Impact of Moderate-Intensity Interval Training on Quality of Life and Self-Efficacy among Obese Adults in Jaipur, Rajasthan

*Corresponding author: Madhuri Singh Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Impact of Moderate-Intensity Interval Training on Quality of Life and Self-Efficacy among Obese Adults in Jaipur, Rajasthan Madhuri Singh 1, * and Jasmine Santha. J 2 1 PhD. Scholar, Independent researcher. 2 PhD. Guide, Independent researcher. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 495-499 Publication history: Received on 17 August 2025; revised on 26 September 2025; accepted on 29 September 2025 Article DOI: https://doi.org/10.30574/wjbphs.2025.23.3.0869 Abstract Introduction: Obesity is an escalating public health issue in India, associated with poor quality of life (QoL) and low self-efficacy, both of which hinder sustained lifestyle modification. High-intensity interval training (HIIT) has proven benefits but is often too strenuous for obese adults. Moderate-intensity interval training (MIIT) may offer a more feasible and culturally acceptable alternative. Methods: A community-based randomized controlled trial was conducted in Jaipur, Rajasthan, among 60 obese adults (BMI ≥ 30 kg/m²), aged 20–50 years, selected through convenient sampling. Participants were randomized into MIIT (n = 30) and control (n = 30) groups. The MIIT group underwent 12 weeks of supervised training (3 sessions/week, 30– 40 minutes), while controls received standard lifestyle advice without structured exercise. QoL was assessed using the WHOQOL-BREF (four domains), and self-efficacy was measured with the General Self-Efficacy Scale (GSES). Assessments were conducted at baseline and after 12 weeks. Data were analyzed using paired and independent t-tests, with significance set at p < 0.05. Results: Baseline socio-demographic and clinical variables were comparable across groups (p > 0.05). After 12 weeks, the MIIT group showed significant improvements in physical health (+16.5, p < 0.001) and psychological QoL (+12.4, p < 0.001), whereas social and environmental domains showed modest, non-significant improvements. Self-efficacy scores improved significantly in the MIIT group (+6.2, p < 0.001) but not in the control group (+0.8, p = 0.19). No adverse events were reported. Conclusion: MIIT significantly enhanced QoL and self-efficacy among obese adults, supporting its role as a feasible and effective intervention for obesity management in Indian urban communities. Keywords: Obesity; Moderate-intensity interval training; Quality of life; Self-efficacy; Randomized controlled trial 1. Introduction Obesity is a rapidly growing public health problem worldwide and has reached epidemic proportions in India. According to the World Health Organization, more than 650 million adults are obese, with prevalence increasing steadily in lowand middle-income countries¹. In India, lifestyle transitions, urbanization, and dietary changes have contributed to rising obesity rates, particularly among urban adults². Obesity is associated not only with metabolic and cardiovascular diseases but also with significant impairment in quality of life (QoL) and reduction in self-efficacy, which further perpetuates poor lifestyle behaviors³. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 495-499 496 Quality of life is a multidimensional construct that includes physical, psychological, social, and environmental wellbeing. Obese individuals often report lower physical functioning, fatigue, mobility restrictions, and poor psychological health, including low self-esteem and depression⁴. Similarly, self-efficacy, defined as the belief in one’s capability to initiate and sustain behavior, is a critical determinant of lifestyle change. Evidence suggests that low self-efficacy is strongly correlated with reduced adherence to exercise, poor dietary control, and failure to achieve weight management goals⁵. Therefore, interventions that improve both QoL and self-efficacy are essential for sustainable obesity management. Exercise is a cornerstone in the treatment of obesity. Traditionally, moderate-intensity continuous training (MICT) has been recommended. However, MICT is time-consuming and often poorly adhered to by obese individuals who perceive exercise as exhausting or monotonous⁶. In recent years, interval training approaches, particularly high-intensity interval training (HIIT), have gained popularity due to their time efficiency and physiological benefits. Yet, HIIT is often too strenuous for obese or sedentary adults, leading to dropouts and low adherence⁷. As an alternative, moderate-intensity interval training (MIIT) has emerged as a feasible and effective approach. MIIT involves alternating bouts of moderate-intensity exercise with periods of active recovery, thereby maintaining cardiovascular benefits while reducing perceived exertion⁸. Studies from Western populations have shown that MIIT can significantly improve cardiovascular fitness, metabolic health, and psychological outcomes⁹. Importantly, MIIT may be more culturally and physically acceptable in populations such as obese Indian adults, who may struggle with continuous high-intensity regimes. Evidence suggests that MIIT improves psychological health markers, including selfefficacy, by providing manageable exercise bouts that build confidence and foster a sense of achievement. Improvements in self-efficacy, in turn, are associated with enhanced QoL and better long-term engagement with physical activity¹⁰. Despite these promising findings, Indian studies specifically exploring the impact of MIIT on QoL and self-efficacy among obese adults remain scarce. This study therefore aims to evaluate the impact of MIIT on QoL and self-efficacy among obese adults in Jaipur, contributing to the evidence base for obesity management strategies in Indian settings. 2. Methodology • Study Design and Setting: - A community-based randomized controlled trial (RCT) was conducted in Jaipur, Rajasthan, between January and June 2025. The study aimed to evaluate the effect of moderate-intensity interval training (MIIT) on quality of life (QoL) and self-efficacy among obese adults. • Sample Size and Sampling: A total of 60 obese adults (BMI ≥ 30 kg/m²), aged 20–50 years, were conveniently sampled from Ward 16, Jaipur, and randomized into MIIT (n = 30) and control (n = 30) groups. Eligible participants were adults willing to participate for 12 weeks and medically cleared for exercise, while those with severe illness, pregnancy, or on structured programs were excluded. Randomization used computer-generated sequences with sealed envelopes; participants and trainers were unblinded, but assessors and analysts remained blinded. • Intervention and Outcome Measures: - The MIIT group underwent 12 weeks of supervised training (3 sessions/week, 30–40 minutes each) consisting of 5 minutes of warm-up, 8–10 cycles of brisk walking/cycling at 60–70% HRmax alternated with 2–3 minutes of active recovery at 40–50% HRmax, and 5 minutes of cooldown, with heart rate and exertion monitored for safety. The control group received lifestyle advice on balanced diet, daily walking, and obesity prevention without structured MIIT. Outcomes included quality of life (WHOQOL-BREF: physical, psychological, social, environmental domains; 0–100 scale) and self-efficacy (General Self-Efficacy Scale: 10 items, score range 10–40), assessed at baseline and after 12 weeks. 2.1. Data Collection and Analysis Data were entered into Microsoft Excel and analyzed using SPSS version 26.0. • Descriptive statistics: Mean, standard deviation, and percentages were used for demographic variables. • Inferential statistics: Paired t-tests were used to compare preand post-intervention scores within groups. Independent t-tests and ANOVA were applied to compare changes between groups. A p-value <0.05 was considered statistically significant. World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 495-499 497 3. Results 3.1. Baseline Characteristics Table 1 Socio-demographic characteristics of study participants (N = 60) Variable MIIT Group (n = 30) Control Group (n = 30) p-value Age (years, mean ± SD) 38.2 ± 6.7 37.6 ± 7.1 0.72 Gender Male 12 (40.0%) 13 (43.3%) Female 18 (60.0%) 17 (56.7%) 0.79 Education Graduate and above 18 (60.0%) 16 (53.3%) Below graduate 12 (40.0%) 14 (46.7%) 0.62 Marital Status Married 22 (73.3%) 20 (66.7%) Single 8 (26.7%) 10 (33.3%) 0.58 Occupation Employed 19 (63.3%) 17 (56.7%) Unemployed 11 (36.7%) 13 (43.3%) 0.67 BMI (kg/m², mean ± SD) 32.8 ± 2.6 32.4 ± 2.8 0.64 Family History of Obesity Yes 14 (46.7%) 15 (50.0%) No 16 (53.3%) 15 (50.0%) 0.81 Table 2 Changes in WHOQOL-BREF scores in MIIT and control groups QoL Domain Baseline Mean ± SD Post-intervention Mean ± SD Mean Change p-value (within group) p-value (between groups) Physical Health MIIT: 42.1 ± 7.8 58.6 ± 6.9 +16.5 <0.001 <0.001 Control: 41.5 ± 8.0 43.8 ± 7.6 +2.3 0.09 Psychological MIIT: 44.3 ± 8.2 56.7 ± 7.5 +12.4 <0.001 <0.001 Control: 45.1 ± 7.9 46.9 ± 7.2 +1.8 0.12 Social Relations MIIT: 48.7 ± 7.4 52.5 ± 6.9 +3.8 0.06 0.09 Control: 47.9 ± 7.1 48.6 ± 7.3 +0.7 0.44 Environment MIIT: 50.2 ± 6.5 53.1 ± 6.1 +2.9 0.08 0.11 Control: 49.6 ± 6.8 50.5 ± 6.6 +0.9 0.36 World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 495-499 498 Table 3 Comparison of General Self-Efficacy Scale (GSES) scores Group Baseline Mean ± SD Post-intervention Mean ± SD Mean Change p-value (within group) MIIT 22.4 ± 4.6 28.6 ± 4.1 +6.2 <0.001 Control 22.9 ± 4.2 23.7 ± 4.0 +0.8 0.19 4. Discussion The present study evaluated the impact of moderate-intensity interval training (MIIT) on quality of life (QoL) and selfefficacy among obese adults in Jaipur, Rajasthan. Findings revealed significant improvements in the physical and psychological domains of QoL as well as a notable increase in self-efficacy scores among the intervention group compared to controls. These results are consistent with growing evidence that structured, interval-based exercise interventions not only improve physiological outcomes but also positively influence psychosocial well-being¹². 4.1. Quality of Life Obesity has been consistently linked to lower health-related quality of life, particularly in the domains of physical and psychological functioning³. In our study, participants in the MIIT group reported marked improvements in physical health and psychological domains, whereas the control group demonstrated minimal changes. Similar findings were reported by Kolotkin et al.⁴, who emphasized that weight reduction and exercise contribute substantially to enhanced physical QoL. Moreover, Fontaine and Barofsky⁵ noted that psychosocial dimensions such as depression, self-image, and fatigue improve following structured exercise programs. Our findings align with previous interval training studies. Gillen and Gibala⁶ observed that even short-term interval training programs significantly improve subjective well-being and energy levels. In an Indian context, Misra et al.⁷ stressed the urgent need for culturally tailored physical activity programs to address the rising burden of obesity and related QoL impairments. The fact that psychological QoL improved significantly in our MIIT group highlights the dual benefits of such programs: reducing obesity-related physical limitations while enhancing mental well-being. 4.2. Self-Efficacy Self-efficacy, defined as the belief in one’s capacity to execute behaviors necessary to produce specific outcomes, plays a pivotal role in initiating and maintaining lifestyle modifications⁸. In this study, MIIT participants demonstrated significantly higher self-efficacy scores post-intervention compared to controls. These results support Bandura’s foundational theory that mastery experiences, such as completing manageable exercise bouts, are the most effective means of enhancing self-efficacy⁹. International literature supports our findings. Jung et al.¹⁰ reported that interval training improved exercise confidence and reduced perceived barriers among overweight adults. Similarly, a study in Korean adults by Kang et al.¹¹ found that self-efficacy strongly predicted adherence to exercise routines and improvements in weight-related outcomes. In an Indian study, Reddy et al.¹² highlighted that low self-efficacy remains a major barrier to sustained lifestyle modification, underscoring the importance of interventions like MIIT that build gradual confidence. Our analysis indicated a significant association between higher educational level and improved self-efficacy. Similar associations have been documented by Sawant et al.¹³ and Okafor et al.¹⁴, who reported that educated adults are more likely to adopt and sustain lifestyle interventions. No significant associations were found with age, gender, or BMI, though trends suggested that younger participants and those with lower BMI tended to have better self-efficacy, echoing findings from Singh et al.¹⁵. Moderate-intensity continuous training (MICT) has traditionally been recommended for obesity management, but adherence is often poor due to monotony and time constraints¹⁶. High-intensity interval training (HIIT) is effective but frequently perceived as too strenuous for obese populations¹⁷. MIIT provides a balanced alternative—time-efficient, less intimidating, and associated with sustained psychological engagement. Our results support the growing consensus that MIIT can be more feasible and acceptable in community-based obesity interventions. 4.3. Strengths and Limitations The strengths of this study include its randomized design, use of validated tools (WHOQOL-BREF and GSES), and focus on psychological outcomes that are often overlooked in obesity interventions. However, limitations include a small World Journal of Biology Pharmacy and Health Sciences, 2025, 23(03), 495-499 499 sample size, short duration, and the reliance on self-reported measures. Additionally, long-term adherence and physiological outcomes (e.g., weight, body composition, VO₂max) were not assessed. Future larger-scale studies with extended follow-up are recommended to validate these findings in diverse Indian populations. 5. Conclusion This study demonstrates that MIIT significantly improves quality of life and self-efficacy among obese adults in Jaipur. By enhancing both physical and psychological health as well as the confidence to maintain lifestyle changes, MIIT represents a promising, culturally adaptable intervention for obesity management in India. Integrating MIIT into community and clinical programs could help address the dual challenges of poor QoL and low self-efficacy that hinder obesity control. Compliance with ethical standards Disclosure of conflict of interest No conflict of interest to be disclosed. References [1] WHO. Obesity and overweight. World Health Organization Fact Sheet. Geneva: WHO; 2021. [2] Jakicic JM, Rogers RJ, Davis KK, Collins KA. Role of physical activity and exercise in treating patients with overweight and obesity. Clin Chem. 2018;64(1):99–107. [3] Kolotkin RL, Andersen JR. A systematic review of reviews: exploring the relationship between obesity, weight loss and health-related quality of life. Clin Obes. 2017;7(5):273–89. [4] Kolotkin RL, Crosby RD, Williams GR. Health-related quality of life varies among obese subgroups. Obes Res. 2002;10(8):748–56. [5] Fontaine KR, Barofsky I. Obesity and health-related quality of life. Obes Rev. 2001;2(3):173–82. [6] Gillen JB, Gibala MJ. Is high-intensity interval training a time-efficient exercise strategy to improve health and fitness? Appl Physiol Nutr Metab. 2014;39(3):409–12. [7] Misra A, Shrivastava U. Obesity and dyslipidemia in South Asians. Nutrients. 2013;5(7):2708–33. [8] Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. [9] Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143–64. [10] Jung ME, Bourne JE, Little JP. High-intensity interval training as an alternative exercise modality for overweight and obese adults: a randomized trial. Appl Physiol Nutr Metab. 2014;39(3):749–56. [11] Kang JH, Jeong BG, Cho YG, Song HR, Kim KA. Factors associated with obesity and its perception among Korean adults. Korean J Fam Med. 2019;40(1):19–25. [12] Reddy KS, Prabhakaran D, Jeemon P. Emerging epidemic of cardiovascular disease in developing countries: knowledge gaps and opportunities for action. Indian J Med Res. 2005;124:259–64. [13] Sawant AM, Shetty D, Mankeshwar R, Ashavaid TF. Prevalence of dyslipidemia in young adult Indian population. J Assoc Physicians India. 2008;56:99–102. [14] Okafor CI, Gezawa ID, Sabir AA, Raimi TH, Enang OE. Obesity, awareness and perception among adults in a Nigerian community. Niger J Clin Pract. 2014;17(6):739–45. [15] Singh AK, Maheshwari A, Sharma N, Anand K. Lifestyle associated risk factors in adolescents. Indian J Pediatr. 2006;73(10):901–6. [16] Wewege M, van den Berg R, Ward RE, Keech A. The effects of high-intensity interval training vs moderateintensity continuous training on body composition in overweight and obese adults: a systematic review and meta-analysis. Obes Rev. 2017;18(6):635–46. [17] American College of Sports Medicine (ACSM). ACSM’s Guidelines for Exercise Testing and Prescription. 10th ed. Philadelphia: Wolters Kluwer; 2021.