# The psychosocial impact of exercise as an intervention for persons living with obesity and female infertility: A rapid scoping review and pilot study

## TL;DR

This study explores how exercise affects the mental health of people with obesity and infertility, finding mixed results due to pandemic-related stress and virtual intervention limitations.

## Contribution

The novel contribution is assessing the psychosocial impact of exercise interventions for people with obesity and infertility, including a pilot study during the pandemic.

## Key findings

- Exercise interventions improved depression, hopelessness, and physical quality of life in the pilot study.
- Anxiety, mental quality of life, and social support declined during the virtual intervention.
- The pandemic context and virtual format likely influenced mixed mental health outcomes.

## Abstract

Persons living with obesity and experiencing infertility are counselled on healthy behaviours, such as increasing physical activity levels, to improve fertility-related outcomes. However, due to the known psychological burden of receiving an infertility diagnosis, there is an important need to consider the psychosocial impact of administering exercise programming for this population. This study aims to assess the psychosocial impact of exercise-based interventions on individuals with obesity and infertility through a rapid scoping review and a pilot study. The rapid scoping review was conducted in MedLine, Embase, and CINAHL. Studies involving exercise-based lifestyle interventions for people with obesity and infertility were included only if they measured a psychosocial outcome as a primary or secondary measure. Expanding upon evidence from our rapid review, a pre-experimental feasibility study (pre-test, post-test with one group) was conducted. The pilot study implemented a virtual exercise intervention for people with obesity and experiencing infertility. Questionnaires measuring anxiety and depression, quality of life (QoL), social support, fertility-related stress, and hopelessness were administered. Based on the nine articles from our rapid review, there is evidence that lifestyle interventions combining exercise, diet, and psychobehavioral components improve psychosocial outcomes like anxiety, depression, QoL, and self-esteem. In our pilot study, 11 participants (Age: 34 ± 3.7, BMI: 40.3 ± 4.54) engaged in the virtual exercise intervention, and seven completed the post-intervention questionnaires. The results of our pilot study showed improvements in depression, hopelessness, physical QoL, and fertility-related stress scores. However, we observed declines in anxiety, mental QoL, and perceived social support measures. Our mixed findings may be due to the unique context of our pilot study. The study took place during the COVID-19 pandemic, where increased stress, anxiety, and isolation, negatively impacted fertility patients. Additionally, the virtual intervention, required by restrictions, may have reduced social interaction and support, worsening one’s mental health.