Reducing Obesity Among People With Disabilities

Abstract

Achieving healthy weight for people with disabilities in the United States is a challenge. Obesity rates for adults and children with disabilities are significantly higher than for those without disabilities, with differences remaining even when controlling for other factors. Reasons for this disparity include lack of healthy food options for many people with disabilities living in restrictive environments, difficulty with chewing or swallowing food, medication use contributing to changes in appetite, physical limitations that can reduce a person's ability to exercise, constant pain, energy imbalance, lack of accessible environments in which to exercise or fully participate in other activities, and resource scarcity among many segments of the disability population. In order for there to be a coordinated national effort to address this issue, a framework needs to be developed from which research, policy, and practice can emerge. This paper reviews existing literature and presents a conceptual model that can be used to inform such a framework, provides examples of promising practices, and discusses challenges and opportunities moving forward.

Keywords: conceptual model; disability; disparities; obesity; surveillance.

Figure 1

Possible mechanism of obesity development in people with physical disabilities (after Liou, 2005). Note. ↓ = decrease; EEPa = energy expenditure of physical activity; FFM = fat-free mass; REE = resting energy expenditure; TEE = total daily energy expenditure.

Figure 2

Reducing obesity and achieving healthy weight among people with disabilities. Note. ADA = Americans with Disabilities Act; ACA = Affordable Care Act.