Changes in physical activity across a 6-month weight loss intervention in adolescents with intellectual and developmental disabilities.
Trackers plus advice are not enough—teens with IDD need skill teaching and daily reinforcement to move more.
01Research in Context
What this study did
Lee et al. (2022) ran a six-month weight-loss program for teens with intellectual or developmental disabilities. Every teen got a Fitbit-style tracker and a goal of 60 minutes of brisk activity each day. Twice a month they also met a coach for lessons on diet and exercise.
The team used a coin flip to decide which teens started the program right away and which waited. Both groups wore accelerometers so the researchers could count real movement, not just logged steps.
What they found
At the end of six months the teens were no more active than before. Average moderate-to-vigorous minutes, sitting time, and body weight all stayed flat. Extra counselling plus a tracker, by itself, was not enough to budge these kids.
How this fits with other research
May et al. (2020) shows one reason the program stalled: it left out reinforcement. May used lottery tickets to reward three adults with developmental disabilities for hitting high heart-rate zones. Every participant reached the target and one lost ten pounds in nine weeks.
Anonymous (2025) gives a second clue. They taught younger students with mild ID to play VR exergames using a clear prompt-fading plan. After sixteen PE sessions the kids played independently and kept moving. T et al. offered no such skill-building or fading steps.
Deserno et al. (2017) explains the tracker-only flop. Kids with developmental coordination disorder met minute goals on active video games, but poor game choice, boredom, and glitches kept the activity meaningless. Meeting a number on a screen is not the same as moving well or having fun.
Why it matters
If you run weight or health programs for teens with IDD, do not rely on trackers and lectures alone. Add real reinforcement like points, prizes, or lottery tickets. Teach the actual movement skills first, then fade prompts. Pick activities that are easy, fun, and glitch-free. Build parent support, because parent activity level is the strongest kid predictor shown in Lee et al. (2022) correlational paper. Make movement pay off today, not six months from now.
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02At a glance
03Original abstract
BACKGROUND: Adolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate-to-vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6-month multi-component weight loss intervention. METHODS: Adolescents and young adults with IDD and overweight or obesity (body mass index ≥ 85 percentile, n = 110, age ~16 years, 52.7% female) and a parent were randomised to one of three intervention groups: face-to-face delivery/conventional reduced energy diet (n = 36), remote delivery (RD)/conventional reduced energy diet (n = 39), or RD/reduced energy enhanced stop light diet (eSLD) (n = 35.) Participants were asked to engage in 60 min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self-monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face-to-face arm was delivered during home-visits and self-monitoring of MVPA and daily steps was completed by self-report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7 days at baseline and 6 months using a portable accelerometer (ActiGraph wGT3x-BT). RESULTS: Mixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4-10 h days) at baseline (n = 68) and 6 months (n = 30) revealed no significant changes in light, moderate- MVPA, or sedentary time across the 6-month intervention (all P > 0.05). Participants obtained 15.2 ± 21.5 min/day of MVPA at baseline and 19.7 ± 19.7 min/day at 6 months (P = 0.119). Mixed modelling indicated no significant effects of group (P = 0.79), time (P = 0.10), or group-by-time interaction (P = 0.21) on changes in MVPA from baseline to 6 months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6 months (n = 24) revealed no significant associations between baseline sedentary time (r = 0.10, P = 0.40) and baseline MVPA (r = -0.22, P = 0.30) and change in MVPA across the 6-month intervention. Additionally, attendance at education/counselling sessions (r = 0.26, P = 0.22) and frequency of self-monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6 months (r = 0.26, P = 0.44). Baseline MVPA (r = 0.02, P = 0.92) and change in MVPA from baseline to 6 months (r = 0.13, P = 0.30) were not associated with changes in body weight across the 6-month intervention. CONCLUSION: We observed a non-significant increase in MVPA (30%), which was not associated with the magnitude of weight loss in a sample of adolescents and young adults with IDD who participated in a 6-month multi-component weight loss intervention. Additional strategies to increase MVPA in adolescents and young adults with IDD participating in weight loss interventions need to be developed and evaluated.
Journal of intellectual disability research : JIDR, 2022 · doi:10.1111/jir.12909