Managing healthy eating and weight
A successful weight reduction plan needs to take into account the health status, motivation and goals of the person with developmental disability. Consider also the goals and motivation of those who support the person (eg family, carers) because they are often responsible for implementing the plan.
Barriers to successful weight management in people with developmental disability include:
- unhealthy or restricted food choices
- physical disability (may limit physical activity)
- inadequate knowledge of nutrition (of person, family or carers), resulting in poor quality food
- use of food to manage behaviours of concern
- inconsistent intervention across different support settings (eg home, work, day program, social groups)
- frequent use of drugs that contribute to weight gain (eg some psychotropic or antiepileptic drugs).
Review medications and consider alternatives to those that can contribute to weight gain; see also Medication reviews.
A multidisciplinary management approach can help to overcome barriers to successful weight management. Strategies may include:
- ensuring the person has access to suitable (ie plain English) educational resources on healthy eating
- ensuring the diet or eating plan is implemented in all settings (eg group home, day program)
- encouraging group-based physical activities, with the household
- investigating community or volunteer services to support physical activity (eg to accompany individuals on a regular walk)
- incorporating incidental physical activity into daily routines (eg walking rather than driving; using stairs when possible; involving the person in domestic tasks such as dog-walking, vacuuming, hanging the washing)
- encouraging involvement in choice and preparation of meals.
Include daily exercise, healthy nutrition and weight management in the person’s National Disability Insurance Scheme (NDIS) plan (see also Support for people with developmental disability and nutritional disorders); funding may be available for:
- advice from a dietitian on the person’s diet, food shopping lists, and meal plans for the entire household
- meal-delivery plans (eg for those who live independently)
- behaviour support to help monitor and change eating behaviours
- an individual physical activity plan (eg from a physiotherapist).
Refer people with complex or refractory obesity to a multidisciplinary obesity or metabolic clinic that coordinates dietary, psychological, pharmacological and surgical interventions. For people with Prader–Willi syndrome, where hyperphagia seems to be centrally mediated, dietary restriction may also be necessary. Restrictive practices must be managed in accordance with NDIS and state or territory policy and legislation; see also Restrictive practices, the law, and the responsibility of the doctor.