Presented by Melissa Crane, PhD
Melissa Crane, PhD, a postdoctoral fellow at the University of Minnesota, presented results of a novel program she researched while at the University of North Carolina Chapel Hill, testing the efficacy of an internet-delivered weight loss program designed to appeal to men at the ObesityWeek 2015 meeting in Los Angeles, CA. November 2-6, in Los Angeles.
"It seems many [weight loss] programs don't meet men's needs or their perceptions of their needs," Dr. Crane said. Men do need weight loss help, and more of them do than women, according to statistics. The Henry J. Kaiser Family Foundation, citing statistics from 2013, says 70% of men and 57% of women in the U.S. are either overweight or obese.1
According to Dr. Crane, despite this high prevalence of overweight and obesity among men, they are under-represented in behavioral weight control programs. Part of the issue, she said, is what men perceive as ''women's'' weight loss programs. Few behavioral weight loss programs are targeted specifically to men. Slowly, that is changing, as researchers are reaching out with weight loss programs specifically for men, she said. "A group in the U.K. has developed a weight loss program with group sessions held at a football stadium," Dr. Crane said. Another program focuses on encouraging men to have a goal of healthy weights to be role models for their children. Commercial weight loss programs in the U.S. have included celebrity male spokespersons and tweaked their programs for men.2
In her research, she has found that men aren't attracted to typical weight loss programs, viewing them as complicated and tailored to women. They want simplified weight loss programs. They also say they want to be able to eat ''masculine'' foods, not ''feminine'' fare that they see promoted for weight loss and consider more appealing to women, such as grilled chicken over lettuce. They see themselves as wanting to lose weight for health reasons, while they say women are more into weight loss to satisfy vanity.
The REFIT Plan Achieves Primary Outcome
With her colleagues, Dr. Crane designed the REFIT (Rethink Eating and FITness) program, a multi-faceted intervention. Its components include reducing calories by making six 100-calorie changes to the diet per day, increasing physical activity and using simplified self-monitoring.
The 100-calorie changes could be something simple like swapping a 20-ounce soda for a 12-ounce one or choosing a thin-crust pizza instead of deep-dish. The goal was to achieve a 4,200 calorie deficit every week, theoretically resulting in a one-pound loss weekly. Strategies to achieve the deficit included swapping out sweets, cutting fat and balancing beverages to healthier choices. All were self-selected.
"The men were 18 to 65, overweight to moderately obese and able to exercise," Dr. Crane said. At baseline, the average weight was 220 pounds. She randomly assigned the 107 men, average age 44, to the intervention group or a waitlist control group.
Physical activity was gradually increased to 225 minutes weekly. The men were encouraged to weigh daily, record their diet changes and exercise sessions. The program included weekly online contact for three months and monthly contact for three months. There were two group sessions and 13 online check-ins.
The primary outcome was weight change over six months. REFIT men lost 5 kilograms (95% CI: -6.1, -3.9) at three months and maintained that loss at six months. This was greater than the change in the control group (P <0.001, 6-month: -0.6, 95% CI: -1.8, 0.5). More REFIT participants (49%) achieved a 5% weight loss as compared to the control group (19%, OR 9.4; 95% CI: 3.2, 27.4).
In the REFIT group, weight loss was associated with the number of online contacts finished, self-reported frequenting of making 100-calorie reductions to the diet, using the simplified self-monitoring form and using a mobile app to track diet and frequency of self-weight (P-values 0.05). REFIT participants completed 86.2% of online contacts. Nearly 96% said they would recommend the program to a friend.2
Adapting REFIT Concepts
The REFIT program isn't available commercially, but Dr. Crane said physicians and others could ''take some of the concepts'' and apply them to a personalized weight loss program for men. The program was effective in producing weight loss that was clinically relevant, she said.2
November 5, 2015
Crane M. Reaching Men with Weight Loss: Randomized Trial of the REFIT Program for Men. The Obesity Society (TOS) Oral Abstract (T-OR-2019). ObesityWeek 2015, Los Angeles, CA. November 2-6, 2015
1. Overweight and Obesity Rates for Adults by Gender. The Henry J. Kaiser Family Foundation. 2013 data. http://kff.org/other/state-indicator/adult-overweightobesity-rate-by-gender/ Accessed November 5, 2015.