While physical activity offers mental health benefits for everyone, the best type of mood-boosting activity varies depending on weight and comorbidities. Researchers of a study recently published in the Journal of Affective Disorders examined the relationship between type, frequency, and duration of physical activity in people with obesity and varying numbers of chronic disease.

While physical activity is key for weight control and for curbing symptoms of anxiety and depression, adults with multiple comorbidities may not be able to engage in the same activities as healthy adults or even an adult with obesity who has no other chronic health conditions. Drilling down to the most beneficial type of activity for those with physical limitations may help inform treatment.

To compare the effectiveness of various types, frequencies, and duration of activities on adults with obesity, with and without comorbidities, the researchers used cross-sectional data from the Behavioral Risk Factor Surveillance (BRFSS), a repeated telephone survey targeting adults aged 18 years or older across the United States. They pulled data collected between 2011 and 2019 (odd years only), resulting in 871,949 participants for the analysis. Of those, 43.82 were healthy, 10.09% were obese with no chronic comorbidities, 11.81% were obese with 1 comorbidity, and 34.8% were obese with 2 or more comorbidities.

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Walking was the most popular activity among all groups. Aerobic exercise and strength training had the greatest mental health benefits for healthy individuals (21.92%, 20.46%, respectively). While running, hiking, and cycling specifically were associated with the greatest mental health benefits in healthy adults, aerobics videos and classes, golf, and swimming benefited individuals with obesity and with 1 comorbidity (22.14%, 20.75%, 19.64% respectively).

For individuals with obesity and 2 or more chronic conditions, only the aerobic videos and classes (19.6%) improved the mental health burden by more than 17%. The researchers also noted a U-shaped curve between exercise frequency, duration, and mental health. Too little and too much were associated with worse mental health outcomes. Patients who exercised for about 40 to 50 minutes, 3 to 4 times a week, reported the most positive mental health scores.

The self-reported nature of the responses may have led to recall bias. Questions around mental health burden and BMI may not have accurately reflected mental health states and clinical obesity. However, the study results may help physicians and clinicians make more targeted activity recommendations for individuals with obesity. “It is important to make different physical activity strategies for people with obesity and obesity-related chronic comorbid conditions to maximize the improvement of people’s mental health,” the researchers concluded.


Xu P, Huang Y, Hou Q, et al. Relationship between physical activity and mental health in a national representative cross-section study: Its variations according to obesity and comorbidity. J Affect Disord. 2022;308:484-493. doi:10.1016/j.jad.2022.04.037