Physical activity for weight loss maintenance in people with and without physical disability: The international weight control registry

BACKGROUND: People with physical disabilities (PWD) are at increased risk for obesity compared to people without disability (PWoD). PWD face barriers to physical activity (PA), which is important for weight loss maintenance (WLM) in PWoD. However, the role of PA in WLM has not been evaluated in PWD. OBJECTIVE: The purpose of this study was to examine differences in PA between PWD and PWoD and whether PA is associated with WLM success among PWD. METHODS: Data were derived from 536 participants already enrolled in the International Weight Control Registry, which included targeted recruitment of PWD. Physical disability was self-reported via study-designed survey capturing presence and type of disability. PA was assessed using the International Physical Activity Questionnaire, and weight history was self-reported as "Successful" (lost weight and maintained ≥1 year), "Regain," or (Lost but regained within 1 year). PA was compared between PWD and PWoD and among PWD by weight history status using generalized regression models. RESULTS: PWD (n = 174) reported more sedentary time (β = 0.34; 95 % CI = 0.16-0.52, p < 0.001), and greater odds of reporting zero total physical activity (OR = 5.18, 95 % CI = 2.19-12.24, p < 0.001), zero total leisure physical activity (OR = 2.22, 95 % CI = 1.51-3.26, p < 0.001), and zero leisure vigorous physical activity (OR = 1.87, 95 % CI = 1.15-3.02, p = 0.011). There were no significant differences in PA among PWD based on weight history status. CONCLUSIONS: PA may not be a critical factor influencing weight maintenance in PWD. Even among successful participants, PWD report lower PA than PWoD, highlighting the need for inclusive PA programs.