What are the Risks of Obesity to People with Disabilities?
— By By Andrea M. Pampaloni, Ph.D.
People with disabilities, particularly those with intellectual disabilities, have one of the highest rates of obesity compared to the general population.
As a group, people with disabilities, particularly those with intellectual disabilities, have one of the highest rates of obesity compared to the general population, including others with obesity. Not surprisingly, they also have higher rates of heart disease and diabetes, common comorbidities of obesity. With obesity on the rise and one in four adults having some type of disability, this is an alarming trend.
Of greater concern is that these numbers may be underreported. Body Mass Index (BMI) is the standard and most commonly accepted measure of obesity. However, BMI can underestimate the level of fat in people with less lean muscle mass, particularly among patients with spinal cord injuries. This suggests that the obesity rate may actually be higher, and that alternate measures of adiposity, such as waist may be more accurate in diagnosing obesity in people with disabilities.
Several reasons contribute to increased levels of obesity among people with physical or intellectual abilities1:
- Physical limitations that make walking or any type of exercise painful or prohibitive
- Lack of access to even basic exercise locations, including sidewalks, parks or exercise equipment
- Limited resources (e.g., transportation, finances, family support) to access to access a gym or other exercise options
- Use of medications, particularly psychotropics, which affect appetite and weight
- Consumption of unhealthy and high-calorie foods
- Lack of advice or awareness on nutrition and diet
- Greater social and health inequities
Are VLCDs an Option for People with Disabilities?
While the link between disability and obesity is clear, research on viable dietary approaches is notably more limited beyond traditional advice (e.g., increase fruits and vegetables, drink plenty of water, etc.). Given the unique challenges central to this often overlooked patient group, a more defined, evidence-based approach is needed.
The Stop Light Diet, originally designed for children, has been successful for adults with intellectual and developmental disabilities.2 Also known as the Traffic Light Diet, this approach is based on consumption of 900 calories per day with limited fat intake. This suggests that other very low calorie diets, in conjunction with an individualized exercise plan that considers the patient’s capabilities, may be viable alternatives for some patients with disabilities. The New Direction Program, a medically-supervised VLCD utilized by physicians and hospitals, offers the added advantage of a multidisciplinary team who can provide the patient with structure and effective communication, which is critical for patients with disabilities.
Certainly more research is needed in this area. Until then, it is imperative that the medical community heed the call for greater connectivity, inclusion and integration with people of disabilities to provide health guidance, including weight management, and to dismantle clear and invisible barriers that restrict access to critical needs of people with disabilities.
- Obesity in People with Intellectual Disabilities
- Weight Management in Adults with Intellectual and Developmental Disabilities: A Randomized Controlled Trial of Two Dietary Approaches
About the Author: Dr. Andrea Pampaloni has over 20 years of communication experience across corporate, academic, nonprofit and government sectors. She provides research and writing services on a range of business issues and industry-specific topics to prepare white papers, articles, proposals, presentations, technical content, and speaking points, as well as marketing-communications content such as blogs, website content, newsletters, news releases and award submissions. Dr. Pampaloni’s research findings have been presented at national and international conferences and published in peer-reviewed journals, and she is a ghostwriter for three books, a Forbes article, and several corporate blogs.