Comparing Differences in Social Media Advertisement Success in Enrolling Men into Weight Loss Programs
Authors:   , Dart Hannah Elizabeth , Forman Evan M 
Published: October 2023

Despite a high prevalence of men with overweight and obesity (71.3%), men are severely underrepresented in behavioral weight loss programs. Common barriers identified by men include prevalence of traditional group-based programs, lack of independence, required drastic dietary changes, and the perception that weight loss programs are not designed with men in mind. Mobile app-based programs pose a possible solution as they allow for individualized weight loss, and are self-paced and flexible by nature. Programs wanting to increase interest from men could emphasize independence rather than group counseling and the role of exercise in their program. However, no study has directly compared men's interest in different types of weight loss programs (i.e., traditional group versus app-based versus gamified; dietary- versus fitness-based; gender-matched versus unmatched imagery). As such, two studies were conducted to examine the effect of recruitment on advertisements portraying six different weight loss programs. Study 1 ran six parallel advertisements differing in intervention type (group, app-based, or gamified) and intervention emphasis (diet or exercise). Study 1 had a preliminary hypothesis to test whether men were less interested in weight loss programs compared to women. The hypothesis of Study 1 was that for men, interest would be greatest in the gamified advertisement followed by the app advertisement followed by the group advertisement, it was expected that the reverse would be true for women. Study 1 also tested the hypothesis that for men, but not women, advertisements featuring exercise would produce more interest than advertisements featuring diet. Finally, an exploratory hypothesis examined the impact of intervention type and intervention emphasis on interest in men and women combined. Cost constraints limited the number of clicks in Study 1, thus not allowing powered comparisons of advertisement success at any point during the enrollment process or comparison of how many eligible participants were generated from each advertisement. Thus, Study 2 utilized already-collected data from a high-volume advertisement campaign that varied in image content and gender targeting data to evaluate differences in superficial interest (clicks), a deeper measure of interest (screening form completions), and number of eligible participants. Specifically, it was hypothesized that the fitness/app image would produce more interest (clicks, screening form completions) and more eligible participants than the diet image or group images, and this effect would be more pronounced for men than for women. Results confirmed the preliminary hypothesis that men had lower overall interest in weight loss programs compared to women. Surprisingly, both men and women were found to have highest interest in the game program compared to app and group. Contrary to the hypothesis, men exhibited higher initial interest in the group advertisements, but interest was not sustained. As hypothesized, men had higher sustained interest in the app program. Women on the other hand, showed higher initial interest in the app advertisement but, in line with the hypothesis, higher sustained interest in the group advertisement. The presence of the exercise emphasis increased men's interest as expected without affecting women's interest. These results suggest gamified programs would be of high interest in both genders. However, gamified programs do not close the gender gap. Program advertisements should highlight exercise change to increase interest in men without impacting interest in women. This study had several limitations including the inability to directly control advertisement buy and underpowered analysis of survey completions and enrollment due to both the process of normalizing and low absolute numbers. Future research should replicate Study 1 with a higher budget to better detect differences. Replication studies should also consider using different recruitment strategies, such as social media platforms other than Meta's Facebook and Instagram. A larger budget could also allow for analysis of population differences to better understand if one program type is better at recruiting diverse samples. Non-binary individuals should also be included in a larger study to ensure future recommendations are as inclusive as possible. Qualitative interviewing offers a better understanding of which program components interested men. Overall, more research is needed to continue to address men's low interest in WL programs.