A qualitative exploration of the views of men working in routine manual occupations, general practitioners and public health strategists about body weight, health and weight management programmes

Background Men are underrepresented in weight management programmes despite being more likely to have increased health risk due to elevated body mass index than women. Gender sensitised weight management programmes have been trialled in an attempt to encourage more men to access support. Despite successes little is known about the views of men that have never attended any form of structured weight management programme. The aim of this research was to increase understanding of the views that men least likely to attend weight management programmes have towards body weight, health and weight management programmes. Methods Participants were recruited purposefully at their place of work. Semi-structured interviews were conducted with sixteen adult men with a BMI>25 who had never participated in a structured weight management programme and were employed in routine manual occupations. Interviews were analysed using an inductive thematic analysis approach to identify themes. Following early data analysis, GPs were identified as having influence on men’s behaviour regarding weight management. Subsequently, ten GPs were recruited and interviewed, along with two public health strategists and findings from the different groups compared. Results Data analysis from interviews with men resulted in three themes (intrapersonal factors, important relationships and hegemonic masculinity) and a number of sub-themes. Analysis from interview with GPs and public health strategists also resulted in three themes (raising the issue, intervening to address weight management and “women are from Venus, men are from Mars”) plus additional sub-themes. Men have high levels of body consciousness, value guidance from GPs, express high levels of agency towards lifestyle choices and seek to preserve their masculinity, which is a barrier to attending weight management programmes. GPs did not feel equipped to deal with obesity sufficiently in primary care and held stigmatised views of men and their needs regarding body weight and weight management. A qualitative comparison of findings between these different participant viewpoints highlighted a number of conflicting beliefs. Conclusion Failure to consider the needs of men in weight management programmes will continue to lead to low participation. Improving health literacy at population level, gender sensitisation of resources, preservation of masculinity and providing men with opportunity to follow self-directed weight management programmes is the most likely way to increase participation. GPs need empowering to feel confident at addressing weight management in men and to have greater appreciation of their influence on the behaviour of this group. Public health commissioners and strategy planners should ensure clearly defined pathways are in place for men and consider the specific needs of men when developing weight management policies or risk failing to meet the needs of this population and contributing to gender health inequalitie