Research ArticleAttitudes of Overweight and Normal Weight Adults Regarding Exercise at a Health Club
Introduction
The health benefits of participation in regular exercise are well known. It is also well established that regular moderate- or vigorous-intensity exercise will lower the risks and symptoms associated with the comorbidities of obesity.1, 2 Furthermore, exercise is the only factor that is consistently associated with reduced weight maintenance in the previously obese.3 On the other hand, although the health benefits of regular exercise have been well documented, only 15% of Americans get enough regular exercise to receive these health benefits,4 whereas only 30% of those trying to lose weight meet the National Institutes of Health guidelines for exercise of 300 minutes/week and only 20% of those trying to lose weight meet the Institute of Medicine exercise recommendations of 420 minutes/week.1
Thus, a paradox exists—an antidote for obesity and its comorbidities is exercise,5 but the majority of obese Americans do not exercise. The paradox becomes more interesting in light of the fact that the obese themselves recognize the importance of exercise for weight control, but they do not exercise. For example, Miller and Eggert found that 58% of overweight individuals reported that the reason they failed at past weight control attempts was that they discontinued exercise.6 Moreover, at the time of their study, only 29% of the overweight sample reported having exercised in the last 3 months, but 97% of this same sample indicated that they would be willing to exercise for 50 minutes/day, 5-6 days/week if accepted into a new weight loss program. This disconnect between past exercise behaviors and future promises to exercise remains elusive.
Another piece of the obesity/exercise paradox is the assumption that the benefits of exercise are tightly coupled to weight loss. This is an erroneous assumption in that there have been several studies showing a reduction in disease status or risk following an exercise program that did not induce weight loss.7 In addition, Blake et al have shown that adiposity does not hinder the fitness response to exercise training in the obese.8 Specifically, these investigators found that obese women who participated in a 14-week exercise program improved their aerobic fitness, muscular strength, muscular endurance, and flexibility to the same degree that normal-weight women did, in spite of the fact that the obese did not lose weight during the exercise program with no differences in exercise adherence or volume between groups.8
It seems clear, then, that the one of the most straightforward things that needs to be done to improve the health status of the overweight population is to get them to exercise. Previous work, however, has identified common barriers to regular exercise, some of which include a fear of being injured, an inability to monitor progress, and a lack of motivation, encouragement, support, companionship, and a safe exercise environment.9, 10 In the hopes of helping overweight people overcome these barriers, the Centers for Disease Control (CDC) has published a list of exercise recommendations, including joining a YMCA or health club.
Membership in a commercial health and fitness club could potentially offer a host of benefits that would address some of the CDC's recommendations for overcoming barriers to exercise. For example, health clubs typically have educated personnel on staff who can assist clients with exercise program design, proper equipment use, nutrition information, and weight management advice. Health clubs also provide an environment for people to exercise with other people who have similar goals. Health clubs provide a comfortable place to exercise during inclement weather, and many clubs offer a tremendous number of amenities for their members. Health clubs offer a relatively safe exercise environment, in that the staff is typically certified in cardiopulmonary resuscitation and available to monitor clients to ensure they are exercising safely.
Despite the benefits that membership in a commercial health club offers, participation at health clubs in the United States is relatively low.11 Overweight people, in particular, may find health clubs intimidating, cost prohibitive, inconvenient, nonaccommodating, and so on.12 Therefore, the purpose of this study was to identify the attitudes of overweight men and women regarding regular exercise in a health club and compare these attitudes to those of normal weight individuals.
Section snippets
Design
To gain insight into what affects an individual's decision to exercise at a health club, this study used a survey instrument based on Ajzen's Theory of Planned Behavior (TPB).13 Briefly, the TPB proposes that human action is guided by (1) one's attitude toward the behavior in question, (2) the perceived social pressure (subjective norm) to perform the behavior, and (3) the ease or difficulty with which one can actually perform the behavior (perceived control). The combination of attitude,
Results
A total of 730 men and 822 women (n = 1,552) completed questionnaires (Table 2). Of these respondents, 64% were OW and 36% NW; 90% were Caucasian and 10% non-Caucasian; and 26% of the sample was younger than 35 years, 47% between 35 and 60 years, and 27% over 60 years of age. Eighteen percent of the sample attended a health club, whereas 82% did not; and more of those under 35 years of age attended (31%) than above the age of 35 (14%, P < .001). Fewer OW individuals (16%) attended a health club
Discussion
No study has yet identified which attitudes determine the overweight person's intent to exercise, much less at a health club, although a few studies have measured overall attitude and intent toward exercise in an attempt to validate the usefulness of a certain theory of behavior for understanding exercise intent.19, 20, 21, 22 Indeed, Boudreau and Godin have shown that the TPB is an appropriate model for understanding the determinants of motivation to be physically active in obese individuals.20
Implications for Research and Practice
Many subgroup differences in attitudes toward health club exercise were identified by this study. Since the number of non-Caucasians participating in this study was relatively small, more research to discover the attitudes of different races, ethnicities, and cultures toward health club exercise should be performed. Additional research should be conducted on individuals who were outside the reach of the current study (eg, those who declined participation or who were inaccessible). Future
Acknowledgments
This study was supported by the International Health, Racquet, and Sportsclub Association.
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