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Noel richardson

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  • 1. Perspectives on research and policy onweight loss and obesity in men’s health Weigh to Men’s Health Belfast 8th June 2011 Noel Richardson PhD Centre for Men’s Health Institute of Technology Carlow Noel.richardson@itcarlow.ie
  • 2. Overview• Why men?• Applying a gendered lens to male obesity• CNDS Study findings• Best practice guidelines in tackling male obesity through the primary care setting
  • 3. Men in Ireland are getting fatter
  • 4. • Obesity levels in men have more than tripled since 1990 (up from 7.8% in 1990 to 25.8% in 2011) and have quadrupled in 51-64 year old men (10.7% to 42.1%) (IUNA, 2011)• Central (or visceral) obesity is more prevalent among men than women and is associated with an increased risk of hypertension, diabetes and metabolic syndrome (World Health Organisation 2009)
  • 5. ‘Gender-competent weightmanagementprogrammes formen’ (p53)
  • 6. Applying a gendered lens to male obesity
  • 7. 1. Men’s diets are less healthy than women’s diets2. Men who are overweight/obese tend not to see their [excess] weight as a cause of concern3. Men tend to lack control over their diets and are less knowledgeable about healthy eating4. Men’s dietary habits tend to be adversely influenced by working unsociable hours5. Men’s approach to food tends to be pleasure-oriented
  • 8. 6. ‘Bigness’ is associated with more dominant notions of masculinity7. Men can often be resistant to healthy eating messages or to being told what to eat8. Men are much less likely than women to consider dieting as a means to weight-loss9. Men tend to view exercise and sport as a more acceptable means of trying to lose or maintain weight10.Men are more open to dietary change or to losing weight when prompted to do so by their GP
  • 9. Key findings from the Community Nutrition and Dietician Service (CNDS) Study HSE South • Quantitative Phase 1 (i) a review of HSE (South) referrals data for the year 2008 (ii) phone questionnaires with 67 obese men who had previously attended the CNDS in 2008 • Qualitative Phase 2 Semi-structured interviews with a purposive sub-sample of obese men (n=10) • Qualitative Phase 3 Two focus groups with CNDS dieticians (n=16)
  • 10. • Men are less likely than women to be referred for lifestyle counselling for obesityMen comprised just 38% (n=3,200) of overall referrals (n=8,424) to the CNDS in 2008...• Addressing Obesity as a Health Issue – ‘the elephant in the room’Obesity typically presents as a secondary rather than a primary conditionSpotlight on other chronic conditions rather than ‘just’ overweight/obesity
  • 11. • Relationship between obesity, identity, self concept and self-esteem Depression, anxiety, feeling embarrassed, emasculated and physically disabled by their weight were frequently cited as consequences of excess weight• Tailored lifestyle interventions have a key role to play in tackling male obesity The CNDS was credited with having a major impact on men’s dietary and lifestyle behaviours.• Lifestyle behaviour change targeted at men should emphasise personal choice and responsibility
  • 12. Best Practice Guidelines in tackling male obesity in the primary care setting
  • 13. 1. Don’t ignore the problem [of male obesity] GPs have a crucial role to play2. Adopt a ‘shared investment’ approach to lifestyle change3. Increase the breadth and capacity of primary care teams to deal with obesity Exercise referral, mental health & addiction services4. Consider the impact of key ‘transitional’ periods in men’s lives5. Account for and anticipate likely problems or barriers to weight-loss
  • 14. 6. Place a strong focus on physical activity as a means to weight loss for men7. Use practical approaches when working with men8. Provide long term follow up with men to enable them to sustain lifestyle changes9. Not all men are the same10. Provide training for primary care teams on how to work effectively with men• (i) increasing men’s awareness of the potential ill effects of excess weight; (ii) ensuring that discussions on weight are an in-built and a natural part of GPs’ consultations with men; (iii) availing of opportunistic brief interventions with men in relation to their weight; (iv) adopting a client-centred approach to weight loss; (v) improving lines of communication between dieticians and GPs in relation to referrals; and (vi) using BMI and/or waist circumference measurements as a routine part of all consultations