Exercise Adherence

Exercise adherence refers to the strength of an individual's commitment to performing physical exercise. People with strong exercise adherence continue physical activity despite opportunities and pressures to withdraw. However, many recreational exercisers quit within 6 to 8 weeks of starting. Adherence improves significantly when exercisers have good family support. Far fewer spouses who exercise together drop out compared with married people who exercise on their own. Exercise adherence is also higher among those who set themselves achievable but challenging goals; whose exercise is supervised or monitored by a coach or trainer; and whose exercise is not intensive to start with, but which becomes gradually harder.

The incorporation of exercise as a consistent lifestyle behavior is not easy for many obese individuals because of poor exercise tolerance and enjoyment. Several factors create obstacles to physical activity of obese and normal weight individuals, such as low motivational status, self-efficacy, negative learning history with exercising, lack of coping skills, and aversive environmental characteristics such as reduced access to physical activity facilities, high costs of training programs, low social and cultural support, and time barriers. Making individuals with obesity move and improving adherence to exercise is a critical challenge: hence the importance to understand the psychological determinants of exercise behavior. Most patients feel that these strategies may be relevant to start physical exercise, but do not guarantee maintenance.

Long-term adherence to an active life-style and weight control can be extremely difficult because of a complex combination of biological, environmental, and psychological pressures. Clinicians should congratulate the patients for every small successes they achieve, and should never criticize failures. Criticism may produce guilt and loss of self-confidence, leading to attrition. An unconditional acceptance of the patients' behavior and a problem-solving approach to address barriers will preserve the clinician-patient relationship. This approach will also help patients understand that the long-term success in weight management is related to a set of skills rather than simply to willpower.