Becoming active post-hospitalisation discharge - an exploration of motivational profiles during exercise change in obese patients

Despite the urgent need to prevent weight regain in the long-term, it remains questionable whether inpatient multicomponent behavioural obesity treatments positively impact their patients, leaving them with favourable (i.e. autonomous) motivational profiles towards exercising. Based on Organismic Integration Theory, a sub-theory of Self-Determination Theory, this study retrospectively examined how exercise motivational profiles relate to exercise behaviour outcomes of a behavioural obesity treatment. Obese patients for whom outpatient treatment was deemed ineffective (N = 262; 34.2% female, body mass index >30 kg/m²) were administered to a 3-week inpatient obesity treatment. The study design incorporates both longitudinal and retrospective cross-sectional aspects. Patients completed questionnaires concerning exercise behaviour (pre-hospitalisation/6 months post-discharge) and behavioural regulations (6 months post-discharge). Exercise motivational profiles were generated based on the six behavioural regulations using K-means non-hierarchical cluster analysis. The self-reported dependent variable represents a change in patients' exercise status (i.e. remaining inactive, becoming active). Chi-square tests related motivational profiles to exercise behaviour. Three profiles emerged: a moderate-controlled cluster (n = 80), a moderate-autonomous cluster (n = 78) and a high-autonomous cluster (n = 104). Of the patients who became active over time, the majority belonged to the high-autonomous cluster. No significant differences were found between patients who became active or remained inactive and whether they belonged to the moderate-controlled or moderate-autonomous cluster. Although the moderate-controlled and moderate-autonomous clusters differ greatly in their motivational quality, moderately controlled motivation does not seem detrimental regarding exercise change, as both clusters result in similar exercise behaviour outcomes.