About Weight Management:
A person’s Body Mass Index (BMI) is a useful tool for understanding and managing weight loss. BMI is defined as weight in kilograms divided by height in meters squared (kg/m2 ). Children who are “at risk” for becoming overweight have BMI values in the 85th to 95th percentile.
For adults, BMI falls in the following ranges:
- Underweight: < 18.5
- Normal Weight: 18.5 – 24.9
- Overweight: 25.0-29.9
- Obese: > 30.0
A BMI calculator can be found at the Centers for Disease Control website: http://www.cdc.gov/healthyweight. Individuals concerned about their weight should be evaluated by a physician who completes a health history and physical examination and determines any medical causes and complications relating to weight.
- Obesity occurs more frequently in individuals with developmental disabilities than in the general population. Some cases are due to genetic conditions that correlate with decreased cognitive potential, such as Down Syndrome, Prader-Willi Syndrome, Klinefelter’s Syndrome, Laurence-Moon-Bardet-Biedl Syndrome and hypothyroidism. Other cases are more readily explained by unhealthy diet and insufficient exercise.
It is important that the weight change goal be realistic and appropriate. Adults should aim to lose about 2 pounds per month. For children, it may be best to change dietary intake and exercise status to maintain weight while increasing height.
- For some adults, a weight program may be considered successful if weight is maintained and no longer increases.
- Weight should be checked and recorded weekly or monthly on the same scale. Changes in weight should be reviewed by a physician so that dietary intake, exercise status, and weight goals can be adjusted as necessary.
An important aspect of weight change is diet and calorie modification.
- For a person in a community living facility to receive a special diet, it must be prescribed by a physician.
- Certain independent living programs provide training in purchasing and cooking low calorie well-balanced foods.
- People who purchase and cook their own food may benefit from a nutritional evaluation by a nutritionist or dietitian, a program that may be available through their health plan.
- Some people benefit from having a “contract” that indicates how much money they should spend on food, and how to allocate funds for items such as snacks from vending machines.
Exercise enhances weight loss; however an exercise plan should be combined with diet and calorie modification.
- Exercise increases physical and cardiovascular health, in addition to improving well-being and self-esteem.
- When weight loss is the goal, some programs have recommended walking at least 1 mile daily.
- Movement and exercise can also be increased by modifying activities and lifestyle routines.
Being overweight or obese carries several important health risks.
- Even if the weight cannot be fully managed, screening and early treatment for diabetes, high cholesterol and lipids, and hypertension is essential to reducing secondary health risks.
- Additional screening of cardiac status and carotid artery blockage may also be appropriate for some.
- Obesity increases risk for cancer of the breast (postmenopausal), endometrium (the lining of the uterus), colon, kidney and esophagus. Consequently, overweight people should be particularly diligent in obtaining age-appropriate cancer screening.
- An emphasis on proper diet and exercise or weight loss can often be strong preventative measures for obesity. Successful prevention may call for attention to the barriers that limit options for individuals with developmental disabilities. Additionally, systemic and regular health screenings can reduce the burden of chronic disease and prolong life.
- In many instances, there exist systematic barriers to proper diet and exercise, including financial limitations, transportation issues, and a lack of awareness of dietary and activity options. Other barriers may stem from caregivers and the lack of a clear program for engaging in regular exercise in residential and day service programs.