A Qualitative Examination of Emotional Experiences During Physical Activity Post-Metabolic/Bariatric Surgery
Open accessAbstract
Purpose Physical activity is critical for weight loss maintenance and cardiometabolic disease prevention after metabolic/bariatric surgery (MBS), but few patients meet recommended levels. While difficulties meeting physical activity recommendations are common in the general population, those who have undergone MBS may have unique psychological barriers to activity that impede success, including negative associations with physical activity that are related to a long history with obesity, weight stigma, and physical limitations. This qualitative study aimed to better understand the positive and negative emotional experiences of post-MBS patients with regard to physical activity to inform the development of an emotion-focused intervention to increase physical activity after MBS.Methods Adults who had MBS in the past 2 years completed semi-structured interviews and psychological/behavioral questionnaires. After transcription, a codebook was developed using inductive and deductive methods. Coded data were analyzed using content analysis.Results Participants were 23 adults (78% female). Contexts that contributed to positive emotions during physical activity included an enjoyable type of exercise, social interaction, mindfulness during exercise, and mastery. Contexts that contributed to negative affect were more unique to the MBS population, including all-or-nothing thinking about exercise, using distraction, depression, negative body image, exercising only for weight loss, and the COVID-19 pandemic.Conclusion For most participants, emotional factors were relevant in the decision to be physically active and in their ability to maintain their habits. An intervention that encourages factors that lead to positive affect and addresses factors that lead to negative affect could be effective in increasing physical activity following MBS.
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Focusing only on negative aspects, having a general dislike of physical activity, or discounting efforts that fall short of personal goals were described as stressful and anxiety-provoking.
“For instance, focusing only on the negative aspects, having a general dislike of physical activity, or discounting efforts that fall short of personal goals were described as stressful and anxiety-provoking.”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [99]
The Results (Contexts that Contribute to Negative Affect) link focusing on negatives and all-or-nothing judgments about activity to negative affect; the Qualitative Result Overview includes anxiety about not meeting an exercise goal. But the Results (Experiences of Negative Affect Associated with Physical Activity) say participants who generally disliked exercise had trouble identifying any strong emotions during it. The paper therefore does not describe all three experiences as stressful and anxiety-provoking. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMindfulness regarding how physical activity feels in the moment with a healthier body is associated with positive affect.
“Mindfulness regarding how physical activity feels in the moment with a healthier body is also associated with positive affect, and many patients will resonate with the term, mindful movement.”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [99]
Recent research suggests that themes associated with positive affect while participating in physical activity after bariatric surgery included enjoyment of the activity itself, social connection, mindfulness, and mastery of a skill.
“Recent research suggests that there are themes associated with positive affect (i.e., excitement, determination, pride, sense of accomplishment, joy) while participating in physical activity after having bariatric surgery. These themes included enjoyment of the activity itself, social connection, mindfulness, and mastery of a skill (99).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [99]
Another theme that emerged as a barrier to physical activity was using weight loss as the primary motivator to be physically active.
“Another theme that emerged as a barrier to physical activity was using weight loss as the primary motivator to be physically active (99).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [99]
A theme related to negative affect was all-or-nothing thinking about physical activity.
“Interestingly, a theme related to negative affect (i.e., frustration, fatigue, dislike) was all-or-nothing thinking about physical activity (99).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [99]
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Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery
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“These themes included enjoyment of the activity itself, social connection, mindfulness, and mastery of a skill (99).”
BackgroundInfluential
- Authors
- Feig, E. H., Harnedy, L. E., Golden, J., Thorndike, A. N., Huffman, J. C., & Psaros, C.
- Affiliations
- Harvard University (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Feig, Emily H.
- Venue
- Obesity Surgery
- Published
- 2021-11-20
- Volume
- 32
- Issue
- 3
- Pages
- 660-670
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- PMC
- PMC8605775
- OpenAlex
- W3214260808
- Cited by
- 16
- References
- 31
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 1 · 2023: 4 · 2022: 4
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Obesity Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HLK23148017)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- metabolic surgery, bariatric surgery
- MeSH terms
- COVID-19, SARS-CoV-2, Adult, Emotions, Female, Humans, Male, Obesity, Morbid, Exercise, Bariatric Surgery, Pandemics
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