Effect of Motivation on Exercise Adherence among Obese Women - Essay Example

? Effect of Motivation on Exercise Adherence among Obese Women By Presented to Effect of Motivation on Exercise Adherence among Obese Women Background to research Women exercise for a variety of reasons that may range from enjoyment to the maintenance of good physical well-being. However, it is also important to acknowledge some of the reasons as to why they don't exercise. Many women blame the weather, lack of time, lack of energy and lack of motivation. Some of these sources are external and we may not have much control over. But most of them are internal reasons that can be controlled by the individual detailing the need for personal change. Lifestyle interventions are the most cost effective means of reducing the risk of a variety of medical conditions and are essential in the treatment of obesity. Continuous insight has been provided into the process of weight maintenance with nearly 80% of successful weight loss maintainers reporting sustained energy expenditure through voluntary physical activity (Jeffrey et al, 2010). However, after starting or attempting a physical programme or activity, it has been realized that about 50% of people drop out after the first six months. The reasons for this vary but what strikes out is that these programmes are too challenging, over restrictive and based solely on fitness data (Williams et., al, 1996). They do not promote self-responsibility and do not empower people enough to make long term behaviour change. As a result, most obese women have been known to embark on outrageous weight loss programs but drop out later on due to lack of motivation. Poor maintenance of exercise in weight loss programs appears to be the major challenge in management of obesity among women. It has been realized that weight loss achieved during a weight loss session is eventually gained at the end of such programs. Increasing attention is being given to the predictors of behavioural maintenance of weight loss because of the apparent effect that self-perception and motivation has on weight loss maintenance. Obese women are generally known to suffer from self-esteem issues hence small dents on their social and physical lives may significantly affect their level of motivation (Wilson, Mack & Grattan, 2008). The conceptual framework provided by the self-determination theory (SDT) can be used to explain the long term adherence of people to exercise by exploring the dynamics of motivation during behavioural change (Silva, 2008). Key proponents of SDT stipulate that motivation varied in nature and that internal motivation is energized by having one's psychological needs satisfied. Various forms of regulatory motives determine the extent of the individual's actions and whether they act in volition or whether they act because they are pressured into it. A person can also be intrinsically regulated to enable them focus on the task and yielding energizing emotions like interest, enjoyment and challenge (Pelletier, Fortier, Vallerand & Briere, 2001). By so doing, they are able to derive motivation from other aspects of their lives that are not related to the problem of weight loss. When individuals perceive exercise as fun or as a challenge then they are more likely to engage in it rather than when they feel pressured to it as a weight loss aid. External regulation of some of the external demands that one is faced with is also a significant factor (Deci & Ryan, 2000). Lasting behaviour change depends not on a person's ability to comply with the demands for change but rather to accept the regulation for change as one's own. Poor eating and exercise behaviour is commonly associated with weight gain. Thus for one to achieve lasting change, it is imperative that they change their behaviour as relates to these two aspects. This should not be done simply to comply with the protocols of weight loss but as a way of accepting these changes to be part of their on-going lifestyle. It is only in this way that weight loss can be achieved. Various individual psychological needs have to be met before behaviour regulation can be achieved. A person must perceive that they have real choices and are at the origin of their decisions which they freely endorse. They must feel that they are competent and have satisfying and supportive social relationships. Hence the individual's social context that fosters autonomous regulation by supporting the basic needs will facilitate the internalization and integration of regulatory processes (Silva et al, 2010). In so doing, support and promotion for more adaptive behaviours and long term outcomes is achieved. This is fundamental for sustained behaviour change. Aims Even though various studies have examined the association between exercise and weight loss maintenance this study focuses on the effect of motivational constructs on exercise behaviour and weight change. The results of this study may have implications for future interventions by highlighting the importance of increased focus on making exercise a positive and meaningful experience rather than attempting to simply modify behaviours. This means going beyond teaching and training particular behaviour change skills like goal setting and self-monitoring. Women must verbalize their own behavioural goals and explore how these goals can be accomplished in the context of their lifestyle. With this information in mind, this study thus aims to use different types of encouragement to intrinsically motivate obese women who are participating in exercise programs. Methodology Study Design and Intervention The proposed study will follow an independent group's design. The independent variables in the study will be whether the individual is obese or not and whether they receive explicit motivation (Ryan & Connell, 1989). Hence among those who are obese, there are those who will receive explicit motivation and those who will not. Similarly, among those who are not obese, there are those who will receive motivation and those who will not. The study will be longitudinal in design where participants will be followed for a period of time and then assessed finally after three months following the end of the programme. 2x2 factorial independent groups ANOVA will be used to analyse the data. Approval will be obtained from the Faculty Ethics Committee and all participants will be required to give informed consent before participating. Sample By design, participants will have to be women. They will be recruited from a local weight support group in the area for women with weight challenges. Women will have to be between 25 – 50 years old and premenopausal owing to the effect of menopause on weight loss. They must have a Body Mass Index (BMI) of between 25 and 40kg/m2 which is a requirement for them to be classified as overweight / obese. They must be willing to attend weekly meetings and be free from major illnesses that could be aggravated by exercise. They must not be taking any medications known to interfere with body weight regulation like antidepressants, anxiolytics and antiepileptics. They must not be pregnant. Non obese women will be recruited from the University through the use of an advertisement in the local notice boards. The above criteria will also be applied during their selection. Measures The following measures will be used: Previous Exercise Involvement and Health A semi-structured questionnaire will be administered to the participants to determine whether they have been involved in any physical activity in the six months before the study. They will also be expected to detail their preferred types of exercise and the social context in which they chose to exercise (Webber, 2010). Overall perception towards exercise will also be elicited at this point. Exercise Inventory All the participants will be required to make a note of their exercise participation both within and outside the programme confines. This will allow them remember how much exercise they have been engaged in and allow record keeping within the programme. Perceived Need Support This variable concerns the quality of social environment that the par at the time of exercise. This will be assessed using the Health Care Climate Questionnaire (HCCQ) (Silva et al, 2010). In order to ensure a facilitative environment for motivation, there must be autonomous support, structure and involvement. Through the use of this questionnaire, autonomous support (for example “I fell that the staff provided me with choices and option”), structure (example “the staff made sure I really understand my condition and what I need to do” and involvement (example “the staff handles people's emotions well”) will be gauged. These responses will be gauged on a Likert-type scale. Behavioural regulations of Exercise This will be determined through the use of the Exercise Self-Regulation Questionnaire (SRQ-E) (Levesque et al, 2007). These determine the degree to which the regulation of an activity has been internalized and integrated. Participants will indicate their reasons for engaging in a particular exercise using the Likert-type scale. Some of the expected response options will be (in order of least to most fully internalized): external regulation (“because I felt like I have no choice about exercising; others make me do it”), interjected regulation (“because I would feel bad about myself if I did not”), identified regulation (“because it feels important to me personally to accomplish this goal”), intrinsic regulation (“because it’s a challenge to accomplish my goal, because it’s fun”) Procedure Participants will be asked to complete the questionnaire on previous exercise involvement and Health before embarking on the exercise schedule. At this point, they will have the opportunity to meet the physical therapist and ask any questions they might have. The HCCQ and SRE-Q will also be administered thereafter to form baseline information. Participants will then be required to attend exercise sessions twice a week for a period of twenty four weeks. The group that will be receiving explicit motivation will also be required to attend these classes once a week for twenty four weeks. Various topics to be tackled in the motivational sessions will include preventive nutrition, stress management, self-care and effective communication skills. The program's principle and style of intervention will be based on SDT with special focus on increasing autonomous regulation toward exercise and weight control. External contingencies will be limited and will not include any monetary or value based rewards. The participants in this group will also be actively encouraged to undertake additional physical activity outside of the programme. The Exercise Programme will last approximately 50 minutes and will include a 5 minute warm up period for stretching and flexibility exercises. The next 30 minutes will consist of aerobic exercises of choice including cycling, rowing, running or aerobics. This will be followed by a 15 minute cool down period with stretching and flexibility exercises. The physical therapist will lead the group twice a week for the first eight weeks. And in the following four weeks, the therapist will only lead one session during the week. After that, the therapist will no longer lead to the group with all the participants being left to exercise alone. The research assistants will however be present during the whole time to answer any queries that the group may have. During the entire study period, the participants will be asked to complete the HCCQ and SRE-Q to be used to determine any forming trends over time. Follow Up At the end of the study period, the participants will be asked to complete the HCCQ and SRE-Q relating to their experiences in the programme. Participants will be appreciated for taking part in the programme. After three months, participants will be contacted and asked to complete a short questionnaire relating to their current exercise behaviour. Dissemination This proposed research aims to provide information for future interventions by highlighting the importance of increased focus on making exercise a positive and meaningful experience rather than attempting to simply modify behaviours to achieve weight loss. The findings of this proposal may be of interest to various academic journals including Journal of Sport and Exercise Psychology, Medicine and Science in Sport and Exercise, Social Support and Health Preventative Medicine, The Psychologist and Public Health Reports . The findings of this report shall also be distributed through academic press to doctors, psychologists and health instructors. The results can also be placed on notice boards for public use to increase the awareness of the effect of motivation on weight loss. References Deci E and Ryan R. (2000). The ‘‘what’’ and ‘‘why’’ of goal pursuits: human needs and the self-determination of behaviour. Psychology Inquiry. 11(4):227–68 Jeffery R, Epstein L, Wilson G, et al. (2000). Long term maintenance of weight loss: current status. Health Psychology. 1:5–16. Levesque CS, Williams GC, Elliot D, Pickering MA, Bodenhamer B and Finley PJ. (2007). Validating the theoretical structure of the Treatment Self-regulation Questionnaire (TSRQ) across three different health behaviours. Health Education Resource.722 (5):691–7 Pelletier LG, Fortier MS, Vallerand RJ and Briere NM. (2001). Associations among perceived autonomy support, forms of self-regulation, and persistence: a prospective study. Motivational Emotions. 25(4):279–306. Ryan R and Connell RM. (1989). Perceived locus of causality and internalization: examining reasons for acting in two domains. Journal of Personality and Social Psychology. 57:749–61 Silva MN, Markland D, Minderico CS, et al. (2008).A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: rationale and intervention description. BMC Public Health. 8:234. Silva MN, Markland D, Vieira PN, et al. (2010). Helping overweight women become more active: need support and motivational regulations for different forms of physical activity. Psychology Sport Exercise. 11:591–601. Webber, K. (2010). Effect of motivational intervention on weight loss is moderated by level of baseline controlled motivation. In the Journal of Behaviour Nutrition and Physical Activity. 7:4. Williams GC, Grow VM, Freedman ZR, Ryan R and Deci E (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology. 70(1):115–26 Wilson P, Mack D and Grattan K. (2008). Understanding motivation for exercise: a self-determination theory perspective. Can Psychology. 49(3):250–6 Read More