Is Weight Loss Different for Men?
By Leanna Skarnulis
WebMD Weight Loss Clinic - Feature
Reviewed By Charlotte Grayson, MD
A weight-loss expert gets a phone call from a friend: "I just made a $50 bet to lose 20 pounds in a month. Tell me how to do it." Guess the caller's sex.
"I get these calls from friends and relatives," says Gary D. Foster, PhD, clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania School of Medicine. "These types of calls are always from men."
That's probably what you'd guess, but you'd be hard-pressed to find research supporting that or any other assumption about how men and women differ when it comes to dieting, Foster says. "Most of the weight-loss research is about women," he says. "There are probably fewer than 10 good studies that separate men and women, and what they address is that men lose more weight and lose it faster."
Still, he and others in the field have run across some anecdotal differences in the two sexes' approach to weight loss. One, Foster says, is that men typically tend to be less process-oriented than women.
"Men don't want the fluff. 'Don't give me all the reasons I'm overweight. I just want to lose weight, not talk about it.' And they don't want to talk about maintenance. They'll deal with that later. Women stereotypically spend more time talking about how they got where they are and about things like emotional eating."
Is It Easier for Men?
"Men are more prone than women to build muscle and have more muscle tissue, and that makes their metabolic rate higher," says Elaine Magee, MPH, RD, WebMD Weight Loss Clinic's "Recipe Doctor." "With many women, their bodies encourage them to lay down fat, to insulate and be a baby incubator."
But age slows metabolism in both sexes, making it harder to maintain a healthy weight.
"If you're 20 pounds overweight, whether you're male or female, it's challenging," says Kathleen Zelman, RD, WebMD Weight Loss Clinic's director of nutrition. "When my husband and I decide to lose a few pounds, it's no easier for him than for me."
And today's more sedentary lifestyles are at odds with your body's design to be more active. For many, the most activity they get is driving to the store to pick up vast quantities of food, to be eaten while lounging in the La-Z-Boy and vigorously waving the remote at the TV.
The Harvard Health Professionals Study, which has tracked more than 50,000 men since 1986, cites three lifestyle factors that predict weight gain for men: less time exercising, more time watching TV, and eating between meals.
Lifestyle changes in recent decades have had a profound effect. Four decades ago, the National Health and Nutrition Examination Survey estimated that 49% of men and 40% of women age 20 or older were overweight (having a body mass index of 25 or higher) or obese (with a BMI of 30 or higher). By 2000, those statistics had been supersized: 67% of men and 62% of women made the list.
The same survey found that obese women outnumbered men: 34% of women vs. 27% of men fell into the obese category. But that's small comfort, because even men who are moderately overweight gamble with serious health risks.
Despite their biological weight-loss advantages, do cultural expectations make it harder for men to diet?
"If you think about a vice president or CEO of a company, our culture could imagine a big, powerful guy of 250 pounds being acceptable," says Foster. "I can't imagine that the social norms would find it acceptable for a 250-pound CEO to be female. The words 'big and powerful' don't have good meaning for a female but do for a male.
"I think the biggest gender difference is, it's more socially acceptable for women to be dieting than men. If you're out with guys and say, 'Please hold the salad dressing,' it has a different ring to it than a woman with her girlfriends."
Still, Zelman says, these cultural messages aren't keeping men from weight-loss success. "I think men are getting the media message about eating properly," she says.
Magee agrees. "I live in California, and 40% of the readers of my nutrition or recipe columns are men. About 30% of the people on my web site guest book are men. And when I do cooking in my daughter's classroom at school, the boys are as excited as the girls."
But typically, men are less likely to seek the support and advice of others -- something that experts agree is important in overcoming the challenges of weight loss.
Foster says it's difficult for men to seek support in group weight-loss programs, where women are likely to outnumber them by four or five to one. "The things women talk about are different," he says. "When you talk to men about cooking and preparing food, a lot of them tune out because in homes where roles are stereotypical, cooking is something their wives do."
Another difference he notes is that women sometimes tend to be better than men at describing exactly what they did to lose weight. "We try to get men to articulate what they did so they can repeat it," he says.
But online support groups -- especially those aimed specifically at men -- may help to make the process more guy-friendly.
Zelman says that male members of the Weight Loss Clinic wanted a resource just for them, prompting the clinic to launch its Dieting for Men: Support Group message board. "I think they're at least open to the fact that if support and chat help women, why wouldn't they help us?"
A Subject Not to Be Taken Lightly
There's no doubt that women face more social pressure to look slim and attractive. But even men who are happy with their cuddly-bear physiques should take a serious look at the risks of carrying around too much weight.
While being overweight brings health risks for both men and women, some fat cells are deadlier than others. Men are much more likely than women to carry excess fat in the trunk and abdomen. And abdominal fat cells release a high level of free fatty acids -- which hurts the liver's ability to break down insulin, a factor in diabetes, and stimulates the liver to produce triglycerides, which increase the risk of heart disease. Abdominal fat cells also contain an enzyme that activates cortisone, which is linked to hypertension and diabetes.
To assess your risk, compute your waist-to-hip ratio, says The Harvard Medical School Guide to Men's Health. Relax your abdomen, and measure the narrowest part of your waist. Then measure the widest part of your hips. Divide the waist measurement by the hip measurement to find your ratio.
The Health Professionals Study showed that men with a ratio above 1.0 had twice the death rate of those below 0.85. Men with ratios above 0.98 were 2.3 times more likely to suffer a stroke as men with ratios below 0.89.
A simpler measure of risk is waist circumference alone. A waist size of 40 inches or more increases health risks, and one of 46 inches or more increases those risks substantially.
Strategies for Success
You know the drill. Eat less. Exercise more. But you don't have to go it alone.
Take advantage of the "Dieting for Men" message board and other resources available through the Weight Loss Clinic. "There's a wealth of educational and nutrition information, and you can get support anonymously," says Zelman. "The program is designed to meet your individual preferences, and we'll take the foods you like and show you how to make them healthier."
Foster advises reframing your thoughts about dieting. "It's not a feminine thing. It's something people do who take themselves seriously."
So if you're eating out with the guys, and they rib you for requesting salad dressing on the side, what should you do?
"One way is with a 'take-charge' mentality," Foster says. "Say, 'I'm paying for this. I'm not going to let a chef determine what I should eat.'" While you're at it, Foster says, take leftovers home instead of scarfing down everything in sight. "It might seem wimpy, but it's actually smart and it saves money."
The experts agree that focusing on health, rather than vanity, is the best way to approach dieting. "The health perspective is acceptable for men," says Magee, author of the series of Tell Me What To Eat books. "They can say, 'I'm watching what I eat because I'm trying to get my blood pressure or cholesterol down.'" More advice from the experts:
- Get your metabolism going: Eat breakfast. Lift weights.
- Don't sit around the table shooting the breeze (and having an extra beer, and eating the rest of what's on your plate). Push away from the table when you're full.
- When you reach for that bag of chips, stop and do a reality check. Don't eat if you're not hungry.
- Exercise regularly. Aerobic exercise is good for reducing abdominal fat.
- Make smart fast-food choices. Eat a salad, easy on the dressing. Choose grilled chicken or a small, plain burger instead of a Whopper or Quarter Pounder.
- Cook at home, where you can control the amount and type of fat and other nutrients. That's what the Food Network is for. Notice all the men cooking.
- Be faithful about journaling your meals. Keeping a food journal is one strategy used by "successful losers," 3,000 people in the National Weight Control Registry who've kept off an average of 66 pounds for 5.5 years.
- Remember, there will be rewards even if you reduce your weight by just 10%: You'll lower health risks, enjoy shooting hoops with the kids, improve your performance in the bedroom, look better, and have more energy.
- Don't wait until you've been diagnosed with diabetes or have a heart attack to take action.
SOURCES: National Health and Nutrition Examination Survey 19992000, CDC. The Harvard Medical School Guide to Men's Health: Lessons From the Harvard Men's Health Studies, by Harvey B. Simon, MD. Gary D. Foster, PhD, clinical director, Weight and Eating Disorders Program; associate professor, University of Pennsylvania School of Medicine. Elaine Magee, MPH, RD, WebMD Weight Loss Clinic consultant, San Francisco. Kathleen Zelman, RD, director of nutrition, WebMD Weight Loss Clinic, Atlanta. WebMD Weight Loss Clinic article: "12 Habits of 'Successful Losers,'" by Elaine Magee, MPH, RD; published July 2, 2003.
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