Influence of Weight Loss Therapy Programs in Body Image Self-Perception in Adults with Intellectual Disabilities

By Ayaso-Maneiro, Javier; Domínguez-Prado, Diego M. et al. | International Journal of Clinical and Health Psychology, September 1, 2014 | Go to article overview

Influence of Weight Loss Therapy Programs in Body Image Self-Perception in Adults with Intellectual Disabilities


Ayaso-Maneiro, Javier, Domínguez-Prado, Diego M., García-Soidan, José L., International Journal of Clinical and Health Psychology


Body image is defined as a multidimensional model which attempts to explain the interpretation that peo- ple consciously make of their own body (Plesa-Skwerer, Sullivan, Joffre, & Tager-Flusberg, 2004). It is hierarchi- cally organized into two different dimensions: physical and affective-emotional (Miguez, de la Montana, Gonzalez, & Gonzalez, 2011). Most studies carried out in general popu- lation to date, focused on the physical dimension of body image, also named as physical self-concept or body size (Jones, 2012). They generally compared body mass index (BMI) with different contrasted subjective scales, but no consensus conclusions can be drawn from them in terms of accuracy when it comes to the self-assessment of their body image (Knight, Illingworth, & Ricciardelli, 2009; Lynch et al., 2009; Madanat, Hawks, & Angeles, 2011; Miguez el al., 2011; Mikolajczyk et al., 2010; Wardle, Haase, & Steptoe, 2006).

The same analysis of the physical dimension of body image was made in population with intellectual disabili- ties (ID), although with fewer published studies. People with Williams syndrome and Prader-Willi syndrome, both with very defined obesity phenotypes, were more likely to develop wrong physical self-concepts, showing significant discrepancies between the image that they better identi- fied with and their actual BMI values (Napolitano, Zarcone, Nielsen, Wang, & Caliendo, 2010; Plesa-Skwerer et al., 2004; Weiss, Diamond, Denmark, & Lovald, 2003). Moreover, sev- eral studies also reported that ID increased the degree of body dissatisfaction (difference between how they think they looked and how they would like to be) with respect to general population (Reel, Bucciere, & SooHoo, 2013; Yuen & Hanson, 2002).

Consequently, if people with ID were more likely to develop erroneous physical self-concepts of body image, it would be essential to establish the basis of a common construct, grounded on the objective analysis of their real- ity, in order to acquire their psychological welfare (Bégarie, Maïano, & Ninot, 2011; Garrido, García, Flores, & de Mier, 2012). With this study, we attempt to provide additional knowledge on the physical dimension of body image, for contributing to the development of this construct.

This fact forces us to take into account the high lev- els of incidence and prevalence of overweight and obesity, associated with high rates of physical inactivity, which are consistently higher in people with ID when compared to those in general population (Bartlo & Klein, 2011; Bégarie et al., 2011; de Winter, Bastiaanse, Hilgenkamp, Evenhuis, & Echteld, 2012; Gazizova, Puri, Singh, & Dhaliwal, 2011; Melville et al., 2008; Reichard & Stolzle, 2011; Wallace & Schlutter, 2008). Thereby, people with ID need to participate in systematic programs of therapeutic exercise oriented to weight loss (Hilgenkamp, Reis, van Wijck, & Evenhuis, 2012; Melville et al., 2011; Temple, Frey, & Stanish, 2006) and, taking advantage of that, it would be interesting to inves- tigate its possible effects on their physical self-concepts and ultimately on their health related behaviors (Pomp, Fleig, Schwarzer, & Lippke, 2013). This could turn out to be a fundamental aspect, especially in Western cultures, to engage and guide population with ID to the practice of phys- ical activities, proper eating behaviors and to avoid harmful behaviors (Silva, Capurro, Saumann, & Slachevsky, 2013).

Therefore, the first objective of this study was to inves- tigate whether people with ID could correctly identify their physical dimension of body image, and the second one was to determine if participating in a weight loss therapy program (WLTP) influenced in any way their perception of this phys- ical self-concept. To achieve this, a comparison between the body image scale proposed by Stunkard, Sorensen, and Schulsinger (1983), and actual body mass index values was performed before and after an intervention with a WLTP. …

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