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Weight Loss Interventions for Adolescents With Intellectual Disabilities: An RCT

Ptomey, Lauren T., Washburn, Richard A., Goetz, Jeannine R., Sullivan, Debra K., Gibson, Cheryl A., Mayo, Matthew S., Krebill, Ron, Gorczyca, Anna M., Montgomery, Robert N., Honas, Jeffery J., Helsel, Brian C, Donnelly, Joseph E·2021·Pediatrics
DOI 10.1542/peds.2021-050261PMC PMC8477713
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Abstract

OBJECTIVES: In this randomized trial, we compared the effectiveness of 2 diets (enhanced stop light diet [eSLD] versus conventional meal plan diet [CD]) and 2 delivery strategies (face–to–face [FTF] versus remote delivery [RD]) on weight loss across 6 months in adolescents with intellectual and developmental disabilities who were overweight or obese. METHODS: Participants were randomly assigned to 1 of 3 arms (FTF/CD, RD/CD, or RD/eSLD) and asked to attend one-on-one sessions with a health educator every 2 weeks to aid in maintaining compliance with recommendations for a reduced-energy diet and increased physical activity. The CD followed the US dietary guidelines. The eSLD used the stop light guide and was enhanced with portion-controlled meals. The FTF arm was delivered during in-person home visits. The RD arms were delivered by using video conferencing. RESULTS: A total of 110 adolescents with intellectual and developmental disabilities (aged ∼16 years, 53% female, BMI 33) were randomly assigned to the FTF/CD (n = 36), RD/CD (n = 39), or RD/eSLD (n = 35) group. Body weight at 6 months was obtained from 97%, 100%, and 86% of participants in the FTF/CD, RD/CD, and RD/eSLD arms, respectively. The eSLD elicited significantly greater weight loss than the CD: RD/eSLD (−5.0 ± 5.9 kg; −6.4%) versus RD/CD (−1.8 ± 4.0 kg; −2.4%) (P = .01). However, weight loss did not differ by delivery strategy: FTF/CD (−0.3 ± 5.0 kg; −0.2%) versus RD/CD (−1.8 ± 4.0 kg; −2.4%) (P = .20). CONCLUSIONS: The eSLD elicited significantly greater 6-month weight loss compared with a CD when both interventions were delivered remotely. Minimal 6-month weight loss, which did not differ significantly between FTF delivery and RD, was observed with a CD.

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  • Remote delivery of behavioral counseling/education sessions is effective in achieving clinically meaningful weight loss at lower delivery cost in individuals with ID.

    “We selected remote delivery based on the demonstrated effectiveness of this approach in achieving clinically meaningful weight loss at lower delivery cost in individuals with ID17,18.”

    From A cooking skills intervention for long-term weight loss in young adults with intellectual disabilities: Rationale and design for a randomized trial (2026) · cites this paper as [18]

    The Discussion reports clinically meaningful six-month weight loss in adolescents with mild to moderate IDD receiving the remotely delivered enhanced Stop Light Diet intervention (−6.4%; 53% lost at least 5%). The Introduction identifies travel costs as a potential barrier to attending on-site programs, but the paper does not establish that remote sessions had a lower delivery cost. The finding also concerns adolescents with overweight or obesity, rather than individuals with ID generally. (LLM, conf=0.88)

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  • Extending eSLD strategies to younger populations has been less successful, with adolescents and young adults with ID regaining weight after 12 months.

    “However, extending these strategies to younger populations has been less successful, with adolescents and young adults with ID regaining weight after 12 months17,18, underscoring the need for interventions that support long-term behavior change.”

    From A cooking skills intervention for long-term weight loss in young adults with intellectual disabilities: Rationale and design for a randomized trial (2026) · cites this paper as [18]

  • Previous research demonstrated clinically meaningful short-term weight loss in both adults and adolescents/young adults with ID using the eSLD approach.

    “Previous research has demonstrated clinically meaningful short-term weight loss in both adults 15 and adolescents/young adults with ID 18,28 and clinically meaningful long-term weight loss (18–24 mos.)15,16 in adults with ID using the eSLD approach.”

    From A cooking skills intervention for long-term weight loss in young adults with intellectual disabilities: Rationale and design for a randomized trial (2026) · cites this paper as [18]

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Research works printed but not linked: 40

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Metadata

Authors
Ptomey, L. T., Washburn, R. A., Goetz, J. R., Sullivan, D. K., Gibson, C. A., Mayo, M. S., Krebill, R., Gorczyca, A. M., Montgomery, R. N., Honas, J. J., Helsel, B. C., & Donnelly, J. E.
Affiliations
  • Departments of Internal Medicine
  • Dietetics and Nutrition
  • Biostatistics and Data Science, The University of Kansas Medical Center, Kansas City, Kansas
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2021-09-01
Volume
148
Issue
3
ISSN
  • 0031-4005
  • 1098-4275
DOI
10.1542/peds.2021-050261
PMC
PMC8477713
Cited by
26
References
3
Language
en

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