An open study of the effectiveness of a multi-component weight-loss intervention for adults with intellectual disabilities and obesity Craig A. Melville 1 *, Susan Boyle 2 , Susan Miller 3 , Susan Macmillan 1 , Victoria Penpraze 4 , Carol Pert 3 , Dimitrios Spanos 1 , Lynsay Matthews 1 , Nicola Robinson 3 , Heather Murray 5 and Catherine R. Hankey 1 1 Centre for Population and Health Sciences, College of Medical and Veterinary Life Sciences, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, 1055 Great Western Road, Glasgow G12 0XH, UK 2 Glasgow and Clyde Weight Management Service, NHS Greater Glasgow and Clyde, Glasgow, UK 3 Mental Health Partnership, NHS Greater Glasgow and Clyde, Glasgow, UK 4 Institute of Diet, Exercise and Lifestyle, Centre for Population and Health Sciences, University of Glasgow, Glasgow, UK 5 Robertson Centre for Biostatistics, Centre for Population and Health Sciences, University of Glasgow, Glasgow, UK (Received 30 June 2010 – Revised 23 November 2010 – Accepted 24 November 2010 – First published online 24 January 2011) Abstract Adults with intellectual disabilities experience high rates of obesity. Despite this higher risk, there is little evidence on the effectiveness of weight-loss interventions for adults with intellectual disabilities and obesity. The present study examined the effectiveness of the TAKE 5 multi-component weight-loss intervention. Adults with obesity were invited using specialist intellectual disability services to participate in the study. Obesity was defined as a BMI of 30 kg/m 2 or greater. TAKE 5 included a daily energy-deficit diet of 2510 kJ (600 kcal), achieved via a personalised dietary prescription. Participants’ body weight, BMI, waist circumference and levels of physical activity and sedentary behaviour were measured before and after the intervention. A total of fifty-four individuals consented to participate, of which forty-seven (87 %) completed the intervention in the study period. There was a significant decrease in body weight (mean difference 24·47 (95 % CI 25·91, 2 3·03) kg; P,0·0001), BMI (21·82 (95 % CI 2 2·36, 2 1·29) kg/m 2 ; P,0·0001), waist circumference (26·29 (95 % CI 2 7·85, 24·73) cm; P,0·0001) and daily sedentary behaviour of participants (2 41·40 (95 % CI 2 62·45, 220·35) min; P¼ 0·00 034). Of the partici- pants who completed the intervention, seventeen (36·2 %) lost 5 % or more of their initial body weight. Findings from the study suggest that TAKE 5 is an effective weight-loss intervention for adults with intellectual disabilities and obesity. The effectiveness of TAKE 5 should be examined further in a controlled study. Key words: Obesity: Weight loss: Intellectual disabilities: TAKE 5 Obesity is recognised as a major public health concern inter- nationally, and the prevention and management of obesity is a priority for health care (1) . There is clear evidence of the negative impact of obesity on health (2) , with an increased risk of chronic health problems (3) and increased mortality (4) . A moderate, sustainable weight loss of 5–10 % of initial body weight has been shown to be associated with significant clinical benefits in individuals with obesity (5) . The evidence used in clinical guidelines (6 – 8) advocates the effectiveness of multi-component weight-loss interventions to support individ- uals to achieve clinically relevant weight loss. The National Institute for Health and Clinical Excellence and the Scottish Intercollegiate Guideline Network (7,8) recommend that multi-component weight-loss interventions should include: (1) dietary changes to create an energy-deficit diet of 2510 kJ/d (600 kcal/d), (2) support to increase the levels of physical activity, (3) the incorporation of behavioural methods to support sus- tained behavioural change. The prevalence of obesity in adults with intellectual disabilities has been consistently reported to be higher in population-based studies than in general population studies (9 – 14) . However, few studies have examined the effec- tiveness of weight-loss interventions for adults with intellec- tual disabilities and obesity (15) . None of the published studies has included an energy-deficit diet or met the current recommendations from clinical guidelines on the use of multi-component interventions for weight loss. Another * Corresponding author: Dr C. A. Melville, fax þ 44 141 357 4899; email craig.melville@glasgow.ac.uk Abbreviations: GCWMS, Glasgow and Clyde Weight Management Service; IPAQ-S, International Physical Activity Questionnaire – short version; PAL, physical activity level; PDP, personalised dietary prescription. British Journal of Nutrition (2011), 105, 1553–1562 doi:10.1017/S0007114510005362 q The Authors 2011 British Journal of Nutrition