Caring Medical - Where the world comes for ProlotherapyOlder men do not see losing weight or being on a diet as beneficial to their knee pain. Researchers say: They better change their attitude.

The Mediterranean diet and osteoarthritisMarion Hauser, MS, RD
In this article we are going to examine the difficulties older men face with joint pain and the need to lose weight and eat a healthier lifestyle. We will look at three studies that get inside the man’s head to show how difficult this can be for him.

Men in the UK ask Oxford University researchers: “Do I really want to be going on a bloody diet?”

This was the title of a paper published in the August 2018 issue of Disability and rehabilitation: “Do I really want to be going on a bloody diet? Gendered narratives in older men with painful knee osteoarthritis.”

In this paper, first published on line in May 2017 researchers examined the problems of disability in men who are told they need to be on a healthy diet so they could increase their chances of successful rehabilitation from knee replacement are discussed.

This comes from researchers at Oxford University: Here are the study’s learning points and highlights:

  • Small reductions in body weight can decrease osteoarthritic knee pain.
  • Intuitively this should provide a strong incentive for weight-loss.
  • However many people undergoing knee joint replacement are categorized as obese. Somewhere the incentive was lost.

“I am too far gone,” “weight loss doesn’t matter anymore.”

The researchers, as just pointed out, had a goal to make rehabilitation better by putting joint replacement patients on a better diet. This is where they ran into barriers. Many older men with osteoarthritis had resigned themselves to the fact that they were “too far gone,” and “it doesn’t matter anymore.”

In the one year study, the Oxford researchers came up with 6 themes that seem to permeate inside a man’s mind when it comes to being told that are obese and need to lose weight to make their rehabilitation more successful. The themes can all relate to the same individual depending on the mood at the time.

  1. I am big and healthy and don’t need to lose weight; (denial/perceived self worth)
  2. Being this size isn’t good for me; (acceptance)
  3. Men don’t have to worry about that sort of thing; (denial/perceived self worth)
  4. I am not as active as I used to be; (justification)
  5. I have worked hard all my life; (justification /perceived self worth)
  6. What is the point in trying anyway? (anger)

The researchers concluded that based on this line of thinking, unique to men, it will be  challenging for men to lose weight even when told it will help post-surgical rehabilitation. Here is a striking statement from the study.

Men may not associate being overweight with being unhealthy

This is not denial, it is a line of thinking that suggests big men are healthy and successful men.
Diet and knee osteoarthritis
What can you do as wife, child or loved one to help an older man lose weight? The researchers suggest:

  • Your man may take pride in being in good shape and may respond better to weight loss strategies that focus on fitness not body size.
  • Men may link weight gain with decrease in activity levels rather than overeating. Get them active.
  • Health care professionals should challenge the assumption that weight loss will follow surgery.(1) Studies show people gain weight after joint replacement. This is something we see all the time, the idea that joint replacement will allow a patient to become more active and thereby lose weight. Not so for many patients.

More than half the men in one study were on diets, researchers examined why they keep failing to lose weight

It is not easy for anyone, especially aging people with arthritis to lose weight. But many try. Researchers from the University of Florida and University of West Florida examined the weight loss strategies of Baby Boomer men (born in 1946-1964).

Publishing in the Journal of human nutrition and dietetics, the Florida researchers aimed to identify weight-loss strategies used by the Baby Boomers to see if they worked.

In the study of 211 men, 82% were classified as being overweight or obese.

  • Fifty-six percent were currently trying to lose weight.
  • Self-managed healthy weight-loss strategies included
    • reducing portions,
    • increasing physical activity,
    • cutting back on fried foods,
    • cutting back on sweets,
    • cutting back on alcohol,
    • using meal replacement drinks/bars and joining a weight-loss program.
  • Self-managed unhealthy strategies included
    • skipping meals
    • using over-the-counter ‘diet pills’.

The more obese men employed the least healthier options more often.

Wives were considered essential to their weight management success

Here is what the researchers determined:

  • Older men struggle more to lose weight. In interviews subjects noted:
    • ‘I’ve been struggling for the last 2-3 years’.
    • ‘The last time I really tried to lose weight I stayed on the diet for just a day or two’.

They also noted “Wives were considered essential to their weight management success.”(2)

In the two above studies we clearly see that it is difficult for aging men to lose weight and they may give up very easily by justifying that “it doesn’t matter any more,” or even acknowledging that they have a weight problem. When men do try to lose weight the bigger the problem, the more reliance on quick fix solutions like diet pills and fasting.

Men justify their weight through anger and apathy

Let’s go back to the above study and revisit the themes men exhibit in trying to lose weight

  1. I am big and healthy and don’t need to lose weight;
  2. Being this size isn’t good for me;
  3. Men don’t have to worry about that sort of thing;
  4. I am not as active as I used to be;
  5. I have worked hard all my life;
  6. What is the point in trying anyway?

Now let’s look at a study from German University researchers in the European eating disorders review. In this study the doctors rated how emotions affect obese men compared to normal weight men.

The basic emotions are:

  • Fear
  • Anger
  • Sadness
  • Happiness
  • Disgust
  • Surprise
  • Trust
  • Anticipation

The researchers found that obese men had reduced scores for all emotions except happiness and disgust; anger showed a trend towards significance.(3)

  • So there is apathy to fear, sadness, surprise, trust, and anticipation. You can call these forward looking emotions.
  • There is living in the moment “happiness,” and
  • anger and disgust which is usually equated with frustration, self-loathing and lack of self-esteem

The information here is to show that older men, facing joint replacement or arthritis pain, have difficulty getting on a healthy lifestyle.

This is such a complex subject. The information here is to show that older men, facing joint replacement or arthritis pain, have difficulty getting on a healthy lifestyle. The challenges are significant as anger, frustration leads to way to uncaring. It is therefore up to a man’s support system to help him and you achieve the goals of a healthy lifestyle for him.

1 Toye F, Room J, Barker KL. Do I really want to be going on a bloody diet? Gendered narratives in older men with painful knee osteoarthritis. Disability and Rehabilitation. 2017 May 5:1-7. [Google Scholar]

2 James DC, Wirth CK, Harville C, Efunbumi O. Weight‐loss strategies used by baby boomer men: a mixed methods approach. Journal of Human Nutrition and Dietetics. 2016 Apr 1;29(2):217-24. [Google Scholar]

3 Giel KE, Hartmann A, Zeeck A, Jux A, Vuck A, Gierthmuehlen PC, Wetzler‐Burmeister E, Sandholz A, Marjanovic G, Joos A. Decreased Emotional Perception in Obesity. European Eating Disorders Review. 2016 Jul 1;24(4):341-6. [Google Scholar]


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