Emotions and physical activity after weight loss surgery: A qualitative study

Lauren E. Harnedy, BA

Massachusetts General Hospital
Emotions and physical activity after weight loss surgery: A qualitative study

Scientific Abstract

Background: Physical activity is critical to maintaining health and weight loss after weight loss surgery (WLS), but most post-WLS patients do not meet national physical activity guidelines.

The upward spiral theory of lifestyle change suggests that positive affect during a health behavior is uniquely reinforcing for continued participation, but WLS patients may have low positive affect related to activity due to their weight history and related weight stigma. This descriptive qualitative study aimed to better understand emotions related to physical activity post-WLS in order to inform the development of an intervention targeting positive affect and physical activity for this population.

Methods: Individual phone interviews were conducted with patients who had WLS at Massachusetts General Hospital within 2 years of enrollment. Interviews asked about current and past activity levels, facilitators and barriers to increasing activity, and emotions experienced before, during, and after a bout of physical activity. The International Physical Activity Questionnaire assessed self-reported moderate-to-vigorous physical activity (MVPA). Interviews were transcribed and coded in Dedoose using directed and conventional content analysis.

Results: Twenty-three participants (M age = 47, 78% female, 52% white) completed the interview. Average MVPA was 199 minutes/week. Positive emotions during activity and social connection emerged as emotional facilitators to physical activity, while having an “all or nothing mindset,” depression, and negative body image were common emotional barriers. Most participants noted positive emotions during (e.g., determination, pride, connection) and after (e.g., accomplishment, pride, joy) physical activity and negative emotions (e.g., anxiety, tired, frustration) were most common prior to physical activity.

Conclusions: In combination with the upward spiral theory, these findings suggest that an intervention to increase positive affect during physical activity has potential to improve well- being and physical activity adherence after WLS.

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research Areas


Lauren E. Harnedy, BA, Jeff C. Huffman, MD, Christina Psaros, PhD, Anne Thorndike MD, and Emily H. Feig, PhD

Principal Investigator

Emily H. Feig, PhD

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