OBESITY AND SWDSPrepared for PACO III

Prepared by:

The Honorable Robert H. Pasternack,Ph.D.

Senior VP

Cambium Learning Group

INCIDENCE/PREVALENCE

According to the Centers for Disease Control and

Prevention (CDC):

SWDs are 38% more likely to be obese than their

non-disabled peers

DOWN SYNDROME

One study found that among teens with Down

syndrome, 86% were either overweight or obese.

Those figures are just as startling for children with

other disabilities

INCIDENCE/PREVALENCE

13% of U.S. families have a child with a disability.

Too often, children with special needs

have been left out of the obesity discussion

SWDS

While SWDs are children first, and disabled

second, they require an extra level of

thoughtfulness, advocacy and attention in order to

maintain a healthy weight.

SOLVING OBESITY

Solutions that work for typically-developing

children may NOT work for SWDs without

modification,

Those solutions that DO work may not be available

in their community

SWDS

SWDs do NOT exhibit the self-regulation of hunger

and fullness that non-disabled kids have

OBESITY

Obesity is defined using body mass index (BMI),

which is an estimate of the amount of body fat a

person has based on his or her height and weight

OVERWEIGHT OR OBESE?

A child is considered overweight if he or she has a

BMI at or above the 85th percentile and lower than

the 95th percentile for children of the same age and

sex.

OBESITY

A child is considered obese if he or she has a BMI

at or above the 95th percentile for children of the

same age and sex

GLOBAL ISSUES

Obesity is a global problem.

Overweight and obesity are the fifth leading risk

factors for global deaths and the problem is

increasing..

GLOBAL ISSUES

Worldwide, obesity has more than doubled since

1980

U.S.A.

In the U.S., more than one-third of all adults are

obese

SWDS

Research has demonstrated conclusively that both

PWDs and SWDs are significantly more likely than

their peers to be overweight or obese

OBESITY

Once people get very heavy, they tend

not to want to do physical activity.

It’s almost a self-fulfilling death sentence .

COSTS

The CDC estimates that health care costs of obesity

related to disability reach $44 billion each year

INCIDENCE/PREVALENCE

According to data from the National Health and

Nutrition Examination Survey (NHANES), 22.5% of

children with disabilities are obese compared to 16%

of

children without disabilities.

GENDER

The problem is more pronounced among girls than

boys

GENDER

Among girls with disabilities age 2-17, the

prevalence of obesity is 23%.

Among their peers without disabilities, the

prevalence is 14%.

GENDER

Among boys with disabilities age 2-17, the

prevalence of obesity is 21%.

Among their peers without disabilities, the

prevalence is 17%.

TWEENS

The problem is particularly acute among young

teens and “tweens.”

The CDC has found that while 18% of

children age 10-14 without disabilities are obese,

the rate for children in the same age group with

disabilities is 30%.

NHANES DATA

80.6% of children with functional limitations on

physical activity were either overweight or obese.

• 50.8% of children receiving special education

services were either overweight or obese.

• 44% of children with Attention Deficit Disorder

(ADD) were either overweight or obese.

ASD

67.1% of the teens with autism spectrum

disorder were either overweight or obese

ASD

• Children with autism are 40% more likely to be

obese than children without autism.

• Children with autism refused foods more than

twice as frequently as their typically developing peers.

• Children with autism consumed more sugar

sweetened beverages and snack foods than their

neuro-typical peers.

DOWN SYNDROME

86.2% of the teens with Down syndrome

were either overweight or obese

COGNITIVE & INTELLECTUAL DISABIL IT IES

39.6% of the teens with intellectual disability

were either overweight or obese

SWDS

SWDs already work harder than their counterparts

just to accomplish

everyday tasks.

Obesity adds an additional layer of difficulty for

both children and their caretakers.

OBESITY

Obesity can make movement more difficult and

curtail a child’s ability to participate in activities,

Including :

P.E.; Playground; Recess; Athletics; Special

Olympics…

BULLYING

Obesity adds an added stigma for children who may

be already stigmatized because of their disability

Bullying occurs more frequently to SWDs than non-

disabled peers

COSTS

Obesity incurs additional health care costs for the

families of SWDs and our entire society

CAUSES OF OBESITY

• The higher price of healthy foods compared to

unhealthy foods

• Increased portion sizes

• Increased availability of processed foods

• Increased consumption of sugar-sweetened drinks

• Decreased physical activity

• Increased screen time

CAUSES OF OBESITY

Inadequate sleep that has been tied to weight gain.

• Increased exposure to endocrine-disrupting chemicals in

food and the environment, which may alter metabolism.

• Climate controlled environments that reduce the

calories burned by sweating and shivering.

• Women giving birth at older ages, which correlates with

heavier children.

RISK FACTORS FOR OBESITY IN SWDS

Risk Factor 1:

A More Complex Relationship with Food

Children with ASD may have an intense aversion to

certain textures, flavors or colors, leading them to eat

a very limited assortment of foods

PARENTS

Parents of children with special needs often are

reluctant to clash with their children over food

PEERS

Another element of Risk Factor1 is peer influence.

The desire to fit in is strong for any child,

particularly one with a disability

SWDs want to eat what their peers are eating

USING FOOD

Parents, therapists and TEACHERS may be in the

habit of using food for behavior modification,

Sometimes food is used to express affection or win

compliance

RI SK FACTOR 2 : BARR IERS TO EXERC I SE

Exercise is vital not just for maintaining a healthy

weight, but also for muscle tone, circulation and

mood

PHYSICAL DISABILITIES

39% of youth with Physical Disabilities

report never exercising at all, according to one study.

BARRIERS

The child’s own functional limitations,

The high cost of specialized programs and

equipment,

A lack of nearby facilities or programs.

RISK FACTOR 3: MEDICATIONS

75% of children with a special health care need take

at least one prescription drug.

Many medications, particularly certain

antipsychotics, antidepressants, anticonvulsants,

neuroleptics and mood

stabilizers, are associated with weight gain.

RISK FACTOR 4: FAMILY STRESS

Parents of SWDs often have schedules crowded with

medical and therapeutic appointments

FAMILY STRESS

With parents of SWDS having so much to do, high

calorie prepared or packaged food may seem like a

more viable option than cooking meals from scratch.

PARENTS

Healthy food, inclusive fitness classes or

professional consultation may simply be financially

out of reach for many parents of SWDs

RISK FACTOR 5 : GENET IC D ISORDERS

Certain genetic disorders that cause SWDs have

obesity as clinical features

RISK FACTOR 6: PERCEIVED RISK

Parents, TEACHERS,pediatricians and coaches may

feel that the activity will be too difficult, too

dangerous, or too disappointing for a child with a

physical, intellectual, or behavioral disability

PEDIATRICIANS

Pediatricians frequently underestimate the benefits

and overestimate the risks of physical recreation for

children with chronic health issues

RISK FACTOR 7: SOCIAL ISOLATION

Children with special health care needs may have fewer

friends than other children their age and thus may miss

out on the chance for free play in an outdoor setting.

SWDs may also be excluded from team sports because

others believe they won’t contribute to victory

RISK FACTOR 8: SCREEN TIME

Screen Time is strongly associated with obesity.

If a child is less engaged in physical activity than

they’re more engaged in sedentary behavior

SCREEN TIME

Childhood obesity is almost directly correlated with

the amount of time children spend in front of

computers and televisions

RECOMMENDATIONS

We need public policies that support physical

activity programs for PWDs.

We need more investment in programs both public

and private.

Private sports and fitness clubs must offer

choices for PWDs

RECOMMENDATIONS

Absence of curb cuts, crosswalks, sidewalks, or

working elevators are major impediments for PWDs

who may be trying to go for a fitness walk or reach a

swimming pool or inclusive exercise class.

Remove BARRIERS

RECOMMENDATIONS

P.E. as a core subject in schools

Increase amount of physical activity for SWDs in

schools

Build capacity of the learning community to focus

on Obesity Prevention