Abstract
Objective: Regular physical activity has beneficial health effects and aids weight management in obese adults, yet satisfactory adherence to physical activity behaviour change is rare. The primary objective was to summarise research evidence concerning influences on long-term physical activity behaviour change in obese adults. Secondary objectives were to scrutinise study quality, and to present recommendations for future research in terms of study design and research areas. Design: Narrative review. Papers were identified from a comprehensive electronic and manual literature search, and included/excluded according to set inclusion/exclusion criteria. Data from included studies was extracted and summarised. Results: Negative influences were social physique anxiety, unrealistic activity messages, and low motivation. Positive influences included social support, activity self-monitoring, increased activity-specific self-efficacy, moderate intensity activities (40-70% of V02-max), moderate activity volumes (2-3 hours/week), short-bout sessions (10-15 minutes) with treadmill access, and home-based physical activity. However, limited strength and volume of evidence or inconclusive findings reduced our confidence in several purported influences. Conclusions: Many factors appear to influence adherence to physical activity behaviour change in obese adults. Although information on influences is accumulating, more research is still needed on how to provide best therapeutic support for this challenging task. Keywords: Adherence, adults, behaviour change, exercise, physical activity, obesity
Highlights
Obesity (defined as having a body mass index (BMI) above 30 kg/m2) is recognised as a global epidemic (I)
I.e. any bodily movement produced by skeletal muscles that results in energy expenditure [4], is inversely related to longterm weight gain [5]
Given the study's primary objective, we elected to include any study with information on factors that influenced physical activity behaviour change adherence, both from a positive and negative point of view
Summary
Obesity (defined as having a body mass index (BMI) above 30 kg/m2) is recognised as a global epidemic (I). Physical activity coupled with dietary restrictions produces greater weight loss compared to diet alone [6]. Whilst there is considerable evidence as to the many beneficial effects of physical activity in obese adults, approaches to facilitating long-term increases in physical activity, and the subsequent attainment of those beneficial effects, are relatively little researched. Many aspects of adherence to physical activity behaviour change are not yet known in normal-weight (BMI 20-25 kg/m2) populations. The primary objective of this narrative review paper was to summarise best available evidence on influences on physical activity behaviour change adherence in obese adults. Erik ~emrningsson'.~*Ph, D-student, Angie Page', PhD, Kenneth FOX', P' rDoefepsasrotmr,eSntteopfhEaxne~rcoissesanned rP~ro, fessor Health Sciences, University of Bristol, UK. Correspondence: Erik Hemmingsson, University of Bristol, Dept of Exercise and Health Sciences, Priory House, 8 Woodland Rd., Bristol BS8 lTN, Avon, UK.
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