Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men

Robertson, Clare; Archibald, Daryll; Avenell, Alison; Douglas, Flora; Hoddinott, Pat; Teijlingen, Edwin van; Boyers, Dwayne; Stewart, Fiona; Boachie, Charles; Fioratou, Evie; Wilkins, David; Street, Tim; Carroll, Paula; Fowler, Colin

doi:10.3310/hta18350

Cited by 171 publications

(254 citation statements)

References 137 publications

(954 reference statements)

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“…being more active encouraging them to eat better). Previous studies 32,112,113 have highlighted that men are more likely to use PA as a strategy to manage their weight than women. Given the important role of PA in long-term weight control, 16,17,19 the promotion of PA (e.g.…”

Section: Factors Associated With Long-term Weight Outcomesmentioning

confidence: 99%

“…31 Men's reluctance to enrol in weight management programmes may in part reflect the way some men perceive weight management as a 'diet' or a 'women's' issue. [32][33][34] It may also be influenced by the setting in which such programmes are delivered; for example, a Slimming World (Alfreton, UK) initiative 35 to target men (by offering men-only groups) failed to increase their engagement by > 2% (i.e. from 3% to 5%).…”

Section: Men and Weight Managementmentioning

confidence: 99%

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Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

et al. 2018

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Background Rising levels of obesity require interventions that support people in long-term weight loss. The Football Fans in Training (FFIT) programme uses loyalty to football teams to engage men in weight loss. In 2011/12, a randomised controlled trial (RCT) found that the FFIT programme was effective in helping men lose weight up to 12 months. Objectives To investigate the long-term weight, and other physical, behavioural and psychological outcomes up to 3.5 years after the start of the RCT; the predictors, mediators and men’s qualitative experiences of long-term weight loss; cost-effectiveness; and the potential for long-term follow-up via men’s medical records. Design A mixed-methods, longitudinal cohort study. Setting Thirteen professional Scottish football clubs from the RCT and 16 additional Scottish football clubs that delivered the FFIT programme in 2015/16. Participants A total of 665 men who were aged 35–65 years at the RCT baseline measures and who consented to follow-up after the RCT (intervention group, n = 316; comparison group, n = 349), and 511 men who took part in the 2015/16 deliveries of the FFIT programme. Interventions None as part of this study. Main outcome measures Objectively measured weight change from the RCT baseline to 3.5 years. Results In total, 488 out of 665 men (73.4%) attended 3.5-year measurements. Participants in the FFIT follow-up intervention group sustained a mean weight loss from baseline of 2.90 kg [95% confidence interval (CI) 1.78 to 4.02 kg; p < 0.001], and 32.2% (75/233) weighed ≥ 5% less than at baseline. Participants in the FFIT follow-up comparison group (who participated in routine deliveries of the FFIT programme after the RCT) lost a mean of 2.71 kg (95% CI 1.65 to 3.77 kg; p < 0.001), and 31.8% (81/255) achieved ≥ 5% weight loss. Both groups showed long-term improvements in body mass index, waist circumference, percentage body fat, blood pressure, self-reported physical activity (PA) (including walking), the consumption of fatty and sugary foods, fruit and vegetables and alcohol, portion sizes, self-esteem, positive and negative affect, and physical and mental health-related quality of life (HRQoL). Mediators included self-reported PA (including walking) and sitting time, the consumption of fatty and sugary foods and fruit and vegetables, portion sizes, self-esteem, positive affect, physical HRQoL, self-monitoring of weight, autonomous regulation, internal locus of control, perceived competence, and relatedness to other FFIT programme participants and family members. In qualitative interviews, men described continuing to self-monitor weight and PA. Many felt that PA was important for weight control, and walking remained popular; most were still aware of portion sizes and tried to eat fewer snacks. The FFIT programme was associated with an incremental cost-effectiveness of £10,700–15,300 per quality-adjusted life-year (QALY) gained at 3.5 years, and around £2000 per QALY gained in the lifetime analysis. Medical record linkage provided rich information about the clinical health outcomes of the FFIT RCT participants, and 90% of men (459/511) who took part in the 2015/16 FFIT programme gave permission for future linkage. Conclusions Participation in the FFIT programme under both research (during the FFIT RCT) and routine (after the FFIT RCT) delivery conditions led to significant long-term weight loss. Further research should investigate (1) how to design programmes to improve long-term weight loss maintenance, (2) longer-term follow-up of FFIT RCT participants and (3) very long-term follow-up via medical record linkage. Trial registration Current Controlled Trials ISRCTN32677491. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 9. See the NIHR Journals Library website for further project information. The Scottish Executive Health Department Chief Scientist Office (CSO) funded the feasibility pilot that preceded the FFIT RCT (CZG/2/504). The Medical Research Council (MRC) funded Kate Hunt and additional developmental research through the MRC/CSO Social and Public Health Sciences Unit Gender and Health programme (5TK50/25605200-68094).

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Section: Factors Associated With Long-term Weight Outcomesmentioning

confidence: 99%

Section: Men and Weight Managementmentioning

confidence: 99%

Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

et al. 2018

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“…An extensive and highly sensitive search strategy using appropriate subject headings and text word 172 terms was developed to identify alternative strategies for weight loss, with a distinct and interpretable 173 focus on strategies for the management of obesity in adult men [13]. estimates of costs and effects; and (ii) the methods used to derive the results.…”

Section: Identification Of Studies: 170mentioning

confidence: 99%

“…Adherence to health lifestyle is an important driver of cost-548 effectiveness and one which has received insufficient coverage in the literature in general. Reviews of 549 clinical effectiveness and qualitative literature conducted in parallel to this review address alternative 550 measures which can motivate men and encourage adherence to interventions [13]. Engaging participants 551 with interventions being tested and ensuring adherence to the therapy under evaluation is a key component 552 of determining an interventions effectiveness, and hence its cost-effectiveness.…”

mentioning

confidence: 99%

A systematic review of the cost-effectiveness of non-surgical obesity interventions in men

Boyers

Avenell

Stewart

et al. 2015

Obesity Research & Clinical Practice

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“…Convenience and compatibility with a busy life are important, [15][16][17] as is the use of community settings for intervention delivery. 18 The style and tone should be relaxed and friendly as opposed to strict and regimented. 16,17 The content should be personalised and accessible, 15,18 but should be delivered in a matter-of-fact way.…”

Section: Introductionmentioning

confidence: 99%

Modifying Alcohol Consumption to Reduce Obesity (MACRO): development and feasibility trial of a complex community-based intervention for men

Crombie

Cunningham

Irvine

et al. 2017

Health Technol Assess

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Background Obese men who consume alcohol are at a greatly increased risk of liver disease; those who drink > 14 units of alcohol per week have a 19-fold increased risk of dying from liver disease. Objectives To develop an intervention to reduce alcohol consumption in obese men and to assess the feasibility of a randomised controlled trial (RCT) to investigate its effectiveness. Design of the intervention The intervention was developed using formative research, public involvement and behaviour change theory. It was organised in two phases, comprising a face-to-face session with trained laypeople (study co-ordinators) followed by a series of text messages. Participants explored how alcohol consumption contributed to weight gain, both through direct calorie consumption and through its effect on increasing food consumption, particularly of high-calorie foodstuffs. Men were encouraged to set goals to reduce their alcohol consumption and to make specific plans to do so. The comparator group received an active control in the form of a conventional alcohol brief intervention. Randomisation was carried out using the secure remote web-based system provided by the Tayside Clinical Trials Unit. Randomisation was stratified by the recruitment method and restricted using block sizes of randomly varying lengths. Members of the public were involved in the development of all study methods. Setting Men were recruited from the community, from primary care registers and by time–space sampling (TSS). The intervention was delivered in community settings such as the participant’s home, community centres and libraries. Participants Men aged 35–64 years who had a body mass index (BMI) of > 30 kg/m2 and who drank > 21 units of alcohol per week. Results The screening methods successfully identified participants meeting the entry criteria. Trial recruitment was successful, with 69 men (36 from 419 approached in primary care, and 33 from 470 approached via TSS) recruited and randomised in 3 months. Of the 69 men randomised, 35 were allocated to the intervention group and 34 to the control group. The analysis was conducted on 31 participants from the intervention group and 30 from the control group. The participants covered a wide range of ages and socioeconomic statuses. The average alcohol consumption of the men recruited was 47.2 units per week, more than twice that of the entry criterion (> 21 units per week). Most (78%) engaged in binge drinking (> 8 units in a session) at least weekly. Almost all (95%) exceeded the threshold for a 19-fold increase in the risk of dying from liver disease (BMI of > 30 kg/m2 and > 14 units of alcohol per week). Despite this, they believed that they were at low risk of harm from alcohol, possibly because they seldom suffered acute harms (e.g. hangovers) and made few visits to a general practitioner or hospital. Intervention The intervention was delivered with high fidelity. A high follow-up rate was achieved (98%) and the outcomes for the full RCT were measured. A process evaluation showe...

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Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men

Cited by 171 publications

References 137 publications

Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

A systematic review of the cost-effectiveness of non-surgical obesity interventions in men

Modifying Alcohol Consumption to Reduce Obesity (MACRO): development and feasibility trial of a complex community-based intervention for men

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