A mixed methods comparison of perceived benefits and barriers to exercise between obese and nonobese women

Background: Obese women have lower levels of physical activity than nonobese women, but it is unclear what drives these differences. Methods: Mixed methods were used to understand why obese women have lower physical activity levels. Findings from focus groups with obese white women age 50 and older (N = 19) were used to develop psychosocial items for an online survey of white women (N = 195). After examining the relationship between weight group (obese vs. nonobese) and exercise attitudes, associated items (P < .05) were tested for potential mediation of the relationship between weight and physical activity. Results: Obese women were less likely than nonobese women to report that they enjoy exercise (OR = 0.4, 95% CI 0.2-0.8) and were more likely to agree their weight makes exercise difficult (OR = 10.6, 95% CI 4.2-27.1), and they only exercise when trying to lose weight (OR = 3.8, 95% CI 1.6-8.9). Enjoyment and exercise for weight loss were statistically significant mediators of the relationship between weight and physical activity. Conclusions: Exercise interventions for obese women may be improved by focusing on exercise enjoyment and the benefits of exercise that are independent of weight loss.