Interventions for adults with intellectual disabilities who are obese
Obesity is linked to serious medical conditions including type 2 diabetes, coronary heart disease, stroke and certain cancers (1,2). The problem of obesity in England is greater for adults with intellectual disabilities (ID) than it is for the general adult population (3). Being obese greatly reduces both the quality of life and the life expectancy of people with ID (4-8). UK obesity guidance recommends multi-component weight management interventions (MCIs), tailored for different population groups (9-12).
This study aimed to explore how multi-component weight management interventions (MCI) can be tailored for adults with intellectual disabilities (ID) who are obese. The study included three phases. Phase one involved an integrative review of MCIs for adults with ID, and a mapping exercise to explore the extent of MCI service provision for adults (including tailored services for adults with intellectual disabilities). Phase two involved semi-structured interviews with a selective sample of NW health care practitioners (including GPs); focus groups involving a selective sample of adults with ID from the NW; and a convenience sample survey of NW carers. Phase three involved synthesis of findings from phases one and two, the sharing of synthesised findings with an expert panel and the development of a theoretical model to inform improvements to MCIs for this population group.
Phase one found some emerging evidence to suggest ways in which MCIs can be tailored for this population group but, due to the few studies and examples identified, it was not possible to recommend how MCIs can be routinely tailored. Phase two identified important barriers and facilitators to weight management from the perspectives of health care practitioners, adults with ID and their carers or supporters. Phase three produced a theoretical model for use in improving MCIs for this population group. To the best of our knowledge, this is the first study which included the perspectives of health care practitioners, adults with ID and their carers to explore barriers and facilitators to weight management and how MCIs can be routinely tailored for adults with ID who are obese. Uniquely, people with ID were involved in the design and co-production of research materials for use in eliciting the views and experiences of this population group.
Obesity is a health inequalities problem for adults with ID. Responding to this is an important matter for policy makers, health care practitioners, service commissioners, providers and researchers. This study’s findings are expected to contribute to obesity and MCI research, policy, guidance and practice for this population group. The study contributes to the work of the National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care, North West Coast (NIHR CLAHRC NWC) in tackling health inequalities.