Current knowledge and impressions of speech-language pathologists of the swallow of persons who are obese

Abstract

Purpose: The overall goal of this study was to provide insight on the topic of dysphagia in the obese population. More specifically, the purpose of this study was to obtain preliminary descriptive data on the knowledge and impressions of speech-language pathologists (SLPs) working in the field of dysphagia on the swallow of persons who are obese. Methods: One hundred seventy-seven SLPs responded to a web-based survey that was posted on two popular listserves that serve the dysphagia community. Results: Descriptive results showed that nearly all SLPs have assessed and treated patients who are obese for dysphagia, that there is little consensus as to how the obese swallow compares to the normal swallow, and that there is a consensus that dysphagia observed in the obese population is most likely related to other concomitant disorders. Conclusions: Results provide preliminary insight into the knowledge and impressions of SLPs working with dysphagia and highlight the need for future research to determine (1) if there is an increased incidence of dysphagia in the obese population, and (2) if obesity itself constitutes a risk factor for dysphagia or if any dysphagia observed in this population is related to other comorbidities.

Implications for Rehabilitation

• Many healthcare professionals (i.e. speech-language pathologists [SLPs]) assess, diagnose and treat individuals for swallowing disorders who are obese in the absence of research or evidence-based medicine on the impact of obesity on the swallow or the impact of obesity on dysphagia rehabilitation (e.g. swallowing exercises).

• Results of this study suggest that: there is not a consensus among SLPs on the swallowing characteristics of persons who are obese; that persons who are obese are more at risk for swallowing disorders; and that the increased risk of dysphagia may be related to concomitant disorders and not the presence of obesity itself.

• Clinicians who work with dysphagia need to understand the impact of obesity on the swallow and on dysphagia rehabilitation with persons who are obese. Future research should focus on establishing estimates of swallowing function in persons who are obese. This information can provide a foundation for efficacy studies of various therapy techniques (e.g. exercises) and ultimately can assist with goal setting and intervention planning.

• Deglutition
• deglutition disorders
• dysphagia
• obesity
• swallowing muscles

Acknowledgements

The authors would like to express their gratitude to all of the respondents for providing their impressions and sharing their thoughts and knowledge. The authors also thank Heather Starmer and Kim Webster from the Department of Otolaryngology-Head and Neck Surgery at Johns Hopkins Medical Institute for their invaluable assistance in developing and modifying the survey and Nancy Pearl Solomon for her editorial assistance on a previous version of the manuscript.

Declarations of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Portions of this study were presented at the 2011 ASHA annual convention, San Diego, CA.