Suddenly, It's a Guy Thing

Yes, they do, says John La Puma, a Santa Barbara-based internist and professionally trained chef with a national practice that focuses on medical nutrition and healthy weight.

"In my practice, men respond well when you tell them what to do and when to do it, what to eat and what not to eat, when to eat and when not to," says LaPuma, whose patients are about evenly divided between the sexes. "Both men and women need specific goals for achievement. But goals are larger, more like visions or missions. Men often need objectives -- little guideposts or milestones along the way. And we need strategies and tactics to get there. It's the language of business school."

Initially LaPuma, who is also the co-author of "The RealAge Diet: Make Yourself Younger With What You Eat" (HarperCollins, 2002) and "Cooking the RealAge Way: Turn Back Your Biological Clock With More Than 80 Delicious and Easy Recipes" (HarperCollins, 2003) took a more traditional approach. "When I was investigating weight-loss programs 10 years ago, I found that 98 out of 100 were targeted for women," he says. "They were often process-oriented -- that is, they tried to make sense of the problem and reason through it the way women often do with relationships, to turn the problems over to fully understand them, and then to come out with a solution better than what they went in with. It's a thoughtful examination of the reasons for eating other than hunger, with small changes making a big difference. I started that way. . . . Three years ago, it became clear to me that it worked for some people but not for others, and the people it worked for tended to be women."

What he observed about the men he treated was that generally they were goal-oriented, numbers-oriented and specific about wanting to be told exactly what to do. In general, he found that approach works for his male patients and some women -- with a caution. "The flip side is that it can seem parental," he says. "But it's not. It's more like a business partner with experience in a specific area. . . . I give them specific goals -- weight, blood pressure, cholesterol -- and I give them a specific time period to do it. . . . It's prescriptive, clear, based in science, and it gives us something to shoot for."

La Puma isn't the only one to see a difference in the way men and women diet. At Weight Watchers (where the amount and kinds of food allowed have been based on a point system that is reliant on calories as well as grams of dietary fiber and fat), low-carb diets are seen as serious competition, especially for male clients. Men have never been a large part of the Weight Watchers constituency. Trying to make sense of that, the company did extensive research about "extreme dieting" -- that is low-carb and no-carb dieting -- in the United States. "We wanted to understand men, and their needs, preferences and weight issues," says Karen Miller-Kovach, the company's chief scientific officer.

Previously, their studies had found that men weren't even comfortable talking about dieting. Then about a year and a half ago, they began to see a difference in their focus groups. "I was consistently hearing men admitting to dieting and weight loss," says Miller-Kovach. "You generally didn't see that. With the no- and low-carb diets, suddenly it was okay for a man to be on a diet and to credit a weight-loss method as the way the weight was lost. Now for the first time it was a macho thing to do."

Not only were men talking about weight loss; women were often making dieting decisions based on the recommendations of men -- their husbands, a co-worker at the office. And the recommendations were for low-carb dieting.

At times, the research showed, a woman's decision to go on a low-carb diet was motivated by a desire to get support from, or give support to, her husband. "We heard from women that 'this low-carb approach is not my preferred way of dieting, but my husband wanted to do it this way. I'm not keen on doing it that way. But if I can get him to do it with me, I'll do it.' "

At other times, women reported they had tried the low-carb approach because they had seen men succeed. A typical female reaction, says Miller-Kovach, was to say, "I know about weight loss and if this guy can lose weight, and he doesn't know about this stuff, I can really do it."

Weight Watchers was so impressed by the change in men's (and some women's) attitudes, that the discovery played a major role in the company's decision to introduce an alternative program to its popular Flex Plan in which foods are assigned a point value, and dieters are given a point goal for each day and week. The recently launched program, the Core Plan, doesn't rely on the traditional Weight Watchers point system. Instead, it offers dieters a list of "allowed" foods (designed to provide both good nutrition and satisfaction) that they can eat and still lose weight.