Abstract
BackgroundDespite rising international rates of obesity, men remain reluctant to participate in weight loss research. There is a lack of evidence to guide the development of effective weight loss interventions that engage men. The objective of this study was to provide a comprehensive process evaluation of the SHED-IT (Self-Help, Exercise and Diet using Information Technology) weight loss program for men, as delivered in the SHED-IT community weight loss trial, and to identify key components associated with success.MethodsIn an assessor-blinded randomised controlled trial, 159 overweight and obese men (BMI 25.0-40.0 kg/m2) were randomised to one of two gender-tailored weight loss interventions with no face-to-face contact, or a control group. The interventions were informed by Bandura’s Social Cognitive Theory (SCT) with men encouraged to complete a Support Book containing SCT-based tasks including goal setting, reward setting, creation of social support strategies and self-monitoring of: i) weight, ii) physical activity, and iii) diet. At post-test, compliance with SCT tasks was examined and men also completed a process evaluation questionnaire.ResultsBoth SHED-IT intervention groups demonstrated greater weight loss during the intervention compared to the control, with no difference between intervention groups. Most men engaged with the SCT tasks although compliance declined over time and utilisation of social support networks and reward selection was poor. In a multiple regression model, the number of goals set (β [95% CI] = -0.3 [-0.6, -0.1], p = 0.01) and the number of weight records documented (β [95% CI] = -0.2 [-0.4, -0.0], p = 0.03) independently predicted weight loss. The process evaluation indicated that men found the programs to be supportive, enjoyable and beneficial.ConclusionsThis process evaluation provides valuable information to inform the development of obesity treatment strategies that engage men. Future studies with men should include a strong focus on self-monitoring and goal setting to enhance behaviour change and improve treatment effects.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12610000699066.
Highlights
Despite rising international rates of obesity, men remain reluctant to participate in weight loss research
We present the findings of a comprehensive process evaluation 3-months post-intervention of the SHED-IT community weight loss randomised controlled trial (RCT) [16]
Participant characteristics The high appeal of a male-only weight loss program of this nature was demonstrated by the recruitment of 159 men from more than 600 enquiries within a one-week period
Summary
Despite rising international rates of obesity, men remain reluctant to participate in weight loss research. Obesity more than triples the risk of developing type 2 diabetes, gall bladder disease and sleep apnoea, and doubles the risk of heart disease, hypertension and asthma [2,3]. Despite the need for weight management, men are less likely to perceive themselves as overweight [4] or to participate in weight loss interventions or research [5]. This may arise from a lack of appeal of traditional weight loss programs and/or reduced motivation after previous failed weight loss attempts [6]. Men report preferences for convenient programs that include personalised feedback, people they can relate to ( other men), the use of humour and minimal disruption to their current lifestyle [6,8,11]
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