Associations of adiposity with functional performance, postural awareness, and body awareness in women

Background Obesity is associated with functional limitations and altered postural and movement-related outcomes, but its relationships with postural awareness and generalized body awareness remain unclear.Objective To compare postural habits, postural awareness, body awareness, psychological status, and functional performance across BMI categories in women and to examine the independent associations of BMI and waist circumference with these outcomes.Methods Eighty women were classified as normal weight, overweight, obesity class I, or obesity class II-III (n = 20/group). Postural habits and awareness were assessed using the Postural Habits and Awareness Scale, body awareness using the Body Awareness Questionnaire, and psychological status using the Hospital Anxiety and Depression Scale. Functional performance was assessed with the Timed Up and Go and Five Times Sit-to-Stand tests and summarized as a Functional Performance Index. Multivariable regression models for BMI and waist circumference were adjusted for age, physical activity, and educational level.Results Postural habits (p = .027), postural awareness (p = .018), and functional performance (p < .001) differed significantly across BMI groups, whereas body awareness, anxiety, and depression did not (all p > .05). Functional performance showed the largest between-group effect (η2 = 0.422), with normal-weight and overweight women performing better than women with obesity class I and class II-III (all adjusted p < .001); in adjusted analyses, BMI (B = 0.049, 95% CI: 0.027–0.071, p < .001) and waist circumference (B = 0.019, 95% CI: 0.010–0.028, p < .001) were independently associated with poorer functional performance, but neither was associated with postural habits, postural awareness, or body awareness.Conclusion Postural habits, postural awareness, and functional performance differed across BMI categories, but after covariate adjustment, BMI and waist circumference were independently associated only with functional performance. Functional performance may therefore be more consistently related to obesity-related anthropometric characteristics than awareness-related outcomes.Trial Registration ClinicalTrials.gov (NCT07500389).