Researchers wanted to understand why women with severe obesity struggle to start and stick with exercise programs. They followed 60 women in a weight loss study for 12 months, with half doing exercise and half not. After the program ended, 11 women shared their experiences about what made exercise hard or easier for them. The biggest challenges were worrying about their bodies not being able to handle exercise, fitting workouts into busy schedules with work and family, and not feeling confident about exercising. The good news? Having support from others and enjoying the exercise made a huge difference. These findings can help doctors and fitness experts design better programs for women dealing with severe obesity.

The Quick Take

  • What they studied: What makes it hard or easy for women with severe obesity to start exercising and keep exercising, both during and after a weight loss program
  • Who participated: 60 women with clinically severe obesity joined a year-long weight loss study. Half the women (30) did diet changes only, while the other half (30) did diet changes plus exercise. After the program, 11 women from the exercise group agreed to talk about their experiences
  • Key finding: Women faced five main obstacles: concerns about their weight and body, worries that their bodies couldn’t handle exercise, low confidence in their exercise abilities, busy schedules with work and family, and lack of support or accountability from others. Having encouragement from people around them and actually enjoying exercise were the biggest helpers
  • What it means for you: If you’re a woman with severe obesity thinking about exercising, knowing these common barriers can help you prepare. Finding a supportive friend or family member, starting with activities you enjoy, and being realistic about your schedule may make it easier to stick with exercise. Talk to your doctor before starting any new exercise program

The Research Details

This study started with a larger research project where 60 women with severe obesity were randomly split into two groups. One group changed their diet only, while the other group changed their diet and added exercise training. Both groups followed their programs for 12 months. After the year ended, the researchers asked 11 women from the exercise group to sit down for interviews and talk about their experiences. The women described what made it hard to exercise, what helped them exercise, and what they wished had been different. The researchers carefully listened to all the interviews, wrote down everything the women said word-for-word, and then looked for patterns and common themes in what they heard.

Understanding real-world barriers and helpers is crucial because it tells us what actually works in people’s lives, not just what works in theory. By listening directly to women’s experiences, researchers can design exercise programs that fit into real life with real challenges like work schedules and family responsibilities. This approach helps create programs that people can actually stick with, rather than programs that look good on paper but don’t work in practice.

This study has both strengths and limitations. The strength is that it directly asks women about their real experiences, which gives honest, detailed information. The limitation is that only 11 out of 60 women participated in the interviews, and they all came from the exercise group, so we don’t know what the other women thought. The study is also relatively small, so the findings may not apply to all women with severe obesity. However, the detailed nature of the interviews provides valuable insights that can guide future program development

What the Results Show

The research identified five main themes that affected whether women exercised. Three were personal factors: concerns about their weight and body image, worries that their bodies couldn’t handle physical activity, and low confidence or enjoyment about exercising. Two were social factors: having too many work and family commitments, and lacking support or accountability from others. Women mentioned that thinking about their weight often made them feel discouraged about starting exercise. Many worried their bodies were too weak or that they might get injured. Some women felt embarrassed or self-conscious about exercising in front of others. The women who did stick with exercise often had someone checking in on them or encouraging them, and they found activities they actually enjoyed rather than forcing themselves to do exercise they hated.

The women also provided suggestions for improving future programs. They wanted more flexible scheduling options that fit around work and family. They appreciated having a supportive community or group to exercise with. Many said they needed more education about what their bodies could actually do and reassurance that starting slowly was okay. Some women mentioned that having professional guidance from trainers who understood severe obesity was helpful. The women also noted that celebrating small wins and progress, not just weight loss, kept them motivated

This research aligns with what other studies have found about exercise barriers for people with obesity, including concerns about physical limitations and lack of support. However, this study provides more detailed, personal insights by actually listening to women’s stories rather than just surveying them with yes-or-no questions. The findings support what exercise scientists already suspected: that social support and enjoyment are just as important as willpower when it comes to sticking with exercise

The biggest limitation is that only 11 women out of the original 60 participated in interviews, and they were all from the exercise group. We don’t know what the women who didn’t exercise thought about their experience. The study only included women, so the findings may not apply to men. The interviews happened after the program ended, so women might have forgotten some details or their memories might have changed. The study was done in one location, so results might be different in other communities or countries. Finally, this is a small study, so while the insights are valuable, they need to be confirmed with larger research

The Bottom Line

If you’re a woman with severe obesity considering exercise: (1) Start with activities you genuinely enjoy, not ones you think you ‘should’ do (moderate confidence). (2) Find a friend, family member, or group to exercise with for support and accountability (moderate-high confidence). (3) Talk to your doctor before starting, and consider working with a trainer experienced with severe obesity (moderate confidence). (4) Be realistic about fitting exercise into your actual schedule, not an ideal schedule (high confidence). (5) Focus on how you feel and small improvements, not just weight loss (moderate confidence)

This research is most relevant for women with severe obesity who are thinking about starting exercise, their family members who want to support them, and healthcare providers designing weight loss and exercise programs. It’s also important for fitness professionals and gym owners who want to create more welcoming environments. This research doesn’t apply to people with mild or moderate obesity, though some insights may be helpful. It also doesn’t replace medical advice from your doctor

Realistic expectations: It typically takes 2-4 weeks to establish an exercise habit. You might notice improvements in how you feel (energy, mood, sleep) within 2-4 weeks. Physical changes in strength or endurance may take 6-8 weeks. Weight loss results vary greatly and depend on many factors beyond exercise. Don’t expect dramatic changes overnight; sustainable progress is slow and steady

Want to Apply This Research?

  • Track three things weekly: (1) Which activities you did and whether you enjoyed them (rate 1-10), (2) Who supported or encouraged you that week, (3) How you felt physically and mentally (energy level, mood, confidence). This focuses on the barriers and facilitators this research identified, not just calories or weight
  • Use the app to find or schedule one enjoyable physical activity per week that fits your actual schedule. Set a reminder to text a friend or family member about your exercise plan, creating accountability. Log one thing you’re proud of each week, even if it’s small (like trying a new activity or exercising when you felt discouraged)
  • Monthly, review your enjoyment ratings to see which activities you’re most likely to stick with. Track whether having support made a difference in your consistency. Notice patterns in what times and situations work best for you. Adjust your approach based on what’s actually working in your life, not what you think should work

This research provides insights into common barriers and facilitators for exercise in women with severe obesity, but it is not medical advice. Before starting any new exercise program, especially if you have severe obesity or any health conditions, consult with your doctor or healthcare provider. They can assess your individual health status and recommend safe, appropriate activities. The findings from this small study (11 women) should not be considered definitive for all women with severe obesity. Results may vary based on individual circumstances, health conditions, and personal factors. If you experience pain, shortness of breath, dizziness, or other concerning symptoms during exercise, stop immediately and seek medical attention.