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Bandini L, Danielson M, Esposito LE, Foley JT, Fox MH, Frey GC, Fleming RK, Krahn G, Must A, Porretta DL, Rodgers AB, Stanish H, Urv T, Vogel LC, Humphries K. Obesity in children with developmental and/or physical disabilities. Disabil Health J 2015; 8:309-16. [PMID: 26058685 DOI: 10.1016/j.dhjo.2015.04.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/01/2015] [Accepted: 04/27/2015] [Indexed: 01/20/2023]
Abstract
Children with developmental or physical disabilities, many of whom face serious health-related conditions, also are affected by the current obesity crisis. Although evidence indicates that children with disabilities have a higher prevalence of obesity than do children without disabilities, little is known of the actual magnitude of the problem in this population. To address this concern, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) held a conference on obesity in children with intellectual, developmental, or physical disabilities, bringing together scientists and practitioners in the fields of obesity and disability to foster collaboration, identify barriers to healthy weight status in populations with disabilities, propose avenues to solutions through research and practice, and develop a research agenda to address the problem. This article describes current knowledge about prevalence of obesity in this population, discusses factors influencing obesity risk, and summarizes recommendations for research presented at the conference.
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Affiliation(s)
- Linda Bandini
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 200 Trapelo Road, Waltham, MA 02452, USA; Department of Health Sciences, Boston University, 635 Commonwealth Ave., Boston, MA 02215, USA
| | - Melissa Danielson
- Division of Human Development and Disability (DHDD), National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, MS:E88, Atlanta, GA 30333, USA
| | - Layla E Esposito
- Child Development and Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd., Rockville, MD 20892, USA.
| | - John T Foley
- Physical Education Department, State University of New York College at Cortland, Cortland, NY, USA
| | - Michael H Fox
- Division of Human Development and Disability (DHDD), National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, MS:E88, Atlanta, GA 30333, USA
| | - Georgia C Frey
- Gallahue Family Professor of Child Development, Kinesiology Department, Indiana University, Bloomington, IN, USA
| | - Richard K Fleming
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125-3393, USA
| | - Gloria Krahn
- Barbara E. Knudson Endowed Chair in Family Policy, Director of External Relations and Economic Development, College of Public Health and Human Sciences, Oregon State University, 2361 SW Campus Way, Corvallis, OR 97331-8687, USA
| | - Aviva Must
- Department of Public Health & Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111, USA
| | - David L Porretta
- Kinesiology, Ohio State University, PAES Building A-244, 305 West 17th Ave., Columbus, OH, USA
| | | | - Heidi Stanish
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125-3393, USA
| | - Tiina Urv
- Intellectual and Developmental Disabilities Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd. Bethesda, MD 20892, USA
| | - Lawrence C Vogel
- Shriners Hospitals for Children, Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA
| | - Kathleen Humphries
- The University of Montana Rural Institute on Disabilities, 52 Corbin Hall, Missoula, MT 59812, USA
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Kirschenbaum DS, Gierut KJ. Five recent expert recommendations on the treatment of childhood and adolescent obesity: toward an emerging consensus--a stepped care approach. Child Obes 2013; 9:376-85. [PMID: 24044703 DOI: 10.1089/chi.2013.0058] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Various organizations published five sets of expert recommendations recently: 2007 Healthcare Organizations' Four Stage Model; 2006 Canadian Clinical Practice Guidelines; 2008 The Endocrine Society Recommendations; 2009 Seven Step Model; and 2010 US Preventive Task Force Recommendations. METHODS We compared the recommendations' approaches and conclusions pertaining to four treatments (self-help groups, outpatient cognitive-behavior therapy [CBT], immersion CBT, and surgery). RESULTS All of the expert committees supported using intensive dietary, physical activity, and cognitive-behavioral counseling; two of the five groups discouraged reliance on educational interventions alone, and two of the groups explicitly promoted a stepped-care approach. CONCLUSIONS Greatest benefits may accrue by encouraging healthcare providers and parents to view medical management and education as foundations to change, but to pursue increasingly intensive viable options until overweight and obese children make clinically significant progress toward improved health and happiness.
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Kirschenbaum DS, Pecora K, Raphaeli T, Germann JN. Do as I do? Prospects for parental participation 1.5 years after immersion treatment for adolescent obesity. Clin Obes 2011; 1:92-8. [PMID: 25585574 DOI: 10.1111/j.1758-8111.2011.00019.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study compared successful with unsuccessful participants and their mothers 1.5 years following completion of an immersion programme for the treatment of adolescent obesity. Teenagers (M age = 14.5; 69.5% female) participated in a 4- to 8-week therapeutic camp; those who continued losing weight 1.5 years post-camp were identified as 'Losers'; those who regained weight were considered 'Gainers'. Twenty-six Loser campers, 23 Gainer campers and all mothers were interviewed about their current weights and lifestyle habits. Losers' and Gainers' mothers both reported losing weight significantly. Relative to Gainer mothers, however, Loser mothers reported 26% fewer high-fat foods in the house and greater likelihood of self-monitoring. Loser campers, relative to Gainer campers, reported self-monitoring more consistently; using trainers more frequently; and consuming fewer calories and less fat. Gainer campers also reported a tendency to use family therapy more than Loser families. The Loser campers reported following the dictates of the programme more than the Gainer campers, as expected. One striking and unique finding, however, was that Gainer mothers seemed to follow the programme for themselves as much as Loser mothers. Apparently for some participants in immersion treatment (like the Loser campers in this study), parents who participate fully may promote sustained success; for other adolescent weight controllers (like the present Gainer campers), having 'Do as I do' mothers clearly does not guarantee sustained changes in lifestyle for the teenagers. A hypothesis based on these results is that additional cognitive-behaviour therapy subsequent to immersion may be useful for this latter group.
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Affiliation(s)
- D S Kirschenbaum
- Northwestern University Medical School, Chicago, IL, USAWellspring Division of CRC Health Group, Chicago, IL, USAIllinois School of Professional Psychology at Argosy University, Chicago, IL, USAChildren's Medical Center - Dallas, Dallas, TX, USA
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Kelly KP, Kirschenbaum DS. Immersion treatment of childhood and adolescent obesity: the first review of a promising intervention. Obes Rev 2011; 12:37-49. [PMID: 20070541 DOI: 10.1111/j.1467-789x.2009.00710.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Obese children have attended weight loss camps and residential programmes for more than 40 years. This paper provides the first systematic review of the effects of those programmes. Twenty-two studies met inclusion criteria (targeted and assessed change in weight status, minimal stay of 10 days and nights). Similar components across programmes included controlled diet, activities, nutrition education, and therapy and/or education regarding behaviour change. Participants lost substantial amounts of weight in all 22 studies, as measured by reductions in per cent-overweight during intervention. Eleven programmes included long-term follow-up evaluations. Compared with results highlighted in a recent meta-analysis of out-patient treatments, these immersion programmes produced an average of 191% greater reductions in per cent-overweight at post-treatment and 130% greater reduction at follow-up. Furthermore, mean attrition rates were much lower when compared with standard out-patient treatment. Inclusion of a cognitive-behavioural therapy (CBT) component seemed especially promising; follow-up evaluations showed decreased per cent-overweight at follow-up by an average of 30% for CBT immersion programmes vs. 9% for programmes without CBT. Explanations for the potentially greater impact of immersion relative to out-patient treatments are presented, including possibly differential effects on self-efficacy for both children and their parents.
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Affiliation(s)
- K P Kelly
- Wellspring, CRC Health Group, Cupertino, CA, USA.
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McLaren L, Adair C, von Ranson K, Russell-Mayhew S, de Groot J, Laverty S, Ball GD, Campbell K, Clark CG, de Freitas T, Hall K, McNeil D, Pacaud D, Porteous T, Sharma AM, Waterman M, Watson-Jarvis K. First, Do No Harm. ACTA ACUST UNITED AC 2009. [DOI: 10.1089/obe.2009.0514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Lindsay McLaren
- Dept of Community Health Sciences, University of Calgary, Canada
| | - Carol Adair
- Depts of Psychiatry and Community Health Sciences, University of Calgary, Canada
| | | | | | | | - Susann Laverty
- SU Wellness Centre (Counselling), University of Calgary, Canada
| | | | | | - Camillia G. Clark
- Pediatric Nephrology Program Alberta Children’s Hospital, University of Calgary, Canada
| | | | - Kristyn Hall
- Child Health, Alberta Children’s Hospital, Canada
| | - Deborah McNeil
- Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada
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