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She Loses, He Loses
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She Loses, He Loses
The Truth about Men, Women,
and Weight Loss
K A R E N M I L L E R - K O VA C H , M S , R D
John Wiley & Sons, Inc.
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Copyright © 2007 by Weight Watchers International, Inc. All rights reserved
Published by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
Wiley Bicentennial Logo: Richard J. Pacifico
Design and composition by Navta Associates, Inc.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any
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The information contained in this book is not intended to serve as a replacement for professional
medical advice. Any use of the information in this book is at the reader’s discretion. The author
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Library of Congress Cataloging-in-Publication Data:
Weight watchers she loses, he loses : the truth about men, women, and weight
loss / Weight Watchers.
p. cm.
Includes bibliographical references and index.
ISBN 978-0-470-10046-2 (cloth)
1. Weight loss—Sex differences. I. Weight Watchers International.
RM222.2.W3252 2007
613.2'5—dc22 2006036225
Printed in the United States of America
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Contents
Acknowledgments vii
Chapter 1 Weight Is Not Just a Female Issue 1
Chapter 2 The Weight-Health Connection: How the
Genders Differ 9
Chapter 3 When and How the Mirror Lies 33
Chapter 4 He’s Fit, She’s Thin: The Language of
Weight Loss 49
Chapter 5 Why Guys Lose Weight Faster 69
Chapter 6 Dress Sizes, Belt Notches, and Other Weight-Loss
Triggers: Why We Lose Weight 87
Chapter 7 How We Lose Weight: The Two Sexes Do It
Differently 105
Chapter 8 Women and Men Need to Eat Fewer Calories:
What Works and What Doesn’t 121
v
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vi CONTENTS
Chapter 9 Move More to Keep It Off 143
Chapter 10 Support: Everybody Needs Some 163
Chapter 11 Couples Win the Weight-Loss Race 181
Chapter 12 Living Healthy: Lifestyle Is Key 201
Sources 213
Credits 231
Index 233
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Acknowledgments
Any book coming from Weight Watchers is a team effort, and She Loses,
He Loses: The Truth about Men, Women, and Weight Loss is no exception.
This book compiles the insights, feedback, experiences, and science
from dozens of sources, including a number of Weight Watchers lead-
ers and Weight Watchers CEO Linda Huett. The credit for putting it all
together in such a masterful and creative way goes to Jodie Shield, who
is an MED, RD, and writer extraordinaire.
A special note of appreciation to the couples who generously pro-
vided their stories for the “Couples Close Up”profiles. As you can tell
from their pictures, these are real people. Unlike the people described
in the introductory stories used to open the chapters and the Real-Life
Lessons (which I’ve answered based on an amalgamation of anecdotes
and questions from a variety of sources), these men and women gave
us both information and inspiration, making the contents of the book
come alive. Thank you.
Thanks, too, to the Weight Watchers Global Development Team,
including Ute Gerwig, Norma Larkin, Sabrina LeBlanc, Palma Posillico,
vii
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viii ACKNOWLEDGMENTS
Jane Waterhouse, and Sarah Watson, for their insights and contri-
butions as we delved into the Weight Watchers vault of consumer
research.
Finally, a note of appreciation to Nancy Gagliardi from the Weight
Watchers Publishing Group and Tom Miller from John Wiley & Sons.
Thanks for doing all that it takes to turn a concept into a manuscript
and finally into a book.
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CHAPTER 1
Weight Is Not Just
a Female Issue
T he statistics couldn’t be clearer: the world is getting fatter. Two-
thirds of American adults are now overweight or obese. Men and
women, empty nesters, and the newly married—the issue of excess
weight touches the majority of households in some way. Clearly,
achieving and maintaining a healthy weight are a desire and a need for
millions of people.
As the world’s leading provider of weight-loss services, Weight
Watchers has over 40 years of experience helping both women and
men lose weight with its comprehensive, proven program that focuses
on lifestyle modification. In other words, by following a scientifically
effective method that teaches people how to lead healthier lives in a
realistic way, Weight Watchers members around the world are achiev-
ing lasting weight loss.
Over the years, Weight Watchers has learned a few things about
1
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2 WEIGHT WATCHERS SHE LOSES, HE LOSES
what makes people tick when it comes to weight issues. One of the
lessons that has been most illuminating is the gaps between the sexes.
The gender gap on the topic of weight is broader and deeper than that
on just about any other health-related issue. Despite the huge nega-
tive impact that excess weight has on men and women alike, there has
not been much medical or clinical research that has tried to understand
the differences in how men and women think about weight, talk
about their weight-related concerns, or approach weight loss. This
book examines what is known about women, men, and weight loss. By
exploring the differences, it seeks to provide an understanding of how
the genders can join forces to lose weight successfully.
Weight-Loss Research Favors Women
In the world of medical research, men have traditionally been the
guinea pigs. Until the past few decades, almost all research on major
illnesses has focused on men. In fact, the male-favored gender gap
has been criticized as discriminatory, and critics have suggested that
it results in better medical care for men than for women. Why have
scientists tended to focus their research on men? A key reason is that
men are simpler to study from a biological perspective. They do not
have the monthly and lifelong hormonal fluctuations that women
have; researchers need to control for women’s hormonal fluctuations
when conducting medical research on them.
There is, however, one area in scientific research in which the vast
majority of studies and study volunteers have been women: weight
loss. Why? When researchers are recruiting participants for a weight-
loss study, the majority of the volunteers are women. In general,
weight-loss trials that are designed to include both men and women
include 80 to 90 percent women and only 10 to 20 percent men. As
you’ll learn from this book, this is due to the fact that men tend to be
less aware of their need to lose weight, and less focused on weight loss,
than women.
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WEIGHT IS NOT JUST A FEMALE ISSUE 3
The reality is that there are very few studies of weight-loss treatment
involving men only in the published medical literature. In doing the
research for this book, only three randomized clinical trials (the gold
standard in research) done exclusively on men were found. And in the
spirit of full disclosure, the condition being treated with weight loss in
one of the studies wasn’t even obesity—it was erectile dysfunction.The
total number of men in the three studies combined was less than 300!
That’s not even a drop in the bucket compared with the thousands (if
not millions) of women who have participated in women-only weight-
loss studies.
The lack of male-oriented obesity research is unfortunate because
it limits the available pool of knowledge on how best to help men lose
weight. Just as women used to be treated for heart disease based on
treatments that had been proved effective in men, weight-loss treat-
ment strategies have largely come from studies done on women.
Assuming that a man is just like a woman in dealing with weight-
related issues is a mistake. Fortunately, Weight Watchers has a great
deal of experience in helping men lose weight, and that expertise is
shared throughout this book.
Different Sexes, Different Bodies
While the fundamental principles of weight loss are the same for both
genders—expending more calories than are taken in—the elements
that lead to the creation of the caloric deficit that invokes weight loss
are not. Indeed, men and women are different; they are biologically
different and emotionally different. Because both biology and psychol-
ogy are integral to successful weight loss, these differences are
extremely important.
The physical variations between the genders require little explana-
tion. The body composition—that is, the proportions of muscle,
bone, and fat that make up the male and female bodies—of men and
women are quite different. A typical man who weighs 154 pounds
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4 WEIGHT WATCHERS SHE LOSES, HE LOSES
has 69 pounds of muscle, 23 pounds of bone, and 23 pounds of
fat (the rest is organs, body fluids, and the like). A typical woman
who weighs 125 pounds has 45 pounds of muscle, 15 pounds of
bone, and 34 pounds of fat. In summary, men are genetically pro-
grammed to have more lean muscle mass and heavier bones than
women. Conversely, women’s bodies are designed to have a higher
fat content.
Technically, the definitions of overweight and obesity are based on the
presence of excess body fat (though Body Mass Index or BMI is used
to categorize people’s weight status—more on this in the next chap-
ter). Here, too, the genders differ. Overweight in men is defined as
between 21 and 25 percent body fat and obesity is defined as greater
than 25 percent. Overweight in women is defined as between 31 and
33 percent body fat and obesity is defined as greater than 33 percent.
Because biologically men are supposed to have less fat and women
more fat, even men and women of the same height and weight should
have very different body compositions.
Given the physical differences between the genders when it comes
to body composition, it’s not surprising that body fat recommendations
for men and women are different as well. The recommendation for
men ranges from 12 to 20 percent and that for women ranges from 20
to 30 percent.
Given their different body compositions, men have a biological
advantage over women when it comes to losing weight. That advan-
tage is explored in chapter 5.
Different Minds
Men and women are not only different physically; their psychological
makeup is distinct as well. The emotional differences between men
and women are an area of great interest. John Gray’s 1992 book Men
Are from Mars, Women Are from Venus caught the attention of the
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WEIGHT IS NOT JUST A FEMALE ISSUE 5
public, sparking discussions of the inherent differences between the
genders when it comes to communication, reactions to problems, and
sources of conflict.
Psychologists are not the only ones interested in how the mental
processes of women and men differ; a great deal of work is going on
in the world of basic science as well. Each year, more and more is being
learned about the links between mental processes and physical func-
tions, especially as they relate to neurotransmitters. A paper published
in 2006 even theorized that the reason men smile less often than
women can be accounted for by the way their respective brains are
wired. It is well established that our behaviors in the realms of eating
and physical activity are influenced by chemical signals in the brain.
And while not much is known about those signals at this point, it is
likely that there are gender differences there as well. As more is
learned about how the brain affects mental well-being as it relates to
excess weight as well as the likely impact of gender differences, rele-
vant treatment options are sure to evolve.
The mental aspects of weight and weight loss cannot be overem-
phasized. The basic physiology of weight loss is relatively simple—in
order to lose weight, fewer calories must be taken in than expended.
But it is the behaviors—eating, exercise, and thinking—that are at the
heart of achieving lasting weight loss. There are clear differences
between men and women when it comes to weight-loss behaviors,
and this book touches on all of them. Of particular interest are the dif-
ferences as weight loss relates to how men and women use language,
a topic explored in chapter 4.
A Word of Caution
This book draws on a variety of sources to sort out the gender differ-
ences and to provide practical insights and solutions so that both men
and women can achieve lasting weight loss. Whenever possible,
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6 WEIGHT WATCHERS SHE LOSES, HE LOSES
clinical studies from the scientific literature are included at the back
of this book. Because, as noted above, there have not been a lot of
scientific trials done on this topic, we used additional sources of infor-
mation as well.
Weight Watchers does a great deal of market research. From focus
groups to segmentation studies and consumer surveys, Weight Watch-
ers spends considerable time and money keeping a finger on the pulse
of people who want and need to lose weight. Generally, companies
doing such research keep close tabs on the results in order to maintain
a competitive advantage in the marketplace.
Over the past ten to twelve years, Weight Watchers has amassed a
lot of market research that has looked specifically at how the genders
differ in the way they think about, talk about, and approach weight
loss. In fact, Weight Watchers probably has more information on this
topic than any other organization in the world. For the first time, the
company has opened its vault of unpublished proprietary information
and is including it in this book. As a result, what you’ll find is a culmi-
nation of clinical and consumer research from which insights and
understanding can be gleaned.
It is important to keep in mind, however, that any research—
clinical or consumer—summarizes the findings involving a group of
people. The reality is that any group of people is made up of individ-
uals who differ. For example, while the research may have found that
women are less likely than men to believe that the most effective way
to lose weight is to exercise, that doesn’t mean that there are not some
women who believe this—they’re just not as common. Based on this
limitation, which is part of any research process, it is easy to develop
stereotypes and make generalizations that don’t hold true when it
comes to individuals. The gender differences explored in this book are
based on research findings. Odds are that not all of the findings will
apply to any given man or woman.
It is important to use the findings as a starting point for understand-
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WEIGHT IS NOT JUST A FEMALE ISSUE 7
ing what separates you from a potential weight-loss partner of the
opposite sex. With that understanding, you can overcome communi-
cation barriers and together, as a couple, find a common ground that
will lead to lasting weight loss.
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