At Alfie, we’ve decided to focus our program on men. There are two reasons for this: first, men are severely underserved by current weight loss programs, despite having similar obesity rates to women; second, research shows that the reason for the former is a difference in perception of weight loss programs and effectiveness of weight loss strategies based on gender, i.e. current programs likely don’t work as effectively for men as they do women.
As a result of research that has included randomized control trials (RCTs) consisting primarily of women, current weight loss programs are designed, whether intentionally or not, to provide strategies that are most effective for weight loss in women (Crane et al. 2015). As a result, major programs today comprise significantly less men than women.
For example, Noom, the most popular weight loss program has been reported to serve a population that is 78-86% female (14-22% male) (Women’s Health). When it comes to programs that can provide greater than 10% average weight loss using GLP-1 medications, like our own, Calibrate is the largest player; however, their user base is only 10% men (Forbes).
In the end, it has become a self fulfilling cycle, where men are 6 times less likely to join weight loss programs, but the main reason behind this is that weight loss programs are not designed for men, as discussed below
Men and women have similar rates of obesity and being overweight; however, several reviews have shown that men represent only approximately 27% of study samples (Crane et al. 2015). Research has shown that men do lose weight when participating in weight loss programs, in fact tend to lose more than women, indicating that lack of success is not a determinant in low participation of men in weight loss programs (Williams et al. 2015). Instead, it is the mismatch between male preferences and the offerings available in today’s market; men have indicated they perceive general weight loss programs to be targeted towards women (de Sousa and Ciclitira 2005).
Crane notes that when it comes to weight loss programs, men state they want individually focused programs that do not include strict meal plans and provide the ability to tailor the diet to their preferences. Additionally, they prefer programs that do not disrupt their daily routine and provide information in a clear and direct manner. Her research group designed a program specifically for men, REFIT, which demonstrated 5% weight loss in only 3 months without utilizing medication by promoting autonomy of men’s decisions making.
A key differentiator in gender and its effect on weight loss is the difference in perception. Studies have shown that weight perception differs significantly between men and women: the mean probability of women to have accurate weight perception was about 80% whereas the mean probability of men was only about 60% (Tsai et al. 2016). A factor in this may be that men perceive larger, muscular bodies as more attractive, whereas societal norms have led women to perceive the opposite (Christensen et al. 2011). Programs designed for women therefore do not include any aspects of weight perception, which has negative impacts on the programs effectiveness for men.
Additionally, weight-related stigma varies greatly between men and women, where weight-related stigma is associated with lower levels of autonomous motivation to exercise, which was in turn associated with lower levels of walking, moderate and vigorous physical activity in women, but has the opposite effect for men (Sattler et al. 2018). Programs for women downplay stigma, whereas in programs for men, stigma can be utilized as an external motivator for weight loss. Lastly, research shows that men lose weight primarily for two reasons: 1) health, and 2) spending more time with family; on the other hand, they perceive women to lose weight for vanity, which leads them to believe current weight loss program goals are more vapid than their own (Sabinsky et al. 2006). Thus, research clearly shows that weight loss factors for men and women lie on almost opposite ends of the spectrum, while current programs attempt to provide a one-size-fits-all approach.
The gender disparity in weight loss programs has been ignored for many years, while it requires signifcant attention, because men benefit from weight loss programs especially if tailored to them (Tsai et al. 2016). The conclusion from the literature is that weight loss interventions that are tailored to appeal to men will likely improve male participation.