Disabilities Can Change Weight-Loss Rules

It's disconcerting enough when you think you're doing the right thing - eating healthy, following the recommended food guidelines - and not getting the hoped for results with a smaller waist and lower weight. It's even worse when you find out that, in fact, you weren't really following the rules all that well after all.

Apparently, that's often the case, especially for women with disabilities.

In one national study, 77 percent of women with disabilities who were surveyed reported that they thought they ate a balanced diet. In another, half of the women with disabilities surveyed said they chose healthy foods. Yet, that same study indicated that only 19 percent of the women involved ate the correct amount of fruits and vegetables, and less than half limited their fat intake.

Perhaps that's part of the reason being overweight or obese is a common secondary condition for women with disabilities. According to Healthy 2010, a national healthy living initiative, only 35 percent of women with disabilities maintain a healthy weight.

In addition to the more obvious issues of mobility, stamina and dependence on others that can affect food purchases, preparation and choice, there are additional societal and economic factors that can make it difficult for women with disabilities to have sufficient control over weight-related issues, such as a lack of economic resources or the need for certain medications.

However, there are even more basic barriers to overcome.

While there are proper weight guidelines and countless weight-loss programs available, methods for obtaining the basic beginning information are often not accessible. For example, most typical scales cannot accommodate someone unable to balance for more than a few seconds, or someone who uses a wheelchair or other assistive device. So answering the most basic question, "What is your weight?" - the starting point for any weight loss program - can be problematic for some women with disabilities without a special trip a rehabilitation center or hospital, which can be tough because of transportation or other issues. This also can make it difficult to track weight-loss progress.

Also, methods for determining Body Mass Index, a widely used factor in determining proper weight, typically do not have an adjustment for limb loss or muscle atrophy. An accurate BMI is also dependent on height measurement, which could be challenging to obtain. That said, there is at least one BMI chart for people with spinal cord injuries available on the Internet.

Determining the correct caloric intake also can be a challenge, as most daily guidelines seem to be based on a particular level of physical activity. How much that needs to be adjusted for someone who uses an electric wheelchair, for example, or even a walker, is not clear, or easy to find.

What is clear is the seriousness of carrying excess weight, including the added risk for many other physical health problems. Being overweight can contribute to emotional problems, including low self-esteem, depression and stress. And some data indicate women with disabilities already are highly likely to be struggling with these issues.

Unfortunately, there aren't any easy answers, and the best defense is self-advocacy and education. Keep a log of food and drink intake, keep questioning health care providers, keep asking for access to scales and keep searching and re-searching the Web for useful information and inspiration. As the disabled population continues to increase, perhaps the answers will, too.