GPs should be paid extra to refer men to weight management services as part of a drive to improve responses to male obesity, a cross-party think-tank says today.
The Social Market Foundation said that new weight management services in traditionally male settings such as pubs, football clubs and barber shops should be used to encourage more men to address their weight issues.
The Government should also launch a major communications campaign challenging harmful stereotypes of masculinity that are preventing some men from seeking help with weight management, the SMF said.
“Masculinising” weight services such as dieting could help men with their weight, the SMF said, citing community projects in places such as Watford. (See Notes for Case Study)
The SMF made the recommendations in a new report assessing male and female experiences of obesity and overweight. In England, the obesity rate is slightly higher for women (29%) than for men (27%). However, men are significantly more likely to have overweight (41% versus 31% for women).
Despite broad similarities in weight issues, there are significant differences in the way men and women respond to obesity and overweight. SMF polling from 2020 shows that women are more likely to want to lose weight than men (66% versus 48%); they were also more likely to follow calls to lose weight to reduce the risk from Covid-19 (by 54% versus 50%).
Men are much less likely to undergo bariatric surgery to lose weight. NHS data for England show that women accounted for 79% of those with obesity undergoing bariatric surgery in 2018/19.
Women also make up 90% of GPs’ referrals to NHS weight management services. GPs have been allocated additional funding for this, receiving £11.50 for every referral. However, the fee is the same regardless of the patient’s gender, and the SMF called for an additional premium payment for male referrals.
The SMF cited recent research findings published in Clinical Obesity which found that even a 30 second “opportunistic” intervention by a GP during consultation about another issue could significantly increase the rate at which men accept weight management programmes.
However, men are less likely to see GPs in general than women. And some GPs are more reluctant to raise weight issues with male patients than with female ones. A financial premium on male referrals would help incentivise GPs to encourage more men to get help with the weight, the SMF said.
The report says: “There is a much stronger hesitancy among men in acknowledging their weight issues, in talking about them openly, and in seeking help. NHS weight-loss programmes are not usually designed for men, and as a result, men are consistently under-represented in programme referrals and enrolments.”
The SMF said that social stereotyping around gender roles also makes some men wary of weight management services such as dieting
In response, the Government should launch a national campaign to improve awareness of obesity and weight management among men. That campaign should masculinise health and empower men to seek health treatment through raising awareness in male settings, such as pubs, or getting male role models and celebrities to talk candidly about their own experiences. The newly-formed Office for Health Improvement and Disparities should co-ordinate this campaign, the SMF said.
Jake Shepherd, SMF researcher, said:
“Men are about as likely as women to be living with obesity, but they are much less likely to get support from the NHS and other services. GPs should be incentivised to do more to encourage men to discuss weight treatment and management services.”
Traditional ideas of masculinity are an obstacle to some men seeking support with overweight and obesity. Those harmful stereotypes should be tackled head on, and the Government should lead that conversation, sending a clear message that there is nothing unmanly about seeking help with weight issues.”
In other recommendations, the SMF said:
- Both the NHS and commercial service providers should look to review their existing weight management programmes, with a view to incorporating male-friendly components into future designs and increasing the amount of gender-specific services available to men. A particular focus should be on creating more “masculine” environments in which men feel comfortable to discuss and work on issues related to their weight.
- Local authority-managed gyms, swimming pools and sports facilities should be required to offer women-only sessions and time slots, to create more safe spaces in which women feel comfortable to partake in physical activity. There should also be attempts to increase the availability of childcare facilities in gyms and sports clubs, allowing women (who undertake most within-household childcare) to prioritise exercise.
- More broadly, policymakers must continue to explore ways of improving safety and promoting inclusivity in public spaces, particularly for women and girls. While health and obesity reduction are not the primary reasons for doing this, evidence suggests a significant proportion of women currently feel unsafe exercising in public spaces, or have been harassed while doing so.
- The government should issue grants to encourage local authorities and/or NHS trusts to trial cash incentive schemes to encourage individuals to lose weight, engage with weight management services and be more physically active. This would help establish best practices for creating cash incentive schemes which have a significant and long-lasting impact on individuals’ weight loss.
- The report, Gendered experiences of obesity, is published today at 09:30 at smf.co.uk/publications/gendered-experiences-of-obesity/.
- Novo Nordisk has provided sponsorship to the Social Market Foundation (SMF) to fund the research and production of the report. Novo Nordisk has had no influence on the content of the report and full editorial control remains the sole responsibility of the SMF.
- The SMF, a registered charity, declares all its sources of funding and retains editorial independence over all its outputs.
- The polling figures used here come from the SMF’s last report on obesity, available here: https://www.smf.co.uk/publications/obesity-and-coronavirus/
In 2014, Watford F.C.’s Community Sports and Education Trust, commissioned by Hertfordshire Council, set up the Shape Up weight project to support middle aged men lose weight using group exercise and sport. Initially scheduled to run up until 2017, due to successful results the project was extended to August 2020.
Shape Up was a free, 12-week weight loss course, and was aimed at men aged 18 to 65 years-old with a BMI of 30 or over and men from the BAME community with a BMI of 28 or over. Sessions are comprised of education and physical activity and are delivered with the aim of sustaining weight loss and healthy lifestyles in the long-term, rather than short-term gains. The course was accessible to all, across all districts of Hertfordshire and Harrow, and it was supported by local GPs who could help sign up participants through their local surgery.
According to the programme’s 2019 Impact Report, a total of 1,291 people took part in the programme, amounting to 54,305,650 calories burnt and a total weight loss of 15,515.9lbs – equivalent to 7.1 tonnes. It also achieved sustainable health changes, as 64% of men managed to maintain 5% weight loss at 12 months.
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