Abstract
BackgroundThe prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part.MethodsA mixed-methods study analysing baseline data on 747 men aged 35–65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme.ResultsObjectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at ‘very high’ risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35–44, 45–54 and 55–64 years respectively). A further 21%, 16% and 13% were at ‘extremely high’ risk. Qualitative data revealed that the powerful ‘draw’ of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others ‘like them’ and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club.ConclusionsThe delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt ‘right’ rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity.
Highlights
The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes
In order to inform further development of weight management and other public health interventions in football club settings this paper reports firstly, on the characteristics of 747 men participating in a randomised controlled trial (RCT, ISRCTN32677491) of a weight management programme [36] designed to attract men at high risk of ill-health due to obesity [37], and, secondly, their accounts of why they decided to participate in the programme
We first describe the characteristics of men who enrolled for Football Fans in Training (FFIT) and their risk of future disease in comparison with Scottish men of the same age
Summary
The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. As argued elsewhere [22], prevailing cultural constructions of masculinities are closely related to men’s decisions about health-related behaviours, including help-seeking [23,24,25] and alcohol consumption [26,27,28], as well as eating, physical activity (PA) and weight loss. With the increasingly male hue of the obesity epidemic, developing weight management strategies which are appealing and acceptable to men is a public health priority [31], and most likely to be successful when working with, not against, cultural ideals of masculinity. Other weight management programmes for men take a similar view and have shown promising results [31,32,33], evidence on what works in weight loss for men is relatively sparse [34] given their underrepresentation in weight loss trials [35]
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