What works for men? Participant perspectives from a mixed-gender weight-management trial with incentives.

Background: Men are underrepresented in behavioral weight-loss trials, limiting the generalizability of findings. While gender-tailored programs have shown success, most research and community-based weight management programs remain mixed-gender. Little is known about men's experiences in these settings or how to best adapt mixed-gender programs to improve their relevance to men. Purpose: To explore men's experiences regarding weight management and to qualitatively evaluate their experiences in the Log2Lose trial. Methods: Semi-structured interviews were conducted with men who participated in the Log2Lose trial, a randomized study evaluating the effects of financial incentives on weight loss. Interviews explored motivations for enrolling, satisfaction with program components, and suggestions for improvement. Data were analyzed using conventional content analysis. Results: Nineteen men completed interviews. Most self-identified as White, were middle-aged, married, and college educated. Six themes emerged: 1) Prior weight loss efforts were self-directed and hard to sustain; 2) Rising health concerns prompted men to seek support; 3) Higher-engagers framed weight loss as a personal responsibility, whereas lower-engagers preferred more external accountability; 4) Traditional social roles influenced dietary changes; 5) Peer relatability defined group experiences more than gender composition; 6) Men valued practical content but wanted more tailored support. Conclusions: Men valued their participation in the Log2Lose trial and identified ways to improve relevance and engagement. This study provides participant-informed guidance to support the development of mixed-gender behavioral interventions that appeal to men and promote more equitable representation in weight loss research.