--- title: "Men with Multiple Long-Term Conditions and Disability in the Game of Stones Weight Management Trial" id: "bmj-open-2-mens-experiences-of-multiple-long-term-conditions-and-or-disability-in-the-uk" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-2-mens-experiences-of-multiple-long-term-conditions-and-or-disability-in-the-uk" content_type: "clinical_feed_article" specialty: "General" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e113802?rss=1" published_at: "2026-09-15T12:32:32.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Men with Multiple Long-Term Conditions and Disability in the Game of Stones Weight Management Trial ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-2-mens-experiences-of-multiple-long-term-conditions-and-or-disability-in-the-uk - **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e113802?rss=1) - **Published At:** 2026-09-15T12:32:32.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - The Game of Stones RCT evaluated a male-targeted **weight management** intervention delivered via behavioural text messages with or without financial incentives versus a waiting-list control. - This mixed-methods process evaluation focused on men living with **multiple long-term conditions (MLTCs)** and/or **disability**, exploring experiences, health outcomes, and trial retention. - The trial randomized 585 men with obesity across three UK centres (Belfast, Bristol, Glasgow); mean age was 50.7 years (SD 13.3). - Of participants, 235 (40%) had MLTCs, 181 (31%) had a single condition, 167 (29%) had no conditions, and 165 (29%) reported a disability; 99 men had both MLTCs and disability and 93 with MLTCs lived in deprived areas. - Men with MLTCs and/or disability were older, less likely to hold degree-level qualifications, and less likely to be in full-time employment compared with men without MLTCs or disability. - Secondary outcome measures included Weight Self-Stigma Questionnaire, EQ-5D-5L (including anxiety/depression subscale), and Patient Health Questionnaire-4; retention at 12 months was also assessed. - Retention at 12 months was higher for men with disability (76%) and for men with no long-term conditions (75%), and lower for men with diabetes (65%). - For men with MLTCs in the intervention arms, self-reported **weight stigma**, well-being, and overall quality-of-life scores improved or remained stable; anxiety and depression screening results were inconsistent. - Semistructured interviews at 12 months (n=54 from intervention groups) highlighted complex, dynamic interactions between health, social factors and motivation: some men were motivated to lose weight, while others were demotivated by hospitalisation, poor mobility, or inability to exercise. - Conclusions: outcomes among men with MLTCs and/or disability ranged from substantial weight loss and health improvement to disengagement or lack of prioritisation, particularly when immobility or diabetes limited ability to act on the programme. - Trial registration: ISRCTN91974895. ## Clinical Analysis & Structured Key Points Objectives To explore experiences, health outcomes and retention of men with multiple long-term conditions (MLTCs) and/or disability within the Game of Stones weight management randomised controlled trial (RCT). Design Mixed-methods process evaluation within an RCT where secondary outcomes included the Weight Self-Stigma Questionnaire, EuroQol 5-Dimension 5-Level (EQ-5D-5L), EQ-5D-5L anxiety and depression subscale, Patient Health Questionnaire-4 and retention. Semistructured interviews were conducted at 12 months and analysed using the framework method. Setting Conducted across three UK trial centres: Belfast, Bristol and Glasgow. Participants 585 men with obesity (mean (SD) age, 50.7 (13.3) years) were randomised to one of three groups: behavioural text messages with financial incentives, texts alone or waiting-list control. Interviews were conducted with 54 participants from the two intervention groups. Results 235 (40%) participants lived with MLTCs, 181 (31%) had a single condition, 167 (29%) had no conditions and 165 (29%) had a disability. Of those with MLTCs, 99 were disabled and 93 were living in deprived areas. Participants with MLTCs and/or disability were older, fewer had a degree-level qualification and fewer were in full-time work. Retention at 12 months was higher for men with disability (76%) or no long-term conditions (75%) and lower for men with diabetes (65%). Self-reported weight stigma, well-being and quality-of-life scores improved or stayed the same for men living with MLTCs in the intervention groups; however, results for anxiety and depression screening scores were inconsistent. Participant experiences indicated complex dynamic health, social and life situations which could provide motivation to lose weight for some but not others. Hospitalisation and poor mobility, with inability to exercise, were demotivating for making changes to reach weight loss targets. Conclusions Men living with MLTCs and/or disability varied from very successful weight loss and improved health to not prioritising or feeling helped by the programme or disengagement due to immobility or diabetes. 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