Physical activity and exercise guidelines for weight management call for at least 60 min of daily activity. However, these documents fail to acknowledge that almost no obese adults meet this target and that non-adherence and dropout are even higher among obese individuals than the general population. The reasons for this level of activity avoidance among obese individuals remain poorly understood, and there are no evidence-based methods for addressing the problem. Opinions among exercise scientists are polarized. Some advocate moderate intensity and long duration, whereas others call for high intensity and shorter duration. The latter approach attributes the inactivity and high dropout to limited discretionary time and the slow accrual of visible benefits. However, higher intensity has been associated with non-adherence and dropout, whereas longer duration has not. A conceptual model is then proposed, according to which obesity interacts with intensity, causing physical activity and exercise to be associated with reduced pleasure among obese individuals. We theorize that, in turn, repeated experiences of reduced pleasure lead to avoidance. On this basis, we call for a research agenda aimed at identifying the causes of activity-associated and exercise-associated displeasure in obesity and, by extension, the causes of the extreme physical inactivity among obese individuals.

This paper examines correlates of physical self-worth (PSW) in exercisers through employing two theoretical constructs popular in motivational psychology. Selfdetermination theory (SDT) and achievement goal orientation theory were adopted, and a cross-sectional survey was employed. Greek exercisers (N = 350, mean age = 30.8 years), participating in 1 of 4 different exercise activities were studied. Theoretical predictions established a model that was tested through path analysis. The selfdetermination continuum was hypothesized to mediate the relation between goal orientations and PSW. Task orientation predicted PSW through intrinsic motivation and identified regulation and, to a lesser extent, through introjected regulation. Ego orientation was related mainly to extrinsic regulation, and it predicted PSW only through the internally regulated variables of intrinsic and identified regulation. The model was found to fit the data well. Results showed that 17.2% of PSW was explained by the 2 motivational constructs.

The main purpose of this study was to examine the relationship between flow experience and goal orientation theory, as well as, the differences in flow experience based on the orthogonal model of goal orientation theory. Two hundred and seventy eight athletes completed the Task and Ego Orientation Sport Questionnaire based on how they usually feel. The challenge and skills ratings were completed 1 h before the competition, based on how they felt at the exact time of answering. In the following, the Flow State Scale-2 was completed up to 30 min after the competition they just participated, along with the challenge-skill ratings, based on how athletes felt during the competition. The results indicated that the athletes’ task orientation may be an important factor for attaining flow in competitive sport, feeling more skillful and estimating the upcoming competition as challenging, while low ego and low task oriented athletes lack these elements, which are important for them to get into flow. Additionally, not the level of task and ego orientation per se, but the balance between athletes’ goal orientation preferences seems important for the formation of flow experience, indicating that high task – high ego and high task – low ego athletes are experiencing the most positive mental state.

Objectives. The importance of personalized and dignified care is increasingly being recognized in health care policy and practice. Despite the known impact of clothing on social identity and self-expression, the impact of hospital clothing on patient well-being has been widely overlooked. Patients are often required to wear hospital clothing, commonly a backless gown, during medical procedures and surgeries. The impact of wearing patient clothing on well-being, during this time of vulnerability, was explored.Design. A sequential multi-method approach consisting of two studies.Methods. Two studies were carried out to consider the impact of the hospital gown on well-being among adults with and without chronic health conditions. The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with adults living with a lifelong chronic health condition (congenital heart disease). The second study was a cross-sectional online survey exploring adults' views (n = 928) and experiences of wearing the hospital gown.Results. Qualitative analysis identified the following master themes: (1) symbolic embodiment of the 'sick' role, (2) relinquishing control to medical professionals, and (3) emotional and physical vulnerability. Quantitative analysis of the online survey data indicated that adults often reported wearing the hospital gown despite a lack of medical necessity. Its design was considered to be not fit for purpose and lacking in dignity.Conclusions. The implications of these findings for health policy and practice are discussed, emphasizing the importance of challenging cultural norms in health care since dehumanizing aspects of care, as symbolically represented by the hospital gown, may adversely impact on patient well-being. Statement of contribution What is already knownGetting dressed is a form of self-expression, which contributes to the construction of social identity, yet few studies have explored the impact of wearing hospital clothing on patient well-being.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Background Gradual elevation of body weight leads numerous individuals to dieting and weight loss behaviours. Nevertheless, the prevalence of obesity continues to rise in industrialised countries. The examination of the motivational determinants of dietary modification ('dieting') in order to identify clusters of individuals in the first 6 months of their effort to control body weight was the aim of the current study. The theories of self-determination and self-esteem formation guided our analysis. Methods A longitudinal study was conducted with three data collection points (N 1 =256; N 2 =135; N 3 =75). Data were responses on the Treatment Self Regulation Questionnaire, Social Physique Anxiety Scale, Physical Self-Description Questionnaire, Kaiser Physical Activity Survey Questionnaire, and items assessing expectations of achievement and selfconfidence. Results Cluster analyses provided stable and validated cluster profiles for all data sets. In the 1st and 2nd data sets, results revealed three groups of dieters labelled as 'media victims', 'try to feel nice' and 'older and experienced'. For the 3rd data set, results supported a 4-group solution ('less adaptive profile', 'second successful dieters', 'successful dieters', and 'unsuccessful dieters'). Health EducationJournal 65 65 65 65 65(1) 2006 53-72 M M Georgiadis et al for an alternative paradigm in weight management, are proposed.Conclusions Psychological theories of self-determination and self-esteem provide important ways of understanding and identifying adaptive and less adaptive weight control strategies.