Abstract WE539: The Relation Between Remote Exercise and Mental Health Outcomes Among Insufficiently Active Adults with Obesity

Introduction: Physical activity (PA) has a strong positive impact on mental health outcomes, including anxiety, depression, and stress; however, there is a scarcity of studies exploring the effects of remote PA interventions for adults with obesity and the potential mechanistic role of depression, stress, anxiety, and sleep. We examined the impact of the PA for the Heart (PATH) intervention on mental health outcomes in insufficiently active adults with obesity. Hypothesis: The PATH intervention group will have significant improvement in anxiety, stress, depression, and sleep outcomes compared to the attention control (AC) group. Methods: This is a secondary analysis of a 6-month RCT including 89 adults with obesity. The PATH intervention group received an online exercise platform with biweekly coaching; controls received self-help reading materials. Participants completed the Center for Epidemiologic Studies Depression Scale (CES-D), NIH Toolbox Perceived Stress Scale, PROMIS Sleep scales related to sleep disturbance (issues falling and staying asleep) and sleep impairment (effects of poor sleep on daytime function), and EuroQol 5-Dimensions quality of life questionnaire. PA was measured via Fitbit Charge 5 (active zone minutes; MVPA). Statistical analyses included t-tests for between-group comparisons, Pearson correlations, and multivariable regression models. Results: The sample (46% white, mean age 48.7±12.2 years, mean BMI 40.04±7.24 kg/m2) was 91% female. Neither depressive symptoms nor perceived stress changed significantly in either group (all p>0.05). Fitbit-measured MVPA declined in controls (-77.3±199.9 min/week) but remained stable in intervention (-5.5±161.3 min/week), though between-group difference was not significant (p=0.086). Strong correlations emerged between depression and stress (r=0.658, p<0.001), depression and sleep impairment (r=0.542, p<0.001), and depression and sleep disturbance (r=0.564, p<0.001). PA changes did not correlate with mental health changes (all p>0.05). In multivariable models, stress (β=0.535, p<0.001) and sleep impairment (β=0.293, p=0.020) were associated with depression, while PA (β=0.017, p=0.041) and depression (β=0.575, p<0.001) were associated with stress. Conclusions: Strong interconnections exist among depression, stress, and sleep in adults with obesity. PA changes did not directly impact mental health outcomes over six months, suggesting longer intervention durations or alternative mechanisms may be needed.