Saturday, 12 January 2013

Aerobic exercise improve psychosocial well-being in obese adolescents

Image source: Richard Masoner - cc
Obesity can often be associated with low self esteem, depression, body image dissatisfaction. As an adolescent, this is further exacerbated by being teased in school, not being able to perform as well in sports, and sometimes social isolation as a consequence of these.

Diet and exercise are the way to lose weight. Reducing calorie intake by decreasing dietary intake by a significant amount is the best way to lose weight. Exercise to burn off calorie, on the other hand, struggles to keep up to anywhere near impact of diet.

However, there are other more important benefits associated with exercise.
One such benefit is described by Goldfield and coauthors in their article published in Journal of Pediatric Psychology September 30 2012:

- 30 adolescents, age 12 to 17, with:
  • BMI > 95 percentile for age and gender (based on Centers for Disease Control and Prevention's growth chart data)
  • Or BMI > 85 percentile for age and gender with elevated number of any of the following:
    • Fasting glucose or 2-hour Oral Glucose Tolerance Test (OGTT) 
    • Fasting triglycerides
    • Insulin
    • High-density lipoprotein-cholesterol (HDL-C)
    • Low-density lipoproteincholesterol (LDL-C)
    • Total cholesterol to HDL-C ratio > 90th percentile 
    • Blood pressure above the 90th percentile
    • First degree relative with type 2 diabetes or cardiovascular disease
- Participants randomly assigned to each of the two groups. Both using GameBike interactive gaming system interfaced with Sony Playstation 2 (example of GameBike)
  • Video game cycling
    • Allowed to choose from a variety of games to play
    • Two 60mins session per week for 10 weeks. Allowed to have break or stop cycling within a session.
  • Music cycling
    • Exercise twice weekly for 10 weeks
    • Game console turned OFF
    • Allowed to listen to music of their choice 


Cycling with gaming or music did not significantly differ in outcome, however when viewed as a group, the following was identified:
  • Increases in aerobic fitness were associated with improvements in self-perceived: 
    • Scholastic competence (r = 0.47, p = 0.016)
    • Social competence (r =0.38, p = 0.05),
    • Appearance esteem (r = 0.76, p = 0.001)
    • Weight esteem (r = 0.48, p = 0.013)
  • Changes in body fat percentage were significantly inversely associated with changes in perceived Social acceptance (r = 0.43, p = 0.032), but not with other psychosocial factors
  • The authors concluded that 
    • aerobic exercise was associated with improvements in body image, perceived academic performance, and social competence in overweight and obese adolescents
    • These psychological benefits were associated with improved aerobic fitness but not with changes in body composition.

While this is a small study, if we were to draw conclusion from this, we can say that exercise helps to make obese adolescents feel better about themselves, even in the absence of achieving weight loss.

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