Effectiveness of Electrical Muscle Stimulation (EMS) on Self-Esteem and Body Mass Index in Obese Men: A Preliminary Study

Background: Obesity and low self-esteem are associated with physical and psychological health and may adversely affect quality of life and daily functioning. EMS has gained attention as a complementary approach to exercise programs.
Methods: In this randomized controlled pretest-posttest study, 48 men aged 30–60 years with a BMI >30 kg/m² were recruited from bodybuilding gyms in Mashhad, Iran, in 2026 and randomly assigned to EMS and control groups (n=24 each). Both groups completed 12 sessions of standard physical fitness training, while the EMS group additionally received EMS-assisted training. Self-esteem was assessed using the Eysenck Self-Esteem Questionnaire, and BMI was calculated from height and weight measurements. Data were analyzed using ANCOVA in SPSS version 27, with post-intervention outcomes compared between groups after adjustment for baseline values.
Results: After adjustment for baseline BMI, a significant between-group difference was observed in post-intervention BMI, with a lower adjusted mean in the EMS group than in the control group (29.698 vs. 31.186 kg/m²; mean difference=−1.488 kg/m², 95% CI: −2.220 to −0.756; F(1,45)=16.756, P<0.001, partial η²=0.271). A significant between-group difference was also observed in self-esteem after adjustment for baseline self-esteem, with a higher adjusted mean in the EMS group than in the control group (22.779 vs. 19.805; mean difference=2.974, 95% CI: 0.559 to 5.389; F(1,45)=6.152, P=0.017, partial η²=0.120).
Conclusion: After adjustment for baseline values, EMS-assisted training was associated with significantly lower post-intervention BMI and higher self-esteem compared with standard training alone. These findings suggest potential benefits of incorporating EMS into exercise programs for obese adult men.