Body mass index in adults with intellectual disability: distribution, associations and service implications: a population-based prevalence study.
Flag women with ID, Down syndrome and independent living for fast BMI screening and weight-management support.
01Research in Context
What this study did
The team pulled every adult with intellectual disability who used NHS services in one English region.
They measured height and weight to calculate BMI.
Then they compared the spread of under-weight and obesity to national norms.
What they found
Women with ID were more often obese than other women.
Both men and women with ID were far more likely to be under-weight.
Down syndrome, female sex and living on your own raised the risk most.
How this fits with other research
Nevin et al. (2005) saw the same sex split in Down syndrome only, so the new data show the pattern holds across all ID.
Kovačič et al. (2020) later proved adults with Down syndrome can still lose 5 % body weight with diet-and-exercise coaching, turning the risk flag into an action plan.
Ferguson et al. (2020) used the same registry style and found 7 % diabetes in the same group, linking high BMI to later metabolic disease.
MacRae et al. (2015) pooled earlier papers and said diabetes rates swing wildly; the 2008 BMI map helps explain why—weight itself swings wildly in this group.
Why it matters
You now have a quick risk checklist: woman, Down syndrome, lives alone.
Put those adults first for nutrition screens, kitchen-skill training and active-support goals.
Add BMI to the annual ISP health review and you catch both dangerous thinness and obesity before they snowball.
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02At a glance
03Original abstract
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.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2007.01018.x