Weil Evette, Wachterman Melissa, McCarthy Ellen P, Davis Roger B, O'Day Bonnie, Iezzoni Lisa I, Wee Christina C
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
JAMA. 2002 Sep 11;288(10):1265-8. doi: 10.1001/jama.288.10.1265.
Obesity, a leading cause of preventable death and chronic disease, is associated with disability. Little is known about obesity among adults with specific disabilities.
To determine the prevalence of obesity in adults with physical and sensory limitations and serious mental illness.
DESIGN, SETTING, AND PARTICIPANTS: The 1994-1995 National Health Interview Survey of 145 007 US community-dwelling respondents, 25 626 of whom had 1 or more disabilities.
Likelihood of being obese, attempting weight loss, and receiving exercise counseling among adults with and without disabilities.
Among adults with disabilities, 24.9% were obese vs 15.1% of those without disabilities. After adjusting for sociodemographic factors, adults with a disability were more likely to be obese, with an adjusted odds ratio (AOR) of 1.9 (95% confidence interval [CI], 1.8-2.0). The highest risk occurred among adults with some (AOR, 2.4; 95% CI, 2.3-2.5) or severe (AOR, 2.5; 95% CI, 2.3-2.7) lower extremity mobility difficulties. After further adjustment for comorbid conditions, adults with disabilities were as likely to attempt weight loss as those without disabilities, except for adults with severe lower extremity mobility difficulties, who were less likely (AOR, 0.7; 95% CI, 0.5-0.9]), and adults with mental illness, who were more likely (AOR, 1.4; 95% CI, 1.2-1.8). Physician exercise counseling was reported less often among adults with severe lower extremity (AOR, 0.5; 95% CI, 0.4-0.7) and upper extremity (AOR, 0.7; 95% CI, 0.5-1.0) mobility difficulties.
Obesity appears to be more prevalent in adults with sensory, physical, and mental health conditions. Health care practitioners should address weight control and exercise among adults with disabilities.
肥胖是可预防死亡和慢性病的主要原因，与残疾相关。对于患有特定残疾的成年人中的肥胖情况知之甚少。
确定有身体和感官障碍以及严重精神疾病的成年人中肥胖的患病率。
设计、地点和参与者：1994 - 1995年美国国家健康访谈调查，共145007名美国社区居民受访者，其中25626人有1种或更多残疾。
有残疾和无残疾成年人中肥胖、尝试减肥以及接受运动咨询的可能性。
在残疾成年人中，24.9%为肥胖，而无残疾者中这一比例为15.1%。在调整社会人口学因素后，残疾成年人更有可能肥胖，调整后的优势比（AOR）为1.9（95%置信区间[CI]，1.8 - 2.0）。最高风险出现在有一些（AOR，2.4；95%CI，2.3 - 2.5）或严重（AOR，2.5；95%CI，2.3 - 2.7）下肢活动困难的成年人中。在进一步调整合并症后，残疾成年人尝试减肥的可能性与无残疾者相同，但严重下肢活动困难的成年人可能性较小（AOR，0.7；95%CI，0.5 - 0.9），而患有精神疾病的成年人可能性较大（AOR，1.4；95%CI，1.2 - 1.8）。在有严重下肢（AOR，0.5；95%CI，0.4 - 0.7）和上肢（AOR，0.7；95%CI，0.5 - 1.0）活动困难的成年人中，医生提供运动咨询的情况较少被报告。
肥胖在有感官、身体和心理健康状况的成年人中似乎更为普遍。医疗保健从业者应关注残疾成年人的体重控制和运动问题。
