Strength Training and Body Image Among Middle-Aged Women in Malaysia: A Narrative Review Using the Health Belief Model

Background: Middle-aged women (aged 40-60) in Malaysia face health concerns due to psychological changes, sociocultural impacts, and hormonal shifts as they age. This study aimed to uncover which aspects of strength training programs enable middle-aged women to better manage their health concerns in Malaysia. Methods: Following the PRISMA guidelines, we utilized the health belief model (HBM) framework to understand how training programs affect the health of middle-aged women worldwide. We focused on women in Malaysia and the unique cultural barriers they experience. Sources were selected from 2010 to 2025. Results: We selected 22 studies within Malaysia to highlight the impacts of strength training on middle-aged women’s health. We found that enhancing self-efficacy led to better management of health concerns for women. The training program also improved women’s psychological well-being. While Western women were motivated by improving their physical appearance, Malaysian women were more interested in exercise to maintain their personal health and their ability to work and care for family. Some Malaysian women found that lack of perceived modesty, as well as difficulty finding women-only exercise spaces and enough free time were significant barriers to exercise. Conclusion: Overall, the health development training programs were beneficial; the programs effectively helped middle-aged women develop their physical and psychological health. Programs in Malaysia should integrate the Health Belief Model (HBM) and address cultural-specific barriers to help women maintain a positive body image with proper exercise structure.