Weight management services for an underserved population: a rapid review of the literature

Abstract

Introduction: Overweight and obesity (OW/OB) rates are increasing among Canadian children and youth, with rates currently affecting one-third of 5–17 year olds. OW/OB is associated with numerous physical and psychosocial consequences, which are compounded when a child has a pre-existing disability. This is concerning considering children with disabilities experience OW/OB at two to three times the rate of their typically developing peers. While the number of weight management programs have been increasing, they are generally designed to meet the needs of typically developing children and often exclude children with disabilities. This review identifies existing weight management programs for youth with disabilities, and examines their characteristics and outcomes.

Methods: A scoping review was conducted using rapid review principles. Three health and social science databases were searched using terms related to “disabilities”, “obesity”, and “weight management”, limited to 2007–2017. Articles meeting the inclusion criteria were summarized and analyzed thematically.

Results: Five articles met inclusion criteria, and described four separate weight management programs. All included children and youth with intellectual disabilities, with one including children with physical disabilities. Programs had three traits in common: (1) utilizing inter/multidisciplinary teams; (2) using technology to deliver the program; and (3) engaging the family during the entire program. All articles reported that the programs reduced body mass index.

Conclusion: The scarcity of programs designed to meet the unique needs of youth with disabilities is alarming. Although a robust evidence base is lacking, current research provides some directions into components that should be considered when designing future interventions.

Implications for Rehabilitation

•    1.  Clinicians should be aware of the high prevalence of overweight and obesity and the resultant consequences in children with disabilities.

•    2.  The use of inter/multidisciplinary teams, technology, and family engagement all appear to be promising approaches to creating successful weight management programs:

•      a.  Weight-management programs should utilize inter/multidisciplinary teams to consider physical, social and psychological aspects of weight and health, to allow treatment plans to encompass a wider range of suggestions and recommendations.

•      b.  Health care providers should consider using technology as a platform to deliver weight-management programs and services and/or to directly track progress.

•    c.  Families are powerful agents of change, and should be consulted and involved in the delivery of weight-management programs.

Keywords:

• Obesity
• disability
• weight management
• children

Acknowledgements

The authors thank Joanne Wincentak for her methodological guidance and Pui Ying Wong for assistance with the search strategy.

Disclosure statement

The authors report no declarations of interest. The first author is supported by the Kimel Family Graduate Scholarship in Pediatric Rehabilitation and the Canadian Institutes of Health Research.