To help obese women exercise more, shift focus away from weight loss

BUFFALO, N.Y. –In the world of working out, weight loss is the 800-pound gorilla in the gym. The topic is unavoidable, particularly for obese women, who often struggle with exercise for a variety of reasons.

But what if you shifted the focus from the battle of the bulge to the other benefits exercise can provide, like better mood, improved sleep and just the ability to walk up a flight of stairs without feeling tired?

That’s the aim of a new program specifically designed for larger women and about to be tested at two YMCA Buffalo Niagara facilities as part of a partnership with a public health researcher at the University at Buffalo.

“The goal is to change the mentality around exercising in general so that the women see it as more of a social activity with people like them, while making it more comfortable for them. By building up their confidence and showing them these other benefits, we hope that will encourage ongoing participation,” says Lucia Leone, PhD, assistant professor of community health and health behavior in UB’s School of Public Health and Health Professions, who is spearheading the program.

“Weight loss is always going to be a factor for them, so ignoring it is not going to work. But we have to find a way to address it without making weight loss the only focus,” Leone adds.

Leone has found a champion of the project in Mary Shaw, a program coordinator at the Ken-Ton Family YMCA, one of two Ys — the other is the Independent Health Family Branch in Amherst — that will debut the program this winter.

“It’s always a great opportunity when you can partner with anyone in the community, but this in particular seemed perfect for us,” Shaw said. “The Y is a fitness facility, but it isn’t your typical gym. We service the whole community, and we do more than provide an exercise experience.”

Leone and her research team convened focus groups consisting of 40 women and a 10-member advisory committee last winter to get feedback on the type of exercise program that is likely to be the most enjoyable and effective.

A few have shared their personal story of how they’ve struggled with exercise in the past, which has helped Leone and her team identify potential barriers the exercise program they develop will need to address.

“One issue specific to women with obesity is that it’s just harder to exercise in general. Physically, you feel more tired, and it’s harder to move when you’re carrying more weight around,” Leone said. “They said it was this catch 22, that as their weight increased they would be less motivated to exercise because it was harder, but that they felt that they should be exercising more when their weight was higher.”

“Unfortunately, many people exercise to lose weight, but exercise alone produces very little weight loss, so when they don’t see results they stop exercising,” Leone adds. “What they don’t realize is that they are missing out on lots of other benefits of exercise that can be reaped regardless of whether they lose weight or not.”

Shaw said the group has provided valuable feedback that will help inform the program. Still, there will be challenges. “A lot of women want to lose weight before they even go to a gym. They’re very self-conscious. Weight loss is significant, but we want to show that there are many intrinsic benefits to being more active, and that some of those can lead to weight loss.”

The 12-week class will begin in early 2017. Participants will start at the same time and at the same level so they can learn the class’ exercise routine together. The exact type of class is being finalized, but is likely to be dance oriented, Leone said.

About 40 women with a Body Mass Index of 30 or higher — the threshold for obesity — will participate in the study. Half will receive access to the new class several times a week, social support in the form of group meetings, and Y membership, while the other half will receive only the Y membership.

“Our argument is that the access alone is not enough if the women don’t feel welcome in the classes. The YMCA tends to be more welcoming than a lot of gyms, but even with that it can be harder for someone who’s larger to feel comfortable,” Leone said.

After three months, researchers will compare the two sets and see if the group that had access to the specially designed class exercised more than the group that received only the Y membership. “Eventually, we’d like to add on other components, such as tailored feedback messages or participation incentives,” Leone said.

Even a small increase in the amount of exercise would be a significant win, Leone said, noting that the vast majority of obese women do not meet current daily recommendations for exercise.

The research focus itself also represents a shift.

“No one else is focusing on enjoyment. Usually when people target this population, it’s only for weight loss studies,” Leone says. “When I first started researching this issue, it was amazing to me how little research there was in trying to understand why women in this population don’t exercise, because of the assumption that they’re just lazy. If we can move the needle even just a little bit within this population, it will make a big impact.”

Another aim of the project is to provide fitness trainers with insight into the struggles obese women face at the gym so they can learn to adapt their classes to be more welcoming and meet the needs of this population.

“If instructors can be more sensitive and aware of the reasons people don’t exercise, it will make us stronger in being able to knock those barriers down,” Shaw said. “That knowledge will also make them better instructors.”

Funding for this project was provided by UB's Office of the Vice President for Research and Economic Development through the Innovative Micro-Programs Accelerating Collaboration in Themes (IMPACT) program.