Reconceptualizing weight of people with intellectual and developmental disabilities in the context of social determinants of health

Abstract

While social determinants of health play a key role in people’s weight, very little attention has been drawn to the role of social determinants in the weight of people with intellectual and developmental disabilities (IDD), who are more likely to be fat. Weight bias not only serves as a social determinant of health in and of itself—negatively impacting fat people’s physical and mental health, including their weight—but, according to research with other populations, it also has an impact on other social determinants of health. This study’s aim was to examine the relationship between state weight bias and the social determinants of health of people with IDD. Using a multilevel linear regression, we analyzed secondary Personal Outcome Measures data about social determinants of health-related outcomes (e.g. community integration, relationships, employment, housing, rights, human security, health care quality) from 4,384 people with IDD (2018–2023), and secondary implicit weight bias data from 2 million people in the 31 states where the people with IDD lived. The more weight bias in the state where they live (independent variable), the fewer social determinants of health-related outcomes people with IDD had present (dependent variable), even when their sociodemographics were controlled. Given this relationship, we believe there needs to be a reframing of how people with IDD’s weight and bodies are thought about and “intervened.” We should move toward a more holistic conceptualization of weight and health, including one that recognizes and attends to social determinants, remedying structural inequities.