OBESITY AND SWDS
Prepared 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 nondisabled 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
DISABILITIES
 39.6% of the teens with intellectual
either overweight or obese
disability were
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 nondisabled 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
R I S K FA C TO R 2 : B A R R I E R S
TO E X E R C I S E
 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:
GENETIC DISORDERS
 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