Men getting in control of their weight and taking charge of their lives.

Fifteen years ago when, as a clinical psychologist, I first began treating patients for obesity and eating disorders with behavioral weight management programs, few if any men appeared asking for my help to lose weight. Those who did were either scared with "death warnings" from their physicians or nudged until death seemed attractive by concerned wives and girl friends. Recently, men have almost equaled the hundreds of female patients I have treated who wish to find better ways to lose unwanted, unsightly and unhealthy pounds. Not only do they come of their own accord, once in treatment, they lose weight more rapidly and maintain their weight loss more successfully than many of their female counterparts. The desire to lose weight and control food, for men, is a contemporary phenomenon that I and many of my colleagues notice with interest and excitement. Why this is true and what factors contribute to their success as dieters, shapes the way we approach designing weight management programs for men.

The "why" men are interested is easy enough to understand. Corporate America has begun to realize that weight loss is a necessary antidote to the financial loss caused by employee illness and disability. Even with a decrease in lung disease and cancer due to a reduction in tobacco use, the numbers rise for other diseases. Businesses are as concerned as the medical profession by the escalating incidence of hypertension, coronary disease and diabetes. Not only are they alarmed, but increasingly affected at the bottom line where cost and concern come together. Their employees are representative of the forever young baby boomers, who are fast tracking their way through a life style stressed by financial and time pressures. They are a generation fed by too much fast food, with too little time left for exercise.

Responding to the need to reduce spiraling insurance rates and employee cost due to illness, companies have begun to insist that their employees that are too valuable to lose or expensive to replace include a reduction in weight in their business plan. Employee physicals are now required more frequently by many major companies. A few, such as Southern California Edison have actually initiated financial rewards and penalties to inspire employee weight reduction and improved health. They recently instituted a plan whereby employees were rewarded with bonuses for weight loss and good health reports and equally penalized with larger contributions toward insurance coverage when their health reports indicated little effort made toward reducing health risks. Weight loss has begun to be recognized criteria for improved health.

In addition to greater demands that their employees take a more responsible role in managing their own health, there is another factor which has sent increased numbers of men to our program and other weight management centers. The employment market has become increasingly competitive. The trend toward downsizing, hiring employees on a project by project basis, and reducing overhead by reducing numbers of employees hired has created greater competition in the job market. Men have been told that their appearance and their health are greater concerns for employees. In order to have an edge in the marketplace, men have to be at their best. They are learning that in order to lead the pack they may need to be at their "Fighting-Best" - lean and healthy.

Men are generally successful weight management patients once they commit to a program. Allen is a typical example of one of our successful male patients. Allen is a lawyer in a major Los Angeles legal firm. Both personal, as well as professional concerns brought Allen to his decision to lose weight. At 38 he is in line for partnership, but his firm, like many, is downsizing, reducing its permanent staff to compensate for a large overhead debt incurred when business was booming. In addition, at a recent physical exam he received the dismaying news that his cholesterol levels were abnormally high. With his extra weight and a family history of coronary disease and diabetes, he was putting himself at risk for both.

Allen approached our program with the same zeal that made him successful on his cases. Prior to choosing our program, he had researched the safest and most sensible way for him to lose weight. He knew he needed to cut his calories and intake of fat and sugar and exercise regularly. He also knew that he wanted to try a program that did not impose the new medications, Phentermine - Fenfluramine. Many of our patients, however, with more weight to lose, or less of a sense that they cannot or will not do it without a jump start, use the medications. They, of course need, a medical evaluation prior to doing so. Since Allen only had 20 pounds to lose and was resistant to drugs of any kind, he chose our program because we offered a choice, one or both, a Medical weight management and/or a Behavioral weight control plan. Because he had yo-yoed up and down in weight most of his adult life (since giving up running due to a knee injury) he was determined that this time he wanted to get it off and maintain the weight loss forever. Allen was used to using experts as resources in his legal cases. He felt he could equally make use of the input and guidance of experts who could teach him how to regain control of his food, exercise and weight. He was smart enough to know that the notion of dieting alone was too short term a view to get weight off and keep it off.

Allen enjoyed our very structured program which was individualized for him. He had read enough diet books to know that no one way suits everyone and that someone had to guide him if he were to make sense of a new plan for life. He liked having the full expertise of our medical staff, nutritionists, exercise and behavioral consultants. Like many men, Allen took to the "task" oriented focused approach to weight loss. He liked knowing and seeing that specific concrete behaviors would lead to both weight loss and learning-life long behaviors to which he could easily and successfully commit his time and attention. His general compulsive nature made him a natural for a structured, guided program where the rewards are; noticeable lost weight and a noticeable gain for the effort. Allen lost weight rapidly, as do many men due to the fact that they have less proportionate body fat than women to begin with.

Once he lost the 20 pounds, Allen began a maintenance program designed to help him add more food to his diet and keep his lost pounds from returning. It is a program designed to help people think thin and to stay thin forever. Men seem to do this more easily than women.

Fewer men then women seem to have suffered from child and adolescent obesity, therefore they have less of a tendency to hold on to dangerous and self destructive images of themselves as "fat" once they lose weight. Thinking and feeling fat unfortunately works against staying thin because there is more of a tendency to say "what's the use anyway" that results in once again eating too much. It seems easier for men to change their self image as they shed weight.

Allen reached his desired total and, at last report, that he is enjoying the benefits. He feels much more secure professionally, has greater energy, lower cholesterol levels, lower blood sugar and most of all, he has control back over his own body. Allen, like most patients, tells us that the best part of losing weight using a guided program is that they learn how to independently take charge of that portion of their lives forever.

Men are great candidates for success in weight management programs. They are motivated by corporate concerns that combine awareness of costs with a concern about health. They are motivated further by a changing employment market which demands that a cutting edge be a thinner one and that they present themselves as responsible for their health and appearance. Once committed to a weight management program, men are successful because they see rewards immediately for their effort. They enjoy a structured, no nonsense, concrete, you do it - it happens approach, where they are in charge of what happens. Furthermore, they are not hampered by clinging to old images of fat, once they become thin.

Getting control of weight is another way of taking charge of your lite. Most people like this sense of empowerment. Men seem to appreciate it and use it as a motivation, both to commit to and to maintain an attitude of - "thinner for life."

Marilyn Ruman, Ph.D. Dr. Marilyn Ruman is a psychologist who directs the Behavioral Weight Management Program R for "THINNER FOR LIFE" in Beverly Hills, California. The program is medically supervised by Dr. Gilbert Person.