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.
Obesity is more prevalent in adults with intellectual disabilities than in the general population, and has been shown to contribute to their reduced life expectancy, and increased health needs. Relatively few studies have examined the effectiveness of weight loss interventions for adults with intellectual disabilities. However, there is evidence to support interventions that take account of the context of the lives of adults with intellectual disabilities, including carer involvement in interventions. To reduce the health inequalities experienced by adults with intellectual disabilities, there is a clear need to develop accessible, evidence-based clinical weight management services.
This study identified specific facilitators and barriers experienced by carers during the process of supporting obese adults with ID to lose weight. Future research could utilise these findings to inform appropriate and effective weight management interventions for individuals with ID.
Attrition and weight loss outcomes for patients with complex obesity, anxiety and depression attending a weight management programme with targeted psychological treatment. Clinical Obesity, 6(2), pp. 133-142. (doi:10.1111/cob.12136) This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/118709/ What is already known about this subject?• Baseline depression is associated with greater attrition rates from weight management programmes and is also with poorer weight loss success.• There is little evidence regarding the role of baseline anxiety as a predictor of attrition or weight loss in weight management programmes.• There is some evidence that patients with baseline mood disorders achieve similar weight loss to controls in weight management programmes with an integrated psychological component What this study adds• This study confirms that baseline anxiety and depression (identified using HADS) is associated with higher attrition of patients from a weight management programme with an integrated psychology service.• Despite a significantly less favourable case-mix of risk-factors for poor weight loss:o Patients with severe anxiety at baseline achieve similar weight loss outcomes to those without baseline anxiety.o Significantly greater weight loss is seen in participants with severe baseline depression at all stages of follow-up in the Glasgow and Clyde Weight Management Service. AbstractObjective: To investigate the effect of baseline anxiety and depression, using different definitions for caseness, on attrition and weight outcomes following a multidisciplinary weight management programme.Design: Prospective observational study. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression with 'caseness' scoring ≥11 and severity ≥14. Participants:All patients who began a weight management programme between 1 October 2008 and September 2009 (n=1838).Setting: Glasgow and Clyde Weight Management Service (GCWMS) is a specialist multidisciplinary service, which aims to achieve a minimum of ≥5kg weight loss. Patients with HADS score ≥14 were referred to the integrated psychology service for psychological assessment/intervention. Results:Patients with caseness (HADS ≥11) for anxiety (33%) and depression (27%) were significantly younger, heavier, more socioeconomically deprived and a higher proportion were female.There was a significant positive correlation between HADS anxiety and depression scores and increasing BMI (r 2 =0.094, p<0.001 and r 2 =0.175, p<0.001, respectively). Attendance and completion was lower throughout follow-up amongst patients with anxiety or depression. More patients with HADS score ≥11 achieved ≥5kg or ≥5% weight loss and by 12 months those with anxiety had a significantly higher mean weight loss (p=0.032). Participants who scored for severe anxiety (HADS ≥14) achieved similar weight loss to those ...
Background: The prevalence of obesity in adults with intellectual disabilities (ID) is rising, although the evidence base for its treatment in this population group is minimal. Weight management interventions that are accessible to adults with ID will reduce the inequalities that they frequently experience in health services. This short report compared the effectiveness of weight management in those with and without ID who completed nine sessions of a multi-component weight management programme. Methods: TAKE 5 is a 16-week multi-component weight management intervention for adults with ID and obesity [body mass index (BMI) ! 30 kg m -2 ].
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