Overweight and Obesity Among Adults With Intellectual Disabilities Who Use Intellectual Disability/Developmental Disability Services in 20 U.S. States (original) (raw)
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The prevalence and determinants of obesity in adults with intellectual disabilities
Journal of Applied …, 2008
People with intellectual disabilities experience significant health inequalities compared with the general population, including a shorter life expectancy and high levels of unmet health needs. Another accepted measure of health inequalities, the prevalence of obesity, has been shown to be higher in adults with intellectual disabilities than in the general population. While the factors contributing to the increased prevalence among adults with intellectual disabilities are not well understood, the high rates of obesity among younger adults highlight the need for further research involving children and adolescents with intellectual disabilities. To take forward the priorities for research and the development of effective, accessible services, there is a need for collaboration between professionals working in the fields of intellectual disabilities and obesity.
Journal of Intellectual Disability Research, 2008
Background Previous studies of weight problems in adults with intellectual disability (ID) have generally been small or selective and given conflicting results. The objectives of our large-scale study were to identify inequalities in weight problems between adults with ID and the general adult population, and to investigate factors associated with obesity and underweight within the ID population. Methods We undertook a population-based prevalence study of 1119 adults with ID aged 20 and over on the Leicestershire Learning Disability Register who participated in a programme of universal health checks and home interviews with their carers. We performed a cross-sectional analysis of the register data and compared the observed and expected prevalences of body mass index categories in the ID and general populations using indirect standardisation for age. We used logistic regression to evaluate the association of a range of probable demographic, physical, mental and skills attributes with obesity and underweight. Results In those aged 25 and over, the standardised morbidity ratio (SMR) for obesity was 0.80 (95% CI 0.64-1.00) in men and 1.48 (95% CI 1.23-1.77) in women. The SMR for underweight was 8.44 (95% CI 6.52-10.82) in men and 2.35 (95% CI 1.72-3.19) in women. Among those aged 20 and over, crude prevalences were 20.7% for obesity, 28.0% for overweight, 32.7% for normal weight and 18.6% for underweight. Obesity was associated with living independently/with family, ability to feed/drink unaided, being female, hypertension, Down syndrome and the absence of cerebral palsy. Underweight was associated with younger age, absence of Down syndrome and not taking medication. Conclusion Obesity in women and underweight in both men and women was more common in adults with ID than in the general population after controlling for differences in the age distributions between the two populations. The associated factors suggest opportunities for targeting high-risk groups within the ID population for lifestyle and behaviour modification.
Research in Developmental Disabilities, 2018
Background:U.S. adults with intellectual and developmental disabilities (IDD) have poorer health status and greater risks for being overweight and obese, which are major drivers of health care expenditures in the general population. Health care expenditures and IDD have not been studied using nationally representative samples, and the impact of overweight and obesity have not been examined.Aim:Using nationally representative data, we aimed to compare the health care expenditures of not-overweight, overweight and obese U.S. adults with IDD, and calculate model-adjusted expenditures.Methods and procedures:Pooled data from the 2002–2011 Medical Expenditure Panel Survey linked to National Health Interview Survey (n = 1224) were analyzed. Two-part model regressions were conducted, with covariates being year of survey, age, sex, race/ethnicity, household income status, geographical region, urban/rural, marital status, insurance coverage, perceived health status, and perceived mental health status.Outcomes and results:Overall, obese adults with intellectual and developmental disabilities had higher expenditures than their non-obese peers. Being obese was associated with an estimated additional 2516inmeanexpendituresand2516 in mean expenditures and 2516inmeanexpendituresand1200 in median expenditures compared with the reference group, who were neither overweight nor obese.Conclusions and implications:Obesity is an important predictor of higher health care costs among community-living adults with IDD Finding effective strategies and interventions to address obesity in this population has great financial and policy significance.
Overweight and obesity among U.S. adults with and without disability, 1999–2012
Preventive Medicine Reports, 2015
Objective. Examine the relationship between disability and overweight/obesity among U.S. adults. Methods. Study sample (N = 30,363) came from the National Health and Nutrition Examination Survey 1999-2012 waves. Disability was classified into five domains using standardized indices. Any disability was defined as having any difficulty in performing at least one of the activities in any of the five disability domains. Logistic regressions were conducted to estimate the association between disability and overweight/obesity, adjusted by individual characteristics and multiyear complex sampling design. Results. Over a quarter (25.99%) of U.S. adults 20 years and older reported having any disability. The overweight/obesity rates across all disability domains were substantially higher than their nondisabled counterparts. The rate of overweight and obesity combined (BMI ≥ 25 kg/m 2), obesity (BMI ≥ 30 kg/m 2), grade 2 and 3 obesity combined (BMI ≥ 35 kg/m 2), and grade 3 obesity (BMI ≥ 40 kg/m 2) among people with any disability were 1.14 (73.54% versus 64.50%), 1.38 (41.37% versus 29.99%), 1.71 (19.81% versus 11.60%), and 1.94 (8.60% versus 4.43%) times the corresponding rate among people without disability, respectively. Compared with their nondisabled counterparts, the adjusted odds of overweight and obesity combined, obesity, grade 2 and 3 obesity combined, and grade 3 obesity were 24% (95% confidence interval [CI]: 14%-36%), 32% (95% CI: 22%-44%), 49% (95% CI: 35%-64%), and 55% (95% CI: 27%-89%) higher among people with any disability, respectively. Conclusion. People with disabilities have substantially higher risk of obesity compared to their nondisabled peers.
Health promotion for people with intellectual disability and obesity
British Journal of Nursing, 2012
Obesity is a significant health problem for people with intellectual disability, as they report a 59% higher rate of obesity as compared with those in the general population (Centres for Disease Control and Prevention, 2006). Causes are multifactorial and obesity leads to a higher risk of developing chronic conditions, such as diabetes and heart disease. While the risks of these conditions generally increase with age, people with an intellectual disability are at risk of developing them earlier owing to their higher levels of obesity. Client groups with mild intellectual disability residing in a group home or family home are at a higher risk of obesity than those in institutional care, mainly owing to increased independence and available choices. Healthcare services have predominantly focused on the primary disability rather than on prevention or reduction of secondary health conditions. As health promotion enables people to gain control over their lives, it is essential to address the health concern of obesity for people with intellectual disability. This article highlights the issues in health care faced by people with an intellectual disability and aspects that health professionals need to consider when engaging in health promotion for those who are obese.
Journal of Intellectual & Developmental Disability, 2018
Background: Increased levels of obesity have been reported for people with intellectual disability based on data mostly gathered in high income countries. Likewise few studies internationally have focussed on underweight in this population. Method: Data on obesity and underweight were analysed from nearly 86,500 youth and adults with intellectual disabilities drawn from 178 countries attending Special Olympic events. Results: Binary logistic regressions identified higher levels of obesity for athletes in high income countriesespecially in North Americaand for females and for adults aged 40 years and over; and for youth aged 8 to 10 years. Rates of underweight were higher for younger adults in low income countries of Asia-Pacific, and highest for males aged 11-13 from lower-middle income countries of Africa. Conclusions: Contrasting intervention strategies are needed globally to enable people with intellectual disabilities to achieve healthy weight.
Obesity, Nutrition, and Physical Activity for People with Significant Disabilities
Physical Disabilities: Education and Related Services
This review of literature focuses on health issues for individuals with Intellectual Disabilities (ID), Intellectual and Developmental Disabilities (IDD), and Multiple Impairments (MI). This population has two to three times higher overweight and obesity prevalence than typically developing individuals. Furthermore, they have higher risk for obesity related diseases such as reduced lifespan and quality of life. Contributing factors for higher rates of overweight or obesity, effective interventions, and barriers to health knowledge and practice are discussed. Implications and future research needs are highlighted.
Reports suggest that 7% to 18% of Australian adults are obese and a further 16% to 55% are overweight. Studies from other countries have indicated that obesity among people with an intellectual disability may be at least, or even more, prevalent. Prevalence rates range from 28% to 59%. The aim of the current study was to investigate the weight distribution of an Australian sample of people with an intellectual disability using Body Mass Index (BMI) to classify males and females, and Kelly and Rimmer’s (1987) Percentage of Body Fat (PBF) formula to also classify males. Forty-one females and 52 males with a mild to severe intellectual disability were assessed. The correlation between BMI and PBF for males was r~.89. BMI classifications revealed a higher percentage of females as overweight (41.4%) and obese (36.6%) compared to overweight males (30.8%) and obese males (30.8%). There were more underweight males (7.6%) than females (4.9%). There was no relationship between living environment and weight classifications on the BMI. The PBF formula indicated that 73% of the males were classified as obese. The possibility of misclassification using the BMI and the need for weight interventions are discussed.