Baseline Body Mass Index Influences the Responses to Exercise Training on Quality of Life in Women with Obesity
Main Article Content
Abstract
Purpose: Exercise has been documented as a critical strategy for improving physical and mental health. However, the impact of exercise training (ET) on quality of life (QoL) among obese is controversial. The present study aims to evaluate the impact of a 20-week ET program in women with obesity and the influence of baseline weight status on QoL responses to the ET program.
Methods: This secondary analysis from a quasi-experimental study included 40 obese women (BMI >30 kg/m2) aged between 18 and 65 years old (20 interventions and 20 controls). The intervention group participated in a moderate-to-vigorous intensity ET thrice a week, nutritional guidance, and psychological support. The control group received the same activities of nutritional guidance and psychological support but did not perform the ET. Measurements of QoL (WHOQOL-Bref) were performed at baseline and after 20- week follow-up.
Results: No significant impact of 20-week ET on QoL among obese women was observed. However, greater improvements in physical health, psychological, social relationship, and environment domains were observed for every increase in 1 unit of baseline BMI, except for the overall QoL score.
Conclusions/Recommendation: We can speculate that the better QoL responses to ET among those with higher BMI at baseline may be explained by the fact that individuals with more severe obesity are more impacted by functional limitations, stigmatization, discrimination, and social isolation; therefore, presenting worse QoL.
Keywords:
Mental health, Exercise, Obesity, Quality of life
Article Details
How to Cite
RIBEIRO, Leonardo G et al.
Baseline Body Mass Index Influences the Responses to Exercise Training on Quality of Life in Women with Obesity.
Medical Research Archives, [S.l.], v. 10, n. 9, sep. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3071>. Date accessed: 08 may 2024.
doi: https://doi.org/10.18103/mra.v10i9.3071.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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10. Sutin AR, Stephan Y, Robinson E, Daly M, Terracciano A. Body-related discrimination and dieting and substance use behaviors in adolescence. Appetite. 2020;151:104689. doi:10.1016/j.appet.2020.104689
11. Lopez-Nava G, Asokkumar R, Lacruz T, Rull A, Beltran L, Bautista-Castaño I. The effect of weight loss and exercise on Health-Related Quality of Life (HRQOL) following Endoscopic Bariatric Therapies (EBT) for obesity. Health Qual Life Outcomes. 2020;18(1):130. doi:10.1186/s12955-020-01359-3
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16. Garber CE. The Health Benefits of Exercise in Overweight and Obese Patients. Curr Sports Med Rep. 2019;18(8):287-291. doi:10.1249/JSR.0000000000000619
17. Imayama I, Alfano CM, Kong A, et al. Dietary weight loss and exercise interventions effects on quality of life in overweight/obese postmenopausal women: a randomized controlled trial. Int J Behav Nutr Phys Act. 2011;8:118. doi:10.1186/1479-5868-8-118
18. Kitzman DW, Brubaker P, Morgan T, et al. Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. JAMA. 2016;315(1):36-46. doi:10.1001/jama.2015.17346
19. Rejeski WJ, Focht BC, Messier SP, Morgan T, Pahor M, Penninx B. Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2002;21(5):419-426. doi:10.1037//0278-6133.21.5.419
20. Van Gemert WAM, van der Palen J, Monninkhof EM, et al. Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial. PloS One. 2015;10(6):e0127520. doi:10.1371/journal.pone.0127520
21. Pearsall R, Smith DJ, Pelosi A, Geddes J. Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis. BMC Psychiatry. 2014;14:117. doi:10.1186/1471-244X-14-117
22. Mediano MFF, Barbosa JS de O, Sichieri R, Pereira RA. Efeito do exercício físico na sensibilidade à insulina em mulheres obesas submetidas a programa de perda de peso: um ensaio clínico. Arq Bras Endocrinol Metabol. 2007;51(6):993-999. doi:10.1590/S0004-27302007000600015
23. Navalta JW, Stone WJ, Lyons TS. Ethical Issues Relating to Scientific Discovery in Exercise Science. Int J Exerc Sci. 2019;12(1):1-8.
24. Dumortier M, Brandou F, Perez-Martin A, Fedou C, Mercier J, Brun JF. Low intensity endurance exercise targeted for lipid oxidation improves body composition and insulin sensitivity in patients with the metabolic syndrome. Diabetes Metab. 2003;29(5):509-518. doi:10.1016/s1262-3636(07)70065-4
25. Lohman TG, Roche AF, Martorell R, eds. Anthropometric Standardization Reference Manual. Human Kinetics Books; 1988.
26. Fleck MP, Louzada S, Xavier M, et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref.” Rev Saúde Pública. 2000;34(2):178-183. doi:10.1590/S0034-89102000000200012
27. World Health Organization. Programme on Mental Health : WHOQOL User Manual. 2012 revision. World Health Organization; 1998:106 p.
28. Durrer Schutz D, Busetto L, Dicker D, et al. European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care. Obes Facts. 2019;12(1):40-66. doi:10.1159/000496183
29. Gaesser GA, Angadi SS. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021;24(10):102995. doi:10.1016/j.isci.2021.102995
30. Oppert J, Bellicha A, Baak MA, et al. Exercise training in the management of overweight and obesity in adults: Synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working Group. Obes Rev. 2021;22(S4). doi:10.1111/obr.13273
31. Berge J, Hjelmesæth J, Kolotkin RL, et al. Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial. Health Qual Life Outcomes. 2022;20(1):34. doi:10.1186/s12955-022-01940-y
32. Carraça EV, Encantado J, Battista F, et al. Effect of exercise training on psychological outcomes in adults with overweight or obesity: A systematic review and meta-analysis. Obes Rev Off J Int Assoc Study Obes. 2021;22 Suppl 4:e13261. doi:10.1111/obr.13261
33. Jepsen R, Aadland E, Robertson L, Kolotkin RL, Andersen JR, Natvig GK. Physical activity and quality of life in severely obese adults during a two-year lifestyle intervention programme. J Obes. 2015;2015:314194. doi:10.1155/2015/314194
34. Batrakoulis A, Loules G, Georgakouli K, et al. High-intensity interval neuromuscular training promotes exercise behavioral regulation, adherence and weight loss in inactive obese women. Eur J Sport Sci. 2020;20(6):783-792. doi:10.1080/17461391.2019.1663270
35. Williamson DA, Rejeski J, Lang W, et al. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Arch Intern Med. 2009;169(2):163-171. doi:10.1001/archinternmed.2008.544
36. Arboleda-Serna VH, Patiño-Villada FA, Pinzón-Castro DA, Arango-Vélez EF. Effects of low-volume, high-intensity interval training on maximal oxygen consumption, body fat percentage and health-related quality of life in women with overweight: A randomized controlled trial. J Exerc Sci Fit. 2022;20(2):108-112. doi:10.1016/j.jesf.2022.01.004
37. Sperlich B, Wallmann-Sperlich B, Zinner C, Von Stauffenberg V, Losert H, Holmberg HC. Functional High-Intensity Circuit Training Improves Body Composition, Peak Oxygen Uptake, Strength, and Alters Certain Dimensions of Quality of Life in Overweight Women. Front Physiol. 2017;8. doi:10.3389/fphys.2017.00172
38. Cruz LN, Polanczyk CA, Camey SA, Hoffmann JF, Fleck MP. Quality of life in Brazil: normative values for the WHOQOL-bref in a southern general population sample. Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 2011;20(7):1123-1129. doi:10.1007/s11136-011-9845-3
39. Pucci GCMF, Rech CR, Fermino RC, Reis RS. Associação entre atividade física e qualidade de vida em adultos. Rev Saúde Pública. 2012;46(1):166-179. doi:10.1590/S0034-89102012000100021
40. Kelley GA, Kelley KS, Hootman JM, Jones DL. Exercise and Health-Related Quality of Life in Older Community-Dwelling Adults: A Meta-Analysis of Randomized Controlled Trials. J Appl Gerontol. 2009;28(3):369-394. doi:10.1177/0733464808327456
41. Nakamura PM, Teixeira IP, Smirmaul BPC, et al. Health related quality of life is differently associated with leisure-time physical activity intensities according to gender: a cross-sectional approach. Health Qual Life Outcomes. 2014;12:98. doi:10.1186/1477-7525-12-98
42. Valadares ALR, Carvalho ED de, Costa-Paiva LH da, Morais SS, Pinto-Neto AM. Association between different types of physical activities and quality of life in women aged 60 years or over. Rev Assoc Medica Bras 1992. 2011;57(4):450-455. doi:10.1590/s0104-42302011000400021
43. Ul-Haq Z, Mackay DF, Fenwick E, Pell JP. Meta-analysis of the association between body mass index and health-related quality of life among adults, assessed by the SF-36. Obes Silver Spring Md. 2013;21(3):E322-327. doi:10.1002/oby.20107
44. Donini LM, Rosano A, Di Lazzaro L, et al. Impact of Disability, Psychological Status, and Comorbidity on Health-Related Quality of Life Perceived by Subjects with Obesity. Obes Facts. 2020;13(2):191-200. doi:10.1159/000506079
45. Freese EC, Acitelli RM, Gist NH, Cureton KJ, Evans EM, O’Connor PJ. Effect of Six Weeks of Sprint Interval Training on Mood and Perceived Health in Women at Risk for Metabolic Syndrome. J Sport Exerc Psychol. 2014;36(6):610-618. doi:10.1123/jsep.2014-0083
2. Rubino F, Puhl RM, Cummings DE, et al. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020;26(4):485-497. doi:10.1038/s41591-020-0803-x
3. Taylor VH, Forhan M, Vigod SN, McIntyre RS, Morrison KM. The impact of obesity on quality of life. Best Pract Res Clin Endocrinol Metab. 2013;27(2):139-146. doi:10.1016/j.beem.2013.04.004
4. Estivaleti JM, Guzman-Habinger J, Lobos J, et al. Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030. Sci Rep. 2022;12(1):12699. doi:10.1038/s41598-022-16934-5
5. Scott KM, Bruffaerts R, Simon GE, et al. Obesity and mental disorders in the general population: results from the world mental health surveys. Int J Obes. 2008;32(1):192-200. doi:10.1038/sj.ijo.0803701
6. Gariepy G, Nitka D, Schmitz N. The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. Int J Obes 2005. 2010;34(3):407-419. doi:10.1038/ijo.2009.252
7. Lash MM, Armstrong A. Impact of obesity on women’s health. Fertil Steril. 2009;91(5):1712-1716. doi:10.1016/j.fertnstert.2008.02.141
8. Jackson SE. Obesity, Weight Stigma and Discrimination. J Obes Eat Disord. 2016;2(1). doi:10.21767/2471-8203.100016
9. Robinson E, Haynes A, Sutin A, Daly M. Self-perception of overweight and obesity: A review of mental and physical health outcomes. Obes Sci Pract. 2020;6(5):552-561. doi:10.1002/osp4.424
10. Sutin AR, Stephan Y, Robinson E, Daly M, Terracciano A. Body-related discrimination and dieting and substance use behaviors in adolescence. Appetite. 2020;151:104689. doi:10.1016/j.appet.2020.104689
11. Lopez-Nava G, Asokkumar R, Lacruz T, Rull A, Beltran L, Bautista-Castaño I. The effect of weight loss and exercise on Health-Related Quality of Life (HRQOL) following Endoscopic Bariatric Therapies (EBT) for obesity. Health Qual Life Outcomes. 2020;18(1):130. doi:10.1186/s12955-020-01359-3
12. Pimenta FBC, Bertrand E, Mograbi DC, Shinohara H, Landeira-Fernandez J. The relationship between obesity and quality of life in Brazilian adults. Front Psychol. 2015;6. doi:10.3389/fpsyg.2015.00966
13. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320(19):2020-2028. doi:10.1001/jama.2018.14854
14. Kercher VM, Kercher K, Bennion T, et al. Fitness Trends From Around the Globe. ACSMS Health Fit J. 2021;25(1):20-31. doi:10.1249/FIT.0000000000000639
15. Kercher VM, Kercher K, Bennion T, et al. 2022 Fitness Trends from Around the Globe. ACSMS Health Fit J. 2022;26(1):21-37. doi:10.1249/FIT.0000000000000737
16. Garber CE. The Health Benefits of Exercise in Overweight and Obese Patients. Curr Sports Med Rep. 2019;18(8):287-291. doi:10.1249/JSR.0000000000000619
17. Imayama I, Alfano CM, Kong A, et al. Dietary weight loss and exercise interventions effects on quality of life in overweight/obese postmenopausal women: a randomized controlled trial. Int J Behav Nutr Phys Act. 2011;8:118. doi:10.1186/1479-5868-8-118
18. Kitzman DW, Brubaker P, Morgan T, et al. Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. JAMA. 2016;315(1):36-46. doi:10.1001/jama.2015.17346
19. Rejeski WJ, Focht BC, Messier SP, Morgan T, Pahor M, Penninx B. Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2002;21(5):419-426. doi:10.1037//0278-6133.21.5.419
20. Van Gemert WAM, van der Palen J, Monninkhof EM, et al. Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial. PloS One. 2015;10(6):e0127520. doi:10.1371/journal.pone.0127520
21. Pearsall R, Smith DJ, Pelosi A, Geddes J. Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis. BMC Psychiatry. 2014;14:117. doi:10.1186/1471-244X-14-117
22. Mediano MFF, Barbosa JS de O, Sichieri R, Pereira RA. Efeito do exercício físico na sensibilidade à insulina em mulheres obesas submetidas a programa de perda de peso: um ensaio clínico. Arq Bras Endocrinol Metabol. 2007;51(6):993-999. doi:10.1590/S0004-27302007000600015
23. Navalta JW, Stone WJ, Lyons TS. Ethical Issues Relating to Scientific Discovery in Exercise Science. Int J Exerc Sci. 2019;12(1):1-8.
24. Dumortier M, Brandou F, Perez-Martin A, Fedou C, Mercier J, Brun JF. Low intensity endurance exercise targeted for lipid oxidation improves body composition and insulin sensitivity in patients with the metabolic syndrome. Diabetes Metab. 2003;29(5):509-518. doi:10.1016/s1262-3636(07)70065-4
25. Lohman TG, Roche AF, Martorell R, eds. Anthropometric Standardization Reference Manual. Human Kinetics Books; 1988.
26. Fleck MP, Louzada S, Xavier M, et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref.” Rev Saúde Pública. 2000;34(2):178-183. doi:10.1590/S0034-89102000000200012
27. World Health Organization. Programme on Mental Health : WHOQOL User Manual. 2012 revision. World Health Organization; 1998:106 p.
28. Durrer Schutz D, Busetto L, Dicker D, et al. European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care. Obes Facts. 2019;12(1):40-66. doi:10.1159/000496183
29. Gaesser GA, Angadi SS. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021;24(10):102995. doi:10.1016/j.isci.2021.102995
30. Oppert J, Bellicha A, Baak MA, et al. Exercise training in the management of overweight and obesity in adults: Synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working Group. Obes Rev. 2021;22(S4). doi:10.1111/obr.13273
31. Berge J, Hjelmesæth J, Kolotkin RL, et al. Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial. Health Qual Life Outcomes. 2022;20(1):34. doi:10.1186/s12955-022-01940-y
32. Carraça EV, Encantado J, Battista F, et al. Effect of exercise training on psychological outcomes in adults with overweight or obesity: A systematic review and meta-analysis. Obes Rev Off J Int Assoc Study Obes. 2021;22 Suppl 4:e13261. doi:10.1111/obr.13261
33. Jepsen R, Aadland E, Robertson L, Kolotkin RL, Andersen JR, Natvig GK. Physical activity and quality of life in severely obese adults during a two-year lifestyle intervention programme. J Obes. 2015;2015:314194. doi:10.1155/2015/314194
34. Batrakoulis A, Loules G, Georgakouli K, et al. High-intensity interval neuromuscular training promotes exercise behavioral regulation, adherence and weight loss in inactive obese women. Eur J Sport Sci. 2020;20(6):783-792. doi:10.1080/17461391.2019.1663270
35. Williamson DA, Rejeski J, Lang W, et al. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Arch Intern Med. 2009;169(2):163-171. doi:10.1001/archinternmed.2008.544
36. Arboleda-Serna VH, Patiño-Villada FA, Pinzón-Castro DA, Arango-Vélez EF. Effects of low-volume, high-intensity interval training on maximal oxygen consumption, body fat percentage and health-related quality of life in women with overweight: A randomized controlled trial. J Exerc Sci Fit. 2022;20(2):108-112. doi:10.1016/j.jesf.2022.01.004
37. Sperlich B, Wallmann-Sperlich B, Zinner C, Von Stauffenberg V, Losert H, Holmberg HC. Functional High-Intensity Circuit Training Improves Body Composition, Peak Oxygen Uptake, Strength, and Alters Certain Dimensions of Quality of Life in Overweight Women. Front Physiol. 2017;8. doi:10.3389/fphys.2017.00172
38. Cruz LN, Polanczyk CA, Camey SA, Hoffmann JF, Fleck MP. Quality of life in Brazil: normative values for the WHOQOL-bref in a southern general population sample. Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 2011;20(7):1123-1129. doi:10.1007/s11136-011-9845-3
39. Pucci GCMF, Rech CR, Fermino RC, Reis RS. Associação entre atividade física e qualidade de vida em adultos. Rev Saúde Pública. 2012;46(1):166-179. doi:10.1590/S0034-89102012000100021
40. Kelley GA, Kelley KS, Hootman JM, Jones DL. Exercise and Health-Related Quality of Life in Older Community-Dwelling Adults: A Meta-Analysis of Randomized Controlled Trials. J Appl Gerontol. 2009;28(3):369-394. doi:10.1177/0733464808327456
41. Nakamura PM, Teixeira IP, Smirmaul BPC, et al. Health related quality of life is differently associated with leisure-time physical activity intensities according to gender: a cross-sectional approach. Health Qual Life Outcomes. 2014;12:98. doi:10.1186/1477-7525-12-98
42. Valadares ALR, Carvalho ED de, Costa-Paiva LH da, Morais SS, Pinto-Neto AM. Association between different types of physical activities and quality of life in women aged 60 years or over. Rev Assoc Medica Bras 1992. 2011;57(4):450-455. doi:10.1590/s0104-42302011000400021
43. Ul-Haq Z, Mackay DF, Fenwick E, Pell JP. Meta-analysis of the association between body mass index and health-related quality of life among adults, assessed by the SF-36. Obes Silver Spring Md. 2013;21(3):E322-327. doi:10.1002/oby.20107
44. Donini LM, Rosano A, Di Lazzaro L, et al. Impact of Disability, Psychological Status, and Comorbidity on Health-Related Quality of Life Perceived by Subjects with Obesity. Obes Facts. 2020;13(2):191-200. doi:10.1159/000506079
45. Freese EC, Acitelli RM, Gist NH, Cureton KJ, Evans EM, O’Connor PJ. Effect of Six Weeks of Sprint Interval Training on Mood and Perceived Health in Women at Risk for Metabolic Syndrome. J Sport Exerc Psychol. 2014;36(6):610-618. doi:10.1123/jsep.2014-0083