Overweight and Obese Adults
Conditions
Keywords
overweight, high-intensity interval training (HIIT), obesity, weight management
Brief summary
Obesity is a complex disease and a major risk factor for cardiovascular and metabolic disorders, particularly atherosclerosis, type II diabetes, and metabolic syndrome; it is also associated with an increased risk of mortality. In addition, obesity is a multifaceted health problem that can adversely affect psychological well-being over time. It may contribute to a sustained vicious cycle by reducing self-esteem, impairing sleep quality, and increasing perceived stress. Hormonal changes occurring during the aging process further emphasize the importance of early intervention for obesity. In this context, incorporating both diet and exercise into daily life represents a powerful strategy for combating obesity. Lack of time is considered one of the major barriers to regular participation in exercise programs. Today, factors such as sedentary lifestyles, demanding work schedules, inadequate stress-coping mechanisms, and impaired body image may reduce individuals' awareness of weight management and healthy living while making it more difficult to develop appropriate strategies. This situation has led researchers to focus on exercise methods that can be implemented effectively within a short period of time. Recent studies have particularly highlighted the High-Intensity Interval Training (HIIT) model, which offers time-efficient exercise. Scientific evidence suggests that HIIT is an effective and time-efficient exercise approach for combating obesity. The aim of this study is to investigate the effects of implementing a feasible HIIT training program through supervised online (individualized online training under physiotherapist supervision) and unsupervised (individual home-based exercise) approaches on changes in body mass index, waist-to-hip ratio, self-esteem, sleep quality, perceived exertion during exercise, physical activity levels, stress management, and motivation to engage in physical activity. Furthermore, the study aims to implement HIIT training without restrictive dietary support to promote the long-term sustainability of a healthy lifestyle. Our goal is to enhance the integration of exercise into daily life under feasible conditions and to achieve positive outcomes among participants.
Detailed description
Obesity is a major concern among noncommunicable diseases in the 21st century. Considered the second leading cause of preventable deaths after smoking, obesity generally results from an imbalance between energy intake and expenditure, leading to the accumulation of excess energy in adipose tissue. Risk factors predisposing individuals to obesity include dietary habits, age, sex, educational level, stress and coping strategies, marital status, number of childbirths, and genetic predisposition. Physical inactivity, which is another major public health concern today, also plays an important role in increasing the risk of obesity. In particular, increased screen time contributes to reduced levels of physical activity and, consequently, to an increase in the prevalence of obesity. Obesity not only adversely affects physical health but also contributes to a vicious cycle by negatively affecting self-esteem, sleep quality, and perceived stress. Women tend to have a greater propensity for weight gain than men from adolescence onward and may have higher rates of obesity. Obesity predisposes individuals of both sexes to various health conditions. Particular attention should be paid to obesity in postmenopausal women due to hormonal changes. In obese men, studies have reported higher incidences of low ejaculate volume, low sperm concentration, and low total sperm count. Considering the hormonal changes that occur with advancing age, early intervention for obesity is of great importance. In this context, integrating dietary and exercise interventions into daily life has emerged as an effective strategy for combating obesity. Time constraints are considered one of the most common barriers to adherence to exercise programs. Under current conditions, factors such as sedentary lifestyles, limited time, difficulties in coping with stress, and disturbed body image may prevent individuals from having sufficient awareness of the effects of body weight on their health or from identifying appropriate solutions. Therefore, recent studies have focused on exercise training models that can be implemented effectively within a short period of time. Current literature recommends high-intensity interval training (HIIT) as a time-efficient exercise approach. Increasing scientific evidence indicates that HIIT is an effective and time-efficient exercise model for combating obesity. High-intensity interval training is a form of exercise consisting of short bouts of high-intensity exercise interspersed with lower-intensity recovery periods. HIIT provides a feasible alternative to prolonged high-endurance training, particularly for individuals who experience time constraints in daily life and therefore do not engage in regular exercise. According to the American College of Sports Medicine's Worldwide Survey of Fitness Trends for 2019, high-intensity interval training (HIIT) was ranked as the leading fitness trend from 2014 to 2018. Current recommendations for meaningful improvements in cardiovascular fitness and metabolic health in adults are to engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week, accumulated in bouts of at least 10 minutes. As an alternative for individuals with limited time, high-intensity interval training (HIIT) has been recommended as a time-efficient exercise intervention that can provide benefits comparable to those of moderate-intensity aerobic exercise. Unlike some dietary approaches, exercise interventions such as high-intensity interval training (HIIT) are known to induce beneficial changes in body function and composition. This suggests that exercise may help mitigate adverse effects that may arise from combinations involving dietary and pharmacological interventions. Findings from various studies have established that HIIT improves physical function by reducing insulin resistance and hepatic fat accumulation, lowering cardiovascular disease risk, and increasing aerobic capacity and muscle strength. The aim of this study is to investigate the effects of implementing a feasible HIIT training program through supervised online (individualized online training under physiotherapist supervision) and unsupervised (individual home-based exercise) approaches on changes in body mass index, waist-to-hip ratio, self-esteem, sleep quality, perceived exertion during exercise, physical activity levels, stress management, and motivation to engage in physical activity. Our goal is to enhance the integration of exercise into daily life under feasible conditions and to achieve positive outcomes among participants.
Interventions
OTHERHigh-Intensity Interval Training (HIIT)
High-Intensity Interval Training (HIIT) is a time-efficient exercise approach based on alternating short bouts of high-intensity exercise with low-intensity recovery intervals. HIIT protocols may vary in terms of exercise intensity, work-to-recovery duration, number of repetitions, and exercise frequency, and can be individualized according to an individual's physical capacity. Particularly among overweight and obese individuals, time constraints are considered a major barrier to regular participation in exercise; therefore, HIIT has emerged as an alternative to traditional moderate-intensity continuous exercise due to its ability to be implemented within a shorter period of time. Current scientific evidence indicates that HIIT can improve cardiorespiratory fitness and aerobic capacity, enhance exercise tolerance, and produce beneficial effects on certain metabolic parameters. However, HIIT is not consistently superior to moderate-intensity continuous exercise in terms of body weight a
Sponsors
Istanbul Medipol University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Age between 18 and 65 years * Body Mass Index (BMI) between 25 and 39.9 kg/m² * Ability to use a mobile application for online exercise training * Literacy
Exclusion criteria
* Individuals currently participating in any exercise and/or dietary program * Individuals diagnosed with a health condition that prevents them from exercising * Individuals with any systemic or orthopedic condition that contraindicates high-intensity exercise * Pregnancy * Individuals with cardiovascular disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| International Physical Activity Questionnaire (IPAQ) | Baseline and 6 weeks | The International Physical Activity Questionnaire (IPAQ) is a standardized instrument developed by the International Consensus Group in 1997-1998 with the support of the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) to assess physical activity and sedentary behavior. The questionnaire can be administered to individuals aged 15-69 years. It assesses three main types of physical activity performed for at least 10 minutes during the previous seven days: walking, moderate-intensity activities, and vigorous-intensity activities, as well as the amount of time spent sedentary on an average day. A separate metabolic equivalent of task (MET) score is calculated for each activity category and then summed. The MET score is calculated by multiplying the MET value of the activity by the number of days and minutes performed. The results are categorized into three levels of physical activity: inactive, moderately active, and active. The questionnaire h |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Waist-to-Hip Ratio (WHR) | Baseline and 6 weeks | Waist circumference will be measured in the standing position at the midpoint between the lowest rib and the iliac crest. Hip circumference will be measured at the widest point of the buttocks. Waist-to-hip ratio will be calculated by dividing waist circumference by hip circumference. The resulting WHR value will be reported as a ratio, with higher values indicating a greater proportion of abdominal adiposity. Sex-specific cut-off values of ≥0.90 for men and ≥0.85 for women will be used for risk classification. |
| Skinfold Thickness Measurement for Body Fat Percentage and Circumference Measurements | Baseline and 6 weeks | Subcutaneous fat measurement is based on the principle that approximately 50% of total body fat is stored in subcutaneous fat depots and that subcutaneous fat thickness is correlated with total body fat. Subcutaneous fat thickness can be measured accurately at specific anatomical sites using a specialized caliper. The measurements obtained will be used to calculate body fat percentage according to the Jackson-Pollock and Siri equations. A Baseline Medical Caliper will be used for the measurements. To minimize measurement error, each site will be measured twice by the same investigator, and the arithmetic mean of the two measurements will be calculated and entered into the relevant equation. Participants will be instructed not to contract their muscles during the measurements, and a constant-tension measuring tape will be used for circumference measurements. |
| Pittsburgh Sleep Quality Index (PSQI) | Baseline and 6 weeks | The Pittsburgh Sleep Quality Index (PSQI) is a 19-item self-report instrument used to assess sleep quality and sleep disturbances. It was developed by Buysse et al. in 1989 and adapted into Turkish by Ağargün et al. in 1996. The PSQI consists of 24 questions, 19 of which are self-report items. The scale comprises seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each component is scored on a 0-3 scale, with a total score ranging from 0 to 21. A total score greater than 5 indicates poor sleep quality. Five questions are completed by the participant's spouse or roommate and are not included in the scoring. In the present study, the 10-item subjective sleep quality section and the section intended to be completed by participants who have a roommate will be used. |
| Perceived Stress Scale (PSS) | Baseline and 6 weeks | The Perceived Stress Scale (PSS), developed by Cohen et al., consists of 14 items and was designed to assess the extent to which individuals perceive situations in their lives as stressful (35). Participants rate each item on a 5-point Likert scale ranging from "Never (0)" to "Very often (4)." Seven positively worded items are reverse-scored. In the study by Eskin et al., titled "Adaptation of the Perceived Stress Scale into Turkish: A Reliability and Validity Analysis," the Turkish version of the PSS-14 demonstrated good internal consistency (Cronbach's α = 0.84) and test-retest reliability (r = 0.87), and was concluded to be a valid and reliable measurement instrument. |
| Rosenberg Self-Esteem Scale (RSES) | Baseline and 6 weeks | Self-esteem assessed using the Rosenberg Self-Esteem Scale (RSES). RSES is a widely used instrument for assessing individuals' perceived self-worth. The scale was adapted to the Turkish culture by Çuhadaroğlu (1986) and Tuğrul (1987). It consists of 10 items, including five positively worded and five negatively worded statements, and uses a 4-point Likert-type response format. As self-esteem is considered a unidimensional construct, the total score will be used in the present study. The scale consists of 10 items, each scored on a 4-point Likert scale. Total scores range from 10 to 40 points, with higher scores indicating higher self-esteem. |
| Motivation Scale for Participation in Physical Activity (MSPPA) | Baseline and 6 weeks | The Motivation Scale for Participation in Physical Activity (MSPPA), developed by Tekkurşun Demir and Cicioğlu (2018), consists of 16 items and three subdimensions. The first subdimension, "Individual Reasons," comprises items 1-6; the second, "Environmental Reasons," comprises items 7-12; and the third, "Amotivation," comprises items 13-16. Scores obtained from the scale are interpreted as follows: 65-80, very high; 49-64, high; 33-48, moderate; 17-32, low; and 1-16, very low motivation. Reverse-scored items are items 16, 15, 14, 13, 9, and 3. |
Countries
Turkey (Türkiye)
Outcome results
None listed