‘I'm a failure again, I can't do it’: Attitudes towards, and experiences of, exercise participation in adults with class III obesity

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL British Journal of Health Psychology Pub Date : 2024-06-24 DOI:10.1111/bjhp.12739

Samuel T. Orange, Jessica Roebuck, Phil Marshall, Leigh A. Madden, Rebecca V. Vince, Beth T. Bell

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Abstract

Objectives

Living within a larger body brings unique challenges to exercise participation, which are poorly understood. This qualitative study explored the attitudes towards, and experiences of, exercise participation in adults with class III obesity.

Design

Individual semi-structured qualitative interviews.

Methods

We recruited 30 adults with class III obesity (body mass index: 45.8 ± 8.6 kg/m²) from a specialist multidisciplinary weight management service. Participants took part in semi-structured interviews while participating in a 6-month home-based aerobic and resistance exercise intervention. Open-ended questions were used flexibly to explore their views and experiences of exercise, encompassing barriers, motives and perceived benefits. Transcripts were analysed using reflexive thematic analysis.

Results

Three themes were developed: (1) a web of barriers; (2) tailored exercise facilitates positive experiences; and (3) a desire to live a normal life. People with class III obesity perceived that they were unable to do exercise; a view that was attributed to perceived judgement, low physical function, pain during everyday activities and failed weight loss attempts. These complex physical and psychosocial barriers to exercise were described as contributing to exercise avoidance. High value was placed on tailored exercise that accommodates the unique needs of moving in a larger body. A desire to carry out everyday tasks underpinned motivations for exercise.

Conclusions

Our findings suggest that multi-component obesity interventions should move away from generic exercise prescriptions designed to maximize energy expenditure, and instead move towards addressing the unique physical and psychosocial needs of people who have class III obesity with tailored person-centred and weight-neutral exercise prescriptions.

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我又失败了，我做不到"：三级肥胖症成人参与运动的态度和经历。

目的：肥胖给运动参与带来了独特的挑战，而人们对这些挑战的了解却很少。这项定性研究探讨了患有 III 级肥胖症的成年人参与运动的态度和经历：设计：个人半结构化定性访谈：我们从专业的多学科体重管理服务机构招募了 30 名 III 级肥胖症成人（体重指数：45.8 ± 8.6 kg/m2）。参与者在参加为期 6 个月的家庭有氧运动和阻力运动干预的同时，参加了半结构化访谈。访谈中灵活使用了开放式问题，以探讨他们对运动的看法和体验，包括障碍、动机和感知到的益处。采用反思性主题分析法对记录誊本进行了分析：得出了三个主题：(1) 障碍网；(2) 量身定制的运动促进积极体验；(3) 希望过上正常生活。三级肥胖症患者认为他们无法进行锻炼；这一观点可归因于他们的判断力、身体机能低下、日常活动中的疼痛以及减肥尝试失败。这些复杂的身体和社会心理障碍被认为是导致患者逃避运动的原因。他们非常重视量身定制的运动，这种运动可以满足较大身体的独特运动需求。完成日常任务的愿望是运动动机的基础：我们的研究结果表明，多成分肥胖症干预措施应摒弃旨在最大限度地增加能量消耗的通用运动处方，转而采用以人为本、体重中性的定制运动处方，满足 III 级肥胖症患者独特的身体和社会心理需求。

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来源期刊

British Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

14.10

自引率

1.30%

发文量

期刊介绍： The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.