Ein Präventionsprogramm im Setting Bundesligafußball zur Gewichtsreduktion bei übergewichtigen Männern : Analyse der Umsetzbarkeit, Effektivität und relevanter Erfolgsfaktoren

Objective: The prevalence of overweight and obese people worldwide has quickly risen during the last few centuries causing millions of deaths from subsequent fatal conditions like cancer, diabetes type 2 and coronary heart disease. Between men and women, men are at even greater risk when overweight. In Germany, about one third of all men between 18 and 79 are overweight. Concurrently, men are distinctly underrepresented in all types of weight reduction and lifestyle change programs due to perceptions of male stereotypes and a lack of interventions fitting their socio-cultural backgrounds. The Scottish Professional Football League Trusts “Footballfans in Training” (FFIT) has been successful in recruiting overweight, middle-aged men to their health promotion program for years. Since its start in 2011 it has been evaluated as sustainably successful for its participants in terms of weight loss and lifestyle change. This work presents the evaluation of the German version of FFIT – Fußballfans im Training, initiated in 2016. Its goal was to evaluate whether the program could successfully be transferred to the German Bundesliga and replicate the results achieved in Scotland. Methods: The 12-week, men-only intervention was hosted by the Football clubs on their own training grounds coordinated by club trainers. The main foci of theoretics lay on nutrition, everyday exercise and behavior change. Physical activity was in average intensity and based on Football exercises if possible. The clubs mostly recruited their fans via their homepages and social media. All interested fans had to be 35 to 65 years old with a minimum BMI of 28 and a minimum waist circumference of 100 cm. After initial health checks all men were measured at the beginning of the courses as well as during the last session. The primary outcome was weight with additional anthropometric, behavioral and psychological outcomes as secondary results. In a non-randomized trial with a waiting list comparison group the program was evaluated for feasibility, effectiveness and key success factors. Results: The program was well-received by German Football clubs and their fans. Men recruited for the FFIT program between January 2017 and December 2018 took part in the evaluation. In a mixed multi-level regression analysis of 477 men (January 2017-July 2018) the results showed a significant weight loss of 6.24 kg (95 % CI: 5.82-6.66) compared to 0.50 kg (-0.47-1.49) in a comparison group recruited from waiting lists. Significant changes over time were also calculated for waist circumference, body fat percentage, all dietary behavior outcomes and sedentary time. Sensitivity analysis confirmed the strong effects. In an explorative analysis of predictors of successful weight loss (5 percent) in 791 men (age: M=49.28, weight: M=113.42 kg) from a total of 19 clubs (January 2017-December 2018), significant results could be presented for EAST (Emotional Attachment To a Sports Team), self-efficacy and some dietary behaviors as well as behavior changes. Discussion: The results of the German FFIT trial add to the understanding that men are successful in weight loss interventions once enrolled. The concept of developing programs that attract men with the cultural setting of professional sports started in Scotland and has since been substantiated by similar programs in different sports and countries. FFIT in Germany has been the largest trial of such replications since the original by the SPFLT. Its idea and success could be taken as one example for German health promotion practitioners how to approach the lack of men interested in most current offers. This could be but is not limited to professional sports as long as men are emotionally engaged. More research is needed to test the feasibility of FFIT’s inherent concept in different settings. Equally, to strengthen the evidence of it working in professional sports, more research on success factors and mechanisms is recommended.