AAHD's Health Promotion and Wellness: Part 1: Obesity and Disability

Article excerpt

Welcome to a new series from the American Association on Health and Disability (AAHD). The mission of AAHD is to advance health promotion and wellness interventions for children and adults with disabilities. AAHD accomplishes its mission through advocacy, education, public awareness and research efforts at the federal, state and community levels. AAHD staff will be writing a series of articles on "Health Promotion and Wellness" for the next 3 issues of Exceptional Parent. We hope you enjoy these articles and consider joining AAHD to receive the Disability and Health Journal and have access to current research, policy and programmatic information on disability and health via AAHD updates. Visit www.aahd.us to learn more about AAHD and membership.

Obesity increases the risk of many health conditions, including heart disease, type 2 diabetes, cancers, high blood pressure, lipid disorders, stroke and more. While obesity affects more than one third of all adult Americans, people with disabilities are more likely to be overweight or obese and often have fewer tools for controlling weight at their disposal.

* 20% of children age 10 through 17 with special health care needs are obese versus 15% of children without special health care needs. (1)

* Children and adults with mobility limitations and intellectual or learning disabilities are at greatest risk for obesity. (2)

* Obesity rates for adults with disabilities are 58% higher than for adults without disabilities (3)

LINK BETWEEN DISABILITY AND OBESITY

Looking at the link from different directions, almost 20% of overweight adults and roughly 30% of obese adults also have a disability, while roughly 36% of people with disabilities are also obese. (3) Of adolescents with special health care needs, more than 35% were either overweight or obese. (4) The same report found that adolescents with special health care needs who are also obese were more likely not to participate in sports or do daily physical activities, watch two or more hours of TV per day, have a TV in their bedrooms, live in unsafe neighborhoods, and experience limitations in attending school, making friends and participating in activities.

To determine obesity in adults, weight and height are used to calculate body mass index (BMI). Adults whose BMI is between 25 and 29.9 are considered overweight, and those whose BMI is 30 or higher are considered obese. For children of the same age and sex, the CDC defines overweight as a BMI at or above the 85th percentile and obesity as a BMI at or above the 95th percentile. However, many researchers believe that for people with disabilities, BMI is not always the best way to measure overweight and obesity because it can underestimate fat in people with less lean muscle mass (http://www.cdc.gov/ncbddd/disabilityandhealth/obesity.html). Some researchers prefer to use waist measurement to determine whether people with disabilities are overweight or obese.

WHY ARE PEOPLE WITH DISABILITIES MORE LIKELY TO BE OVERWEIGHT OR OBESE?

There are many reasons why people with disabilities may have a higher incidence of overweight and obesity, including the following:

* They might have fewer healthy food choices.

* Some medications affect appetite and contribute to weight gain.

* Physical limitations, pain or lack of energy can exercise more difficult. …