Disabled children are at great risk of developing obesity. In the current issue of Deutsches Ärzteblatt International, Thomas Reinehr and his colleagues from Witten/Herdecke University describe possible ways to prevent or treat this problem (Dtsch Arztebl Int 2010; 107(15): 268-75).
There are many reasons that a disabled child may be overweight. One reason may be the disability itself, for example, if this includes the cerebral regions responsible for weight regulation. Lack of exercise may also be important; this may be linked to a physical or mental disability or be due to overprotective care providers.
These children or adolescents are anyway restricted by their disabilities and the consequences of overweight are often more serious than for healthy persons. Problems associated with disability include social isolation, restricted mobility, and depression. These problems are often exacerbated by overweight, further reducing the child's independence.
Current therapeutic approaches for obese children and adolescents are of little or no use for obese disabled children. Only a few interventional studies have been performed which are adapted to specific disabilities. The patients can be assisted in reducing their overweight if they are instructed about the importance of nutrition and exercise and are helped in reducing factors which restrict their mobility.