Obesity is an even greater health problem for people who have spina bifida than it is in the general population. Effects can include:
- Further limits to mobility, leading to a spiralling problem of decreased energy use and weight gain, making it harder for the individual to keep up with peers in social and work situations.
- Additional pressure on skin, thus increasing the already high risk of skin breakdown and pressure sores, particularly in areas without sensation or those that become wet.
- Social rejection, which may already be a problem due to others' lack of sensitivity and understanding of disability, may be worsened.
- Negative effects on daily living, particularly independence in dressing, continence management and hygiene, because of difficulties in moving a large, heavy body and reaching private areas of the body.
Very young children with spina bifida usually grow at about the same rate as their peers and are quite physically active, so they usually do not become obese. However, as they grow older children who have spina bifida, especially those who also have hydrocephalus, are at very high risk for developing obesity: beyond age 6 at least 50% of children who have spina bifida are overweight, and in adolescence and adulthood over 50% are obese. There are many reasons for this.
- Mobility problems make it harder for individuals to be physically active.
- Older children and adults are typically less active due to the requirements of school and work for sedentary activity, and due to the increasing difficulty of moving a larger body.
- Individuals with spina bifida need fewer calories each day, and must eat less than others to avoid gaining weight and becoming obese, because:
- On average those who have spina bifida are not as tall as their non-disabled peers, and therefore need fewer calories for growth, and
- Studies have shown that people with spina bifida have less lean body mass than their peers, and even when other factors like physical activity are equal, have a lower basic metabolic rate (fat cells have slower metabolic rates than other cells like muscle cells).
Successful prevention of obesity depends upon family commitment and involvement to changing behaviours that lead to weight gain. The combination of aerobic exercise and a well-balanced diet will help everyone to maintain a healthy weight.
- Nutrition education is important, not just for the individual with spina bifida but for the whole family. Check the Canada Food Guide for information on eating a well-balanced diet.
- Exercise can include swimming, rowing, and pushing distances in the wheelchair. Increasingly, there are also opportunities to participate in athletics and at facilities that are wheelchair accessible (such as Rotary Challenger Park in Calgary). If nothing is readily available in your community, there are books and videotapes for wheelchair aerobics to get you going.