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| Reasons for not exercising | Barriers | Strategies to increase adherence |
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| “I would like to exercise, but I feel immediately tired and breathless, and my knees hurt” | Low fitness, pain | Exercising with individuals having the same limits, to reduce the intensity of exercise |
| “I do not like exercising, it is boring” | Boredom, lack of stimuli | Planning enjoyable activities or amusing exercising (e.g., group dancing or walking) |
| “I do not like exercising alone, but when I go walking with friends I realize that I slow down the group, which makes me feel inadequate” | Comparison with other individuals | Exercising with subjects having similar problems, in order to avoid competition |
| “Exercising in a gym or a swimming pool or even walking in a public garden makes me feel ashamed, observed, judged, mocked at” | Body image dissatisfaction | Arranging a protected environment, and specific courses (gym or swimming pool) for obese persons |
| “I’d like to exercise, but I have no time. Back from work, I am too tired and I have to take care of my family” | Time constraints | Reorganizing daily activities fitting exercise as a priority. Turning everyday activities into exercise (using stairs, walking to work, etc.) |
| “The weather was horrible; I had to stay at home” | Weather constraint | Planning short walk in small groups; reducing objectives but maintaining change and adherence |
| “I feel so bad when I exercise, that I feel as if I am going to die” | Death fear | Increasing goals very slowly, to avoid any sense of breathlessness |
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