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Emotional factors impact physical activity post-bariatric surgery

A study investigating the positive and negative emotional experiences of physical activity in post-bariatric patients has found that emotional factors were relevant in their decision to be physically active and in their ability to maintain their habits, according to researchers from Massachusetts General Hospital, Boston. They also report that an intervention that encourages factors that lead to positive affect and addresses factors that lead to negative affect, could be effective in increasing physical activity following surgery. The findings were reported in the paper, ‘A Qualitative Examination of Emotional Experiences During Physical Activity Post-metabolic/Bariatric Surgery’, published in Obesity Surgery.

The authors noted that patients who have undergone bariatric surgery may have specific psychological barriers to physical activity including negative associations with physical activity that are related to a long history with obesity, weight stigma, as well as physical limitations. Therefore, the investigators designed a qualitative study to better understand the positive and negative emotional experiences of post-bariatric patients associated with physical activity, and whether the findings could lead to the development of an emotion-focused intervention to increase physical activity post-surgery.

In total, 23 adults (78% female) were included in the study. All had undergone bariatric surgery in the past two years and they completed semi-structured interviews and psychological/behavioural. Six participants scored above the clinical cutoff (≥8) for anxiety, one scored above the clinical cutoff for depression, and six scored above the cutoff (≥4) for a high internalised weight bias score.

The authors found that descriptions of positive affect associated with physical activity were common and included excitement, determination, pride, accomplishment and joy. Many reported an improvement in mood during or after physical activity.

They also found that descriptions of negative affect associated with physical activity were common and included anxiety, fatigue, depression, frustration, negative body image and the COVID-19 pandemic. The majority of data mentioning anxiety attributed the emotion to external factors. However, several participants described anxiety about the physical activity itself.

The authors noted that describing the ways emotions relate to physical activity, the participants provided insight into what helps them succeed or what is getting in the way. For example, finding an enjoyable activity leads to a more positive experience during the workout and identifying enjoyable activities and socialising were common features of physical activity that people find to be positive and reinforcing.

“This population, while also experiencing the typical barriers to physical activity that are common across society, is unique in their recent major step toward improving their health and making a lifestyle change,” the authors concluded. “Therefore, they are at a stage where they may be especially open to making changes, but also have unique emotional concerns that may hinder successful adoption of the high level of physical activity that is recommended to aid weight loss maintenance and prevent future disease.”

Further information

To access this paper, please click here


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