Obesity is now equally common (~30%) in men and women, but most attendees at health services for the management of obesity are women. For every obesity related condition, other than stroke, health outcomes are worse in men that women.

Contrary to the views of some, men are interested in their health and well being and are not fundamentally irresponsible. Approximately 90% of Australian men over the age of 35 visit their general practitioners one of more times each year, although 60% indicate that their concerns are not adequately addressed.

Men have behaviour patterns and communication styles that are biological in origin and need to be understood and accounted for in the delivery of health care. The uptake of preventative health messages is lower in men possibly because: health promotion messages lack the gender specific approach used in marketing, incidental contact with health care environments is limited, and there is a tendency not to network and discuss health issues in the same way as women. Education is a strong determinant of health outcomes for men and the provision of adequate information is pivotal.

Delayed help seeking results from self monitoring and fundamental barriers to access which include inconvenient opening hours, a need for immediacy, environments which confer a sense of vulnerability, and practitioners with limited time and insufficient training in communicating with men.

Particularly when associated with the metabolic syndrome, obesity is characterised by specific problems in men including low testosterone, erectile dysfunction, lower urinary tract symptoms, and obstructive sleep apnoea which magnifies the occurrence of these, occurs twice as frequently in men compared to women.

Men, in general, will not volunteer issues beyond immediate concerns; the appropriate questions need to be asked. Communicate directly, with clear and authoritative explanations, and liberal use of humour.

Use triggers such as increased effectiveness and performance in work and family roles, and maintenance or improvement, of sexual function, rather than health per se to engage and motivate.

An approach to constructing, and the elements of, an optimal management plan will be discussed.