Abstract
Background Barriers to healthy eating and exercise mediate the odds of weight loss success. To identify the trajectory of barriers to healthy eating and exercise and its association with weight change during obesity management program.Methods Indexed is a mixed-method study. Purposive sampling was used to enroll 250 participants in a six-month obesity management program. The perceived barriers to healthy eating and exercise were quantitatively measured using standardized questionnaires,i.e., Barriers to Healthy Eating and Exercise and qualitatively through in-depth interviews throughout the obesity management program (baseline, 3- and 6-months).Results The sample was middle-aged (41.8 ± 8.5 years) presenting with obesity (31 ± 3.7 kg/m2) and slight female preponderance (70%). At baseline, the scores for barriers to healthy eating (2.7 ± 0.8, out of 5) and exercise (2.7 ± 0.7, out of 5) were low and comparable; and they improved after 6-month participation in the obesity management program. Improvement in knowledge- (amount of exercise, portion size estimation), attitude- (amotivation for diet and physical activity, tiredness for exercise) and practice-related (lack of time for diet and physical activity, and exercise skills) barriers to exercise and healthy eating were positively associated with weight change (P < 0.01). Qualitative analysis identified social (eating out, festivities) and environmental (low neighborhood walkability and safety, food accessibility, culture-centric foods) barriers.Conclusions The trajectory of perceived barriers to healthy eating and exercise indicates improvement throughout the obesity management and is positively associated with weight loss.