The lived experiences of being physically active when morbidly obese: A qualitative systematic review

Abstract

The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: “Identity” with the three subthemes: “considering weight,” “being able to,” and “belonging with others.” The theme and subthemes were merged into a meta-synthesis: “Homecoming: a change in identity.” The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of “homecoming” when active.

Barriers to and motivators for physical activity among people with Type 2 diabetes: patients' perspectives

“…Identifying and understanding the causes of physical activity behaviour is essential for developing lifestyle modification programmes designed to promote exercise . Barriers to participation in regular physical activity have been studied in various populations . Common obstacles include lack of time, health problems, bad weather, environmental considerations such as convenient access, safety and cost, lack of social support, professional guidance, and lack of self‐efficacy .…”

Eu Tenho Um Corpo Gordo, E Agora? Relatos De Mulheres Obesas Que Participaram De Uma Intervenção Não Prescritiva, Multidisciplinar E Baseada Na Abordagem “Health at Every Size®”

“…56 Quando a perda de peso era pequena ou muito baixa, percebeu-se uma atitude negativa dos participantes para dar continuidade às atividades. Ilustrativamente, em um dos estudos, foi relatado: "você não consegue permanecer engajado nas atividades físicas se você não vê resultados".…”

“…No entanto, o foco excessivo no peso corporal também levantou percepções negativas de alguns participantes, como, por exemplo 56 : "ter as medidas e o peso corporais aferidos e ouvir que você é culpado não foi bom".…”

“…Outro fator levantado como empecilho para a prática de atividade física foi a autonomia, como destacado na seguinte fala 56 : "me dê um personal trainer que me tire da cama todos os dias e me faça me exercitar que, sim, eu perderia peso".…”

“…Diferentemente das barreiras observadas na revisão de literatura de Toft & Uhrenfeld, 56 o peso corporal não foi fator determinante para a adesão de nossas participantes às atividades físicas. Pelo contrário, parece que o distanciamento dessa expectativa, como explorado nos eixos interpretativos anteriores, tornou as participantes mais engajadas nas atividades e lhes permitiu destacar outros ganhos como sendo de sucesso.…”