Managing weight with a learning disability
It's important for everyone to be a healthy weight. If you look after someone with a learning disability who needs to lose or gain weight, there are ways you can help them.
Having a learning disability can make it harder to understand new information, learn new skills and communicate.
Some people with learning disabilities may find maintaining a healthy weight difficult, and they may need help understanding information and advice about diet and nutrition, cooking and regular physical activity.
Learning disability charity Mencap says that people with a learning disability are more likely to be either underweight or overweight. People with profound and multiple learning disabilities are often underweight because of poor feeding and swallowing, while others are overweight because they aren’t getting the support they need to make healthy diet and lifestyle choices.
In some cases, learning disabilities are associated with other conditions that make being overweight more likely, such as Down's syndrome , which also affects a person’s height, or Prader-Willi syndrome , which causes an insatiable appetite. These factors can make weight management particularly challenging.
If you care for a person with a learning difficulty, it’s important to think about helping them to maintain a healthy weight. Being underweight or overweight raises the risk of serious health problems, and can affect their quality of life.
There are easy read leaflets on food and easy read leaflets on exercise that can help people with learning disabilities to build their knowledge, understanding and confidence in this area.
Body mass index (BMI) is generally the best measure of whether someone is a healthy weight for their height. You can check the BMI of someone you care for by using our BMI healthy weight calculator.
However, it's sometimes not enough to use BMI to check the weight of someone with a disability, as this may not give the full picture. For example, the person may have a health condition that can affect their weight or height. If this is the case, their doctor can help.
What you can do
Elaine Gardner is a dietician with experience in working with people with learning disabilities, and their carers.
Elaine says it is important to think about the lifestyle of the person you care for, and how it can be changed to promote a healthy, balanced diet and to include more physical activity, if needed. She says good communication is key:
“People with learning disabilities live in all kinds of situations. Some may live independently, sometimes with help from support workers. Others may live with their carer,” says Elaine.
“Whatever the circumstances, it’s really important that, when interacting with the person you’re looking after, you give them information and support to encourage healthy choices.”
If you are concerned about the weight of the person you care for, set a time to sit down and talk about it.
A conversation that includes the person with learning disabilities, carers and support workers is a good way to begin to make lifestyle changes.
It may also be necessary to ask the person's doctor to investigate any underlying medical problems that may be related to unusual weight loss or weight gain.
Elaine suggests how diet changes can be made in the following situations:
- Shopping for food : Help the person you care for to draw up a shopping list of foods and drinks. Using pictures on the list is helpful if they are shopping on their own and have trouble reading. Set a time for a weekly shop, and encourage healthy choices.
- Cooking at home : Draw up a cooking schedule for the person you care for. Make sure it contains healthy meals, and that, if necessary, support is provided around mealtimes to ensure that regular, healthy meals are eaten. See below for resources that can help you to plan and make healthy meals for the person you look after.
- Between meals : Encourage the person you care for to make healthier choices when buying snacks – for example, by swapping biscuits for fruit.
- Out and about : If the person you care for eats out regularly in restaurants or a canteen, encourage them to make healthy choices from the menu.
- Keep records : If you feel that the person you care for isn't eating properly, keep records of the food they eat and the food they waste, to build up a picture of their eating habits.
Counting calories? Check out our handy guide to What 100 calories looks like. You might be surprised at the differences between certain food groups.
If the person concerned needs to increase their energy intake to gain weight, one step is to look at increasing their portion sizes. If, however, their appetite is poor or they are unable to eat more, it may be appropriate to give them calorie-enriched foods or drinks to supplement their diet, or to fortify (add essential nutrients) their food on a short-term basis. However, you should first seek advice from a health professional, to ensure that the person's individual needs are met and they have a tailored nutrition plan in place to monitor any dietary supplements.
Get more advice for underweight children and underweight adults.
Exercise is key to managing weight, not only because it helps burn calories for those needing to lose weight, but because it can also stimulate appetites for people needing to gain weight.
How can you help the person you care for build more physical activity into their day? Elaine suggests talking to them about the activities they are interested in. Think about scheduling regular physical activity and providing support, if necessary, to help ensure that it happens.
To make sure the person you care for is getting enough exercise, check what their recommended physical activity guidelines are. For example, mobile adults aged 19-64 should try to be active daily and do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week.
Find physical activity guidelines for:
- young people (5-18 years old)
- adults (19-64 years old)
- older adults (65 and over)
Getting more support
If you need more support in helping the person you care for to manage their weight, go with them to see their doctor.
“People with a learning disability should have an annual health check with their doctor,” says Elaine. "If you are concerned about their weight, then make an appointment.
“Their doctor can advise on physical activity and healthy eating. In some areas, there are community support programmes for people with learning disabilities and their carers, which teach people about how to maintain a healthy weight. Their doctor will know what’s available locally and be able to refer them.”
If the person you care for is overweight, ask the doctor if there is a community weight management service they can benefit from. The service aims to help people:
- achieve a sustainable weight loss
- limit further weight gain
- get into a regular eating pattern
- achieve a balanced diet
- become more physically active
- reduce overeating and portion sizes
- learn new long-term lifestyle skills
Anyone who wants to use the service is screened by a qualified weight management adviser to determine their suitability for the service and their programme preference. For some people with learning disabilities, a one-to-one programme may be available.
See below for resources that can help with physical activity.