of weight stigma mean that attempting to lose weight is not always men’s most pressing health and wellbeing concern.
  • Most men described the experience of attending commercial weight management programmes as unsettling, as aspects of such programmes confused and further emotionalised their relationship with food whilst also adopting a strictly behavioural approach to explain and encourage weight loss.
  • We recommend a more affective and genuinely personal approach amongst commercial weight programmes, that sufficiently acknowledges the delicate position that attendees are placing themselves in. As the existing behaviour focused approach to losing weight employed by commercial weight management services does not fully prepare men to emotionally negotiate distressing encounters with weight regain.
  • For men living with obesity who want to lose weight, fears about reverting to old habits, doubts about having enough self-discipline, and the difficulties of living in an obesogenic yet size shaming society are reflected within their ongoing identity adjustments.

To read the full report click here.