A multi-dimensional model for the treatment of overweight and obese males in a community setting

 

Background: In the United Kingdom (UK) 65.4% of men are overweight or obese. In England the direct costs of treating obesity were estimated in 2002 at approximately £46 million. Obesity develops when energy intake exceeds energy expenditure over a prolonged time.

Reviewing weight loss initiatives reveals that most studies are undertaken on female subjects which may not take account of issues relevant to men. This research takes a multidisciplinary approach to male obesity encompassing nutrition, exercise/activity, and the psychological aspects of behaviour change as proposed in the transtheoretical model of change (TTM)

Aims: To determine whether obese and overweight males go through set stages of behavioural change when trying to lose weight.

Methods: Study 1 established the effectiveness of psychometric tests as screening tools for weight management. Data on current nutritional and activity habits were collected. Forty six males were recruited. In Study 2 nineteen Trainers delivered a l2-week weight management course, evaluated by weight loss and reduction in waist measurement in 54 Clients.

Results: Data from the psychometric tests used in study 1 informed the screening criteria for Study 2. Clients achieved a mean weight loss of 4.65kg (P<0.001) and mean waist circumference reduction of nearly 5cm (P<0.001). In addition, daily steps increased by 3947 (P<0.001) and energy intake decreased by 315 kcal (P<0.05). Weight loss efficacy significantly increased (P<0.01) as did decisional balance difference (P<0.01). An increase in the level of efficacy correlated with reductions in waist measurement (P<0.05).

Conclusion: It is possible to train novice trainers to deliver an effective weight management course.

Increases in self-efficacy and decisional balance were in line with TTM theory. This research provides a programme of weight management for men, meeting the need for "Accredited Health Trainers" highlighted in the UK government white paper "Choosing Health".