Eating well and exercising regularly can be a challenge for anyone. But for those with autism spectrum disorder or intellectual disabilities, that challenge is exponentially greater.
Many young men and women with autism and intellectual disabilities face a significantly higher risk for obesity, and all the health complications that follow.
Yet, a small, new pilot study suggests that a diet and exercise program tailored to such individuals -- and offered in a group environment with family support -- can halt weight gain or even trigger notable weight loss.
The program paired U.S. Department of Agriculture (USDA) recommendations with "goal-setting to make progress towards eating more healthy foods and engaging in physical activity," explained study lead author Laura Nabors.
"We also encouraged helping with preparing meals with family, and shared information about health with the family to promote family health," Nabors added. She's a professor with the University of Cincinnati (UC) School of Human Services.
Nabors cited medications and unique food preferences -- often for high-calorie foods -- as two main culprits that can drive weight gain in these groups. "They also may not prefer many types of daily activities, due to limited interests for only certain types of activities," she added.
Dr. Dan Coury, medical director of Autism Speaks' Autism Care Network, agreed.
Sensory problems -- including hypersensitivity to tastes or smells -- "can lead to a restricted diet, which may not be healthy, lacking a variety of foods," noted Coury, who is also a professor of pediatrics at Ohio State University.
And alongside coordination and comprehension challenges, "part of having autism is having restricted interests or behaviors," he added. "Many people with autism or intellectual challenges prefer to keep to themselves, and as a result may not venture out for simple exercise such as walking in the neighborhood, much less more strenuous exercise such as running."
That can leave caregivers in a quandary, said Jean Gehricke, an associate research director with the Center for Autism & Neurodevelopmental Disorders.
Because of their food issues, they may resist a balanced diet, putting these young people at risk for weight gain and obesity, he noted. "In addition, parents may have a hard time finding places that are safe for playing outside and running, or being afraid that their child would tantrum or elope in a public space," Gehricke said.
Nabors said that the study aimed to help both parents and their kids by recognizing that "young adults, in this case those with [autism and intellectual disabilities], are more likely to get healthy if they are able to eat healthy foods they like and exercise in ways they enjoy."
With that in mind, the study focused on 17 UC students who were offered programming designed for young adults with autism or intellectual disabilities.
Between January 2020 and April 2021, the students were offered weekly group classes -- either in-person or online (due to COVID lockdowns) -- that provided practical advice concerning good nutrition and regular exercise. The classes were led by a team of 10, including faculty, undergraduate and grad students, and a disability researcher.
Dietary information focused on ideal portion sizes, USDA nutrition recommendations, the importance of vitamins and minerals, and unhealthy foods to avoid. There was also guidance on reducing stress and improving sleep.
In addition, eating and exercise goals were drafted for each student. For example, they were encouraged to increase their fruit intake; to help with meal preparation; to drink water instead of soda; and to spend more time walking, biking, dancing or swimming.
Height and weight measurements were taken every two to three months, and parents were interviewed regarding their child's eating and exercise habits.
The result? While one student gained weight, two of the obese students lost a significant amount of weight. Among the rest, body mass index (a measurement based on height and weight) held steady.
Parental assessments were positive, and three-quarters of the students themselves said they were eating healthier.
The investigators concluded that the program, while preliminary, seemed "promising."
The program's success comes as little surprise to Kim Musheno, vice president of public policy with the Autism Society in Rockville, Md.
All kinds of people sign up for all kinds of weight-loss training programs "because they're looking for help," she said. "They're looking to be taught how to recognize when they're overeating and why. How to exercise. They want to be taught about healthy foods and healthy lifestyles.
"I think we have lower expectations for children with autism and intellectual disabilities," Musheno added. "We think they can't learn. But many really can. They just need support, just like anybody else."
The findings were published online recently in Advances in Neurodevelopmental Disorders.
There's more on autism and obesity at Autism Speaks.
SOURCES: Laura Nabors, PhD, ABPP, CPH, professor, School of Human Services, University of Cincinnati; Kim Musheno, vice president, public policy, Autism Society, Rockville, Md.; Jean Gehricke, PhD, Autism Speaks' Autism Care Network, and associate research director, Center for Autism & Neurodevelopmental Disorders, and associate professor, department of pediatrics, University of California, Irvine; Dan Coury, MD, medical director, Autism Speaks' Autism Care Network, and professor, pediatrics and psychiatry, Ohio State University, and developmental & behavioral pediatrics, Nationwide Children's Hospital, Columbus, Ohio; Advances in Neurodevelopmental Disorders, Aug. 25, 2021, online