Service Delivery

Overweight and obesity in older people with intellectual disability.

de Winter et al. (2012) · Research in developmental disabilities 2012
★ The Verdict

Most older adults with ID are obese; check BMI and waist yearly and pair any exercise plan with diet and behavior supports.

✓ Read this if BCBAs serving adults with ID in day programs or residential settings.
✗ Skip if Clinicians working only with children under 18.

01Research in Context

01

What this study did

Grindle et al. (2012) weighed and measured 945 Dutch adults with intellectual disability who were 50 or older.

They used BMI and waist size to judge obesity.

The team also recorded medicine use, exercise level, and living place.

02

What they found

About 1 in 4 adults had obesity by BMI.

Almost half had obesity by waist size.

Rates were higher than in same-age adults without disability.

Down syndrome, little exercise, and antipsychotic drugs raised risk.

03

How this fits with other research

Hsieh et al. (2014) saw the same pattern: adults with ID carry more obesity, especially women and those with Down syndrome.

Sasson et al. (2022) pooled 17 exercise trials and found workouts alone did not shrink obesity numbers.

That seems to clash with F et al.’s call for “address inactivity,” but the two papers measure different things.

F et al. counted how many people are obese; J et al. asked if exercise fixes it.

Together they tell us: screen first, then plan diet plus behavior support, not just gym time.

04

Why it matters

Add waist circumference to every annual BMI check for clients 50-plus with ID.

Flag Down syndrome, low activity, and antipsychotic use as red flags.

Pair any activity goal with nutrition and behavior plans—exercise alone is not enough.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Measure waist and BMI today for every client 50-plus with ID and note antipsychotic use.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
945
Population
intellectual disability, down syndrome, autism spectrum disorder
Finding
not reported

03Original abstract

Overweight and obesity are major health problems associated with increased cardiovascular disease risk, which is not sufficiently studied in people with intellectual disability yet. The present study was part of the Healthy Ageing in Intellectual Disability (HA-ID) study. The aim of this study was to establish (1) the prevalence of overweight, obesity and body fat percentage in older people with intellectual disability (ID) through measurement of Body Mass Index (BMI), waist circumference, waist-to-hip ratio (WHR) and skin fold thickness, and compare this with prevalence of overweight and obesity in the general population, and (2) the association of overweight and obesity with participant and treatment characteristics (gender, age, level of ID, Down syndrome, autism, independent living, smoking, (instrumental) activities of daily living ((I)ADL), physical activity and use of atypical antipsychotic medication) using regression analyses. In this cross-sectional study 945 persons, aged 50 and over with borderline to profound ID, living in central settings, in community settings and independently were included. Overweight and obesity were highly prevalent, with more obesity (26%) than in the general Dutch older population (10%) as measured by BMI, and 46-48% obesity as measured by waist circumference and WHR respectively. Women, people with Down syndrome, higher age, less severe ID, autism, people who are able to eat independently, preparing meals and doing groceries independently, people with physical inactivity and use of atypical antipsychotics were significantly more at risk of being overweight or obese. This merits specific actions by policy makers and clinical practice to improve health outcomes.

Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.09.022