如何科学地敦促身边的男性减肥？ BMC Public Health

论文标题：Exploring the influences on men’sengagement with weight loss services: a qualitative study

期刊：BMC Public Health

作者：MeganElliott, FionaGillison & JulieBarnett

发表时间：2020/02/25

DOI：10.1186/s12889-020-8252-5

男性往往倾向于不参加减肥计划，但探究这背后的原因的研究很少。发表在BMC Public Health上的一项新的定性研究的主要作者，在接下来的分享中，讨论了她的团队针对这个问题的研究。

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我们对如何减肥或多或少都会有一些了解，但这并不能改变我们的行为。使用正规的减肥服务可以有效地帮助那些想要减肥的人们。在英国大部分地区，想要减肥的人可以参与循证小组或一对一的减肥计划。

然而，参与这些减肥计划的男性数量却很少。Counterweight, Weight Watchers, SlimmingWorld and Rosemary Conley Diet 和Fitness Clubs等机构的顾客群中，男性至只占到了11-25%。在全球肥胖率攀升的如今，英国超重的男性比女性更多，但他们对减肥计划的参与之低，令人担忧。

我们发表在BMC PublicHealth 上的文章探索了促使男性参加减肥计划的因素。在与18名有不同减肥经历、参与程度不等的男性的访谈中，我们发现了两个关键的主题：因为恐惧引起的改变以及对现有减肥服务的态度。

主题1：因为恐惧引起的改变

医疗人员的诊断、指示和介绍病人去减肥机构都使男性更有动力参加减肥计划。肥胖带来的无法挽回的损害和行动不便，和让病人了解到一些替代疗法，都明显影响病人的行为。

“我的体重已经增加到160公斤...我的家庭医生说，如果我不想继续增加体重，就可能需要有一个胃带。我说不，我们不要搞成那样。”——[参与者2]

看到体重问题对家庭成员的长期影响，往往使男性更有动力去了解自己处境的严重性：

“我失去了我的小姨子...她生前一直有很严重的体重问题。我看，嗯，这是最终让她送了命的主要原因。”——[参与者8]

主题2：对现有减肥服务的态度

虽然有强大的健康和恐惧因素，男性仍往往不愿意参与或坚持减肥。这可以用以下两个亚主题解释其原因：

1：以女性顾客为重心的服务场所：男性属于少数，使他们在减肥方面尤其感觉不自在和尴尬：

“在Weight Watchers，有大约40个女人和我和另外两个男人，我感觉被孤立了。”——[参与者4]

一些男性认为，以女性顾客为重心的减肥服务威胁到他们的身份认同，而参与减肥或关注体重是缺乏“男子气概”的事情。有些男士还说，他们在同龄人面前，体重是个难以启齿，找不到共鸣的话题：

“我认为主要原因是和男性减肥有关的负面标签，使男性认为减肥和关注自己的体重很娘。”——[参与者7]

2：现有减肥服务对男性的不友好：通常，现有的减肥服务不是男性想要的；男性认为专注于讨论体重和赞扬减肥的计划太霸道和有侵入性。所以，男性多不愿意参与，或三心二意，或半途而废：

“我不喜欢那些互相为对方鼓掌的尴尬套路。他们还每星期评出本周的最优减肥者什么的，让我受不了。”——[参与者13，重复参与了付费计划]

对实践的影响

本研究中的男性都由于医学诊断的结果，或并发症的发生带来的恐惧，产生了强烈的动力去减肥。研究还凸显了医疗专业人员使病人关注体重问题的重要作用。但由于男性比女性更不常去看家庭医生，所以，我们应该找一些其他的，诊外的方法来增加男性的参与。

调查结果认为，现有以女性为主的减肥服务不符合男性的偏好。所以减肥机构必须提供更适合各种男性的，令他们更满意的服务形式，例如，全男性、男女混合、和一对一。

了解促进或阻碍参与的因素是解决问题和降低肥胖，超重和相关的健康问题的关键。

摘要：

Background

Engagement of menwith commercial and UK National Health Service (NHS) weight loss services islow, and few studies report on why this may be. However, evidence shows thatmen who do participate in weight loss programmes tend to lose as much, or moreweight than women. The present study aimed to explore men’s experiences andexpectations of mainstream weight loss services in the UK, following referralfrom a medical professional, particular in relation to barriers and motivators.

Methods

Semi-structuredinterviews were conducted with 18 men with a BMI over 25 kg/m2 includingthose who had, and had not, attended group-based or one-to-one weight lossservices. Interviews were analysed using thematic analysis.

Results

Two themes wereidentified; 'Fear as a motivation for change' (1) and 'Attitudestowards existing weight loss services' (2). Within theme two, twosubthemes were identified; ‘Female dominatedservices’ and ‘Incompatibility of existing services formen’. The findings suggest that fear, as a result of a medical diagnosisor referral is a mechanism for motivating men to engage with weight lossservices. This was often augmented by awareness of other people’s experiencesof poor health due to their weight. The gender imbalance and attitudes towardsexisting weight loss services deterred men from engaging with or continuouslyattending sessions. This imbalance resulted in feelings of self-consciousness,shame and a perceived stigma for men using weight loss services. Theseexperiences highlighted the importance of providing services which align withmen’s preferences to promote engagement.

Conclusions

A medicaldiagnosis or referral serves as a strong motivator for men to engage withweight loss services by invoking fear of negative consequences of not losingweight. Men perceived weight loss services to be feminised spaces, in whichthey felt self-conscious and out of place. As a result, men were deterred fromengaging and considered their options were limited. Implications for service designand commissioning are discussed. Involving men in research, service design andevaluation is key to improving their engagement and weight loss.

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