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Doctors need to be attentive to the weight concerns of disabled adults, who are twice as likely as other adults to be obese

Adults with physical or sensory (sight or hearing) disabilities and those who have serious mental health problems are nearly twice as likely to be obese as other adults, and they usually want to lose weight, concludes a new study. Individuals who find it difficult to stand, walk, or climb stairs have the highest risk of becoming obese, probably due to their limited ability to exercise.

Doctors should address the weight concerns and exercise opportunities of disabled patients to help them avoid obesity, suggest Christina Wee, M.D., M.P.H., and Lisa I. Iezzoni, M.D., M.Sc., of Beth Israel Deaconess Medical Center. In the study supported in part by the Agency for Healthcare Research and Quality (HS10223), the researchers used data from the 1994-1995 National Health Interview Survey of 145,007 community-dwelling people in the United States—25,626 of whom had one or more disabilities—to calculate the likelihood of being obese among adults with and without disabilities.

Among disabled adults surveyed, 25 percent were obese versus 15 percent of nondisabled adults. After adjusting for sociodemographic factors, disabled adults were twice as likely as nondisabled adults to be obese. Individuals with lower extremity mobility difficulties were most likely to be obese, followed by those with limited vision and hearing problems. After further adjustment for coexisting medical problems, disabled adults were as likely as nondisabled adults to try to lose weight.

The exceptions were adults with severe lower extremity mobility difficulties, who were less likely to attempt weight loss, and adults with mental illness, whose psychotropic medications often caused them to gain weight, who were more likely to try to lose weight. Doctors were as likely to counsel disabled as nondisabled adults about weight loss, except for disabled adults with severe lower extremity and upper extremity mobility difficulties, perhaps because they perceived greater impediments to their physical activity. More research is needed on the link between sensory disabilities and weight, concludes Dr. Iezzoni.

More details are in "Obesity among adults with disabling conditions," by Evette Weil, B.A., Melissa Wachterman, B.A., Ellen P. McCarthy, Ph.D., M.P.H., and others, in the September 11, 2002 Journal of the American Medical Association 288(10), pp. 1265-1268.

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