Table 1 Multi-component interventions

Jackson 1982 [31]

Gender: all females

Duration: 14 weeks of every 2 weeks group sessions (60 min each) led by a teacher.

(a) Mean weight change, kg: -5.75^b

(b) Mean weight change, kg:-0.59

Australia

(a) Treatment group

(a) 7 sessions with the parents, 6 sessions with group members and the teacher. Diet: Advice on healthy eating diet, avoid fad diets. Activity: General advice on physical activity e.g. using stairs instead of elevator. Behaviour: self-monitoring, reward, punishment, change of rate of eating, reinforcement.

(a) Mean weight change, kg :-6.25

(b) Mean weight change, kg :-0.59

(a) Mean weight change, kg: -6.08

(b) Mean weight change, kg: +0.33

Community

n = 6

Maintenance: none reported

(a) Mean weight change, kg: -7.33

Quasi-experimental study with a control group

Weight status: 10 % overweight

(b) No intervention

(b) Mean weight change, kg: 0.00

Age (years), mean: 21.8

Significant weight reduction of (a) across all the follow up

ID, mean IQ : 38.17

(b) Control group

n = 6

Age (years), mean: 23.5

ID, mean IQ :40.33

Attrition/drop out: none

Harris 1984 [32]

Total n = 21

Duration: 7 weekly group sessions and 1 hour booster session 26 weeks after the first session.

(a) Mean weight change, kg:-3.0 (p < 0.05) ^b

USA

Weight status: not reported

(a) Diet: education on healthy balanced diet, distinguishing high and low calorie foods, diabetic exchange diet (ADA, 1977). Activity: 5–10 min aerobic exercise at the end of session. Behaviour: stimulus control, self-monitoring, self-reinforcement, goal setting, self-contacting. Carers attended the sessions.

(a) Mean weight change, kg :-0.76

Community

(a) Completers

Maintenance: none reported

(b) Mean weight change, kg :+2.39 (p < 0.05)

Quasi-experimental study with a comparison group

n = 10

(p < 0.05)

Gender: 8 females, 2 males

Age (years) ^a: 22.7(6.37)

ID, IQ ^a : 52.5 (12.80)

(b) Non completers: 11

Attrition/drop out: 11

Ewing 2004 [33]

(a) participants with ID

Duration: 8 week intervention. The “HELP” intervention (Health Education Learning Program) led by health educators. 8 group sessions and 2 to 4 home visits.

(a) Mean BMI change, kg/m² : 0 ^b

USA

Total n = 154, final n = 92

Diet: a home visit to develop dietary plan and do a grocery visit. Activity: a home visit to develop an exercise programme e.g. walking routes, optional brisk walk after the sessions. Behaviour: motivation to change, relapse prevention, avoidance of “automatic thinking”.

(b) Mean BMI change, kg/m²: -0.89

Community

Weight status, BMI^a: 35.4 (7.0)

Maintenance: none reported

No significant difference between (a) and (b)

Quasi-experimental study with a comparison group

Gender: 54.4 % females

Age (years) ^a : 39.7 (11.5)

ID, IQ^a : 50.2 (14.3)

Attrition/drop out: 18.8 %

(b) no ID

Total n = 270, final n = 97

Weight status, BMI^a:38.4 (8.6)

Gender: 84.5 % females

Age (years) ^a:49.9 (11.48)

Attrition/drop out: 30 %

Study/Location/Type

Participants

Intervention

Results

Mann 2006 [34]

Total n = 324, available data for 192

Duration: 8 weekly group sessions (90 min each) using health education “Steps to Your Health” led by trained staff . Included home visits.

Mean BMI change, kg/m²: -0.31^b (p < 0.05)

USA

Weight status, BMI^a : 35.38 (6.85)

Diet: individual dietary plan and a grocery store visit. Activity: optional brisk walking and individual exercise programme. Behaviour: motivation to change, relapse prevention, barriers to change.

Community

Gender:66.7 % females, 33.3 % males

Maintenance: none reported

Uncontrolled quasi-experimental study

Age (years) ^a : 38.6 (11.5)

ID, IQ^a : 50.7 (13.3)

Attrition/drop out: 20 %

Bazzano 2009 [35]

Total n = 85 signed up, 44 completers

Duration: 7 months of 2 weekly group sessions (120 min each) led by professionals specialized in ID. “The Healthy Lifestyle Programme” focusing on health education and peer mentoring. Phone calls included.

Mean weight change, kg:-1.2 (p < 0.05) ^b

USA

Weight status: 36.4 % overweight, 38.6 % obese, 18.2 % very obese

Diet: education and cooking demonstration. Activity: education and supervised physical activity (90 min). Exercise in local parks and fitness facilities. Behaviour: behaviour modification and reward systems. Carers were encouraged to attend the sessions.

Mean BMI change, kg/m²: -0.5 (p < 0.05) ^b

Community

Gender: 61 % females, 39 % males

Maintenance: none reported

Uncontrolled quasi-experimental study

Age (years): 18-59

ID: 68 % mental retardation, 25 % ≈ mental retardation, Cerebral palsy, epilepsy, and autism diagnosed in 15 % to 20 %

Attrition/ drop out: 35 %

Geller 2009 [36]

Total n = 45

(a): Empowerment model. 1st year: Twice weekly sessions led by a physician (60 min each): Group and individual sessions based on the “Funk” model. Diet: meal planning, cooking demonstrations. Activities: music chairs, dancing, exercise to music. Behaviour: Activities creating feelings of community, feelings of success and of being important.

(a) + (b) (n = 43) Mean weight change, kg:-0.26^b

(a) + (b) (n = 38) Mean weight change, kg:-0.78

(a) + (b) (n = 36) Mean weight change, kg:-0.74

(a) + (b) (n = 14) Mean weight change, kg:-2.73

USA

Gender: 25 females, 18 males

(b): 2nd year, once weekly group sessions -same as (a)

Community

Weight status: obese/ overweight:-Age (years): average 42.6

Weight maintenance: none reported

Uncontrolled quasi-experimental study

ID: not reported

Attrition/ drop out: 2 dropped out, 14 completed 18 month measurements

Melville 2011 [37]

Total n = 54

Duration: 6 months of 9 sessions every 2–3 weeks individual consultations (45-60 min each) based on the GCWMS led by a dietician and a medical graduate.

Mean weight change, kg (SD): -4.47 (4.45) (p < 0.0001) ^b

UK

Weight status, BMI^a : 40 (8.03)

Diet: 600 kcal/d energy deficit diet. Activity: aim for 30 min of moderate physical activity for 5 days per week. Behaviour: goal setting, problem solving, cue avoidance, stimulus control. Carers were encouraged to assist if needed.

Mean BMI change, Kg/m²:-1.82 (p < 0.0001)

Community

Gender:40.7 % males, 59.3 % females

Maintenance: none reported

Uncontrolled quasi-experimental study

Age (years)^a:48.3 (12.01)

ID: 31.5 % mild, 31.5 % moderate, 35.2 % severe, 1.9 % profound.

Attrition/drop out: 3 dropped out, 4 non completers on time

Study/ Location/ Type

Participants

Intervention

Results

Saunders 2011[38]

Total n = 79 registered, Weight status: mean BMI 38.0

Duration: 6 months of one individual session (60-90 min) and monthly consultations (30 min each) led by dietician, behaviour analysts, physiologists.

(n = 73) Mean weight change, kg:-6 ^b

USA

Gender: 41 % males, 59 % females

Diet: a 1200 to 1300 kcal/d diet based on volumetrics, at least 5 portions of fruits and vegetables; up to three low-calorie, meal/snack-replacement shakes; two packaged entrees of less than 300 calories each and other low calorie items, 2 shake mixes from Health Management Resources (HMR) daily (110 kcal per serving). Activity: Optional. A game board aiming to increase number of steps. Behaviour: praise, problem solving, reward system. Carers could assist if needed.

Mean BMI change kg/m² ≈ -2.7 % mean weight loss: 6.3

Community

(6 month completers)

Maintenance: 6 months of less intensive meetings. Weight loss could continue if wanted.

Uncontrolled quasi-experimental study

ID: not reported

Attrition/drop out: 73 six month completers, 43 twelve month completers