Autism & Developmental

Evaluation of an approach to weight loss in adults with intellectual or developmental disabilities.

Saunders et al. (2011) · Intellectual and developmental disabilities 2011
★ The Verdict

Adults with IDD lost six percent of their weight when shakes, portion meals, walking, and photo rewards were packaged together.

✓ Read this if BCBAs running day-hab or group-home programs for adults with IDD.
✗ Skip if Clinicians who only treat children or who lack approval to handle food incentives.

01Research in Context

01

What this study did

Seventy-nine adults with intellectual or developmental disabilities joined a six-month weight-loss program.

They used meal-replacement shakes, portion-controlled dinners, and picture logs of their food.

Each photo earned a small cash reward. Staff also coached them to walk more.

02

What they found

Most adults stuck with the plan.

The group lost an average of six percent of their starting weight.

Sixty-four out of seventy-three adults dropped pounds.

03

How this fits with other research

Sasson et al. (2022) pooled seventeen exercise-only trials and found no weight change in people with ID.

Mount et al. (2011) shows you need food changes plus rewards, not just walking.

Fahmie et al. (2013) tried diet and exercise with youth. Kids ate less candy but weight stayed the same.

Adding small cash rewards, as R et al. did, may be the missing piece for adults.

04

Why it matters

If you serve adults with IDD, swap one regular meal for a portion-controlled entrée. Add a photo log and a tiny prize. This simple bundle produced real weight loss without fancy equipment or clinic visits. Start Monday with one participant and a phone camera.

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→ Action — try this Monday

Pick one adult, give them a shake at lunch, and pay a dollar for each photo of their plate.

02At a glance

Intervention
self management
Design
pre post no control
Sample size
79
Population
intellectual disability, developmental delay
Finding
positive
Magnitude
medium

03Original abstract

Of 79 overweight adults with intellectual or developmental disabilities who participated in a weight loss intervention, 73 completed the 6-month diet phase. The emphasis in the intervention was consumption of high volume, low calorie foods and beverages, including meal-replacement shakes. Lower calorie frozen entrees were recommended to control portion size. A walking activity was encouraged. Participants attended monthly meetings in which a small amount of cash was exchanged for self-recorded intake and exercise records completed on picture-based forms. Average weight loss was 13.2 pounds (6.3%) of baseline weight at 6 months, with weight loss shown by 64 of the 73 individuals enrolled. Those completing a 6-month follow-up phase showed weight loss of 9.4% of baseline. Increased choice and control are discussed as possible contributors to individual success.

Intellectual and developmental disabilities, 2011 · doi:10.1352/1934-9556-49.2.103