Fear as a barrier to physical activity in young adults with obesity: a qualitative study

Abstract

Obesity continues to be a growing public health problem worldwide. In adults with obesity, physical activity has health benefits beyond those directly attributable to weight loss. However, adults with obesity encounter various barriers to physical activity. Some barriers including fear, have received little academic attention, particularly in adults under 45 years. The aim of this qualitative study was to explore how fears about physical activity are experienced by, and impact on, adults with obesity aged 18 to 45 years. Semi-structured interviews were undertaken in a sample of 10 participants with a body mass index greater than 30 kg/m 2 . Analysis was conducted using the six phases of thematic analysis from the guidelines of Braun and Clarke. Participants gave detailed accounts of their experiences of fear and how it impacted on physical activity. Three themes were extracted: (1) fear as a barrier to physical activity; (2) threats, concerns and worries about weight underpinning fear(s) of activity; and (3) the consequences of fear(s). The findings suggest that the emotion of fear, particularly pain-related fear(s), were a frequent and important barrier to physical activity among younger adults with obesity. This is an important finding because of the risk it poses to health behaviour change. The findings provide some evidence that younger adults experience fear avoidance beliefs aligned to the conceptual principles of the Fear Avoidance Model. Further research is needed to further explore this relationship in a larger sample of younger adults with obesity, and explore its implications for promoting behaviour change in this group.

Comparison of time‐matched aerobic, resistance or combined exercise training in women living with obesity: The EXOFFIT study

“…48 Training using a women-specific program with women similar to themselves and without men, 37,49 alongside exercising in a private space, an environment which potentially feels safe and non-judgmental are factors that are likely to have addressed some of the feelings and fear of stigmatization and judgment that are negatively correlated with exercise engagement with this cohort. 46,49 Overall study attrition (21%) was comparable with dropout rates observed in previous obesity and sedentary adult exercise literature. 40,42,50,51 Similar to other research, the main reasons for dropouts were ill health, lack of time and changed mind.…”

“…45 Close supervision by health care professionals may have contributed to higher adherence. Fear of injury, pain and failure are known barriers to exercise engagement in women with obesity, 46,47 while professional support is a strong facilitator. 48 Training using a women-specific program with women similar to themselves and without men, 37,49 alongside exercising in a private space, an environment which potentially feels safe and non-judgmental are factors that are likely to have addressed some of the feelings and fear of stigmatization and judgment that are negatively correlated with exercise engagement with this cohort.…”

“… 48 Training using a women‐specific program with women similar to themselves and without men, 37 , 49 alongside exercising in a private space, an environment which potentially feels safe and non‐judgmental are factors that are likely to have addressed some of the feelings and fear of stigmatization and judgment that are negatively correlated with exercise engagement with this cohort. 46 , 49 …”

Psychological interventions for weight reduction and sustained weight reduction in adults with overweight and obesity: a scoping review protocol

“…The lack of longer-term (or population) success associated with these interventions may be due to a primary focus on increasing energy expenditure and reducing dietary intake 14. While these factors are critical for weight loss, they ignore the complex psychological factors (eg, emotional, such as fears and behavioural, such as avoidance) that underpin overweight and obesity 6 15–18. These factors can contribute to disordered eating, low self-esteem, depression, anxiety and stress (which may lead to weight gain) 15 19.…”

“…Furthermore, these interventions often ignore the environmental factors that contribute to weight gain, such as food accessibility, social support and cultural norms 20. With the previous emphasis on diet and physical activity interventions seemingly having little impact on population prevalence of overweight and obesity, there is now a case to explore additional weight management strategies, focusing on the psychological factors that may underpin overweight and obesity 17 21…”