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ffirs.qxp 2/8/07 9:34 AM Page iii

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.

ffirs.qxp 2/8/07 9:34 AM Page ii
ffirs.qxp 2/8/07 9:34 AM Page i

She Loses, He Loses

ffirs.qxp 2/8/07 9:34 AM Page ii
ffirs.qxp 2/8/07 9:34 AM Page iii

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.

ffirs.qxp 2/8/07 9:34 AM Page iv

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
form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise,
except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without
either the prior written permission of the Publisher, or authorization through payment of the
appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA
01923, (978) 750-8400, fax (978) 646-8600, or on the web at www.copyright.com. Requests to the
Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons,
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http://www.wiley.com/go/permissions.

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
and the publisher specifically disclaim any and all liability arising directly or indirectly from the
use or application of any information contained in this book. A health care professional should
be consulted regarding your specific situation.

For general information about our other products and services, please contact our Customer
Care Department within the United States at (800) 762-2974, outside the United States at (317)
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Wiley also publishes its books in a variety of electronic formats. Some content that appears in
print may not be available in electronic books. For more information about Wiley products, visit
our web site at www.wiley.com.

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

10 9 8 7 6 5 4 3 2 1
ftoc.qxp 2/8/07 9:35 AM Page v

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
ftoc.qxp 2/8/07 9:35 AM Page vi

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
flast.qxp 2/8/07 9:36 AM Page vii

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
flast.qxp 2/8/07 9:36 AM Page viii

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.
c01.qxp 2/8/07 9:37 AM Page 1

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
c01.qxp 2/8/07 9:37 AM Page 2

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.
c01.qxp 2/8/07 9:37 AM Page 3

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
c01.qxp 2/8/07 9:37 AM Page 4

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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