Excess weight and obesity: understanding the causes in order to provide a remedy
By Laude de Verdun, dietician at the Jérôme Lejeune Institute.
By properly understanding the mechanisms of weight gain and obesity, we can allow friends and family to educate and help their loved one with Down syndrome.
What might be the causes of excess weight and obesity?
There may be multiple causes of excess weight or obesity. These can include genetic predisposition, weight-gaining treatments (antipsychotics, antiepileptics), eating habits, food-related impulsivity, lack of options for physical activity and sport, and a sedentary lifestyle.
Prevention and treatment of excess weight among people with Down syndrome can be achieved through therapeutic education involving their close circle. It is often complicated for these dependent people to avoid gaining weight. They may have many people around them who aren’t all aware of how important it is to prevent excess weight. People with Down syndrome often gain weight after moving into care home type institutions.
Here are some explanations:
- A culture of giving out little treats at parties or so-called “special” occasions that come around almost daily, and carers who give candy out as rewards too easily.
- Heavy and unbalanced snacks that are not necessary for adults who have finished growing and have no particular additional needs.
- Unsuitable portions (which don’t vary according to age, gender and appetite)
- The lack of an in-house dietician, leading to meals without dietary monitoring on a collective level and a lack of tailored consultation on an individual level.
- Disrupted sleep: sleep can often be disturbed when sleeping in the same room as other residents
- The presence of vending machines
- On the positive side, vending machines allow them to manage their pocket money, giving them a certain independence. They decide how to use their money. Parents also often mention how vending machines create a convivial atmosphere.
- On the negative side, vending machines offer food and drink that is very high in sugar. Care homes should choose vending machines that offer healthy produce (fresh fruit, dried fruit, etc.), or only drinks such as coffee, tea and herbal tea, in order to help residents make healthy choices.
- Little or no physical exercise during the day. People with Down syndrome or a mental disability often take a small bus or car to get to their activities or place of work. They do little physical activity, if any at all.
It is important for this population to opt for low GI foods from a young age and to limit snacking and sugar intake outside of meals. Soda and candy vending machines should be banned in care homes in the same way they are in schools in France (law of August 9, 2004 on public health policy, which prohibits the installation of vending machines in schools as of September 1, 2005).
Since it has such a significant impact on their health, special attention should be paid to the diet of people with Down syndrome on a daily basis.