All ETDs from UAB

Advisory Committee Chair

James O Hill

Advisory Committee Members

Brenda Bertrand

Tapan Mehta

James H Rimmer

R Drew Sayer

Holly R Wyatt

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


People with physical disabilities (PWD) are at higher risk of obesity than people with-out physical disability (PWoD). For PWD, obesity presents a greater risk of secondary conditions; preventable medical, emotional, or social problems resulting directly or in-directly from an initial disabling condition. There is incomplete information about how disability-specific concerns influence obesity treatment and weight management, in part because PWD have typically not been included in this research. Additionally, while studies exist examining weight loss in PWD, a dearth of research exists examining weight loss maintenance for this population. Previously, weight control registries have been a valuable tool in gaining information about weight loss maintenance success. For example, registries concluded that physical activity is a key component for weight maintenance, which was later confirmed in numerous randomized trials. However, PWD face barriers to physical activity that impact engagement. Additionally, current physical activity surveys have not been designed to include PWD and allow for comparisons across PWD and PWoD. Thus, the role of physical activity in weight maintenance for PWD is also unknown. Therefore, the focus of this dissertation was to 1) compare weight history between PWD and PWoD enrolled in the International Weight Control Registry (IWCR) 2) Evaluate the reliability and validity of a physical activity survey adapted to include PWD and PWoD and 3) Investigate differences in physical activity engagement between PWD and PWoD who were successful vs. unsuccessful at weight loss maintenance in the IWCR. Results demonstrate that PWD and PWoD have a similar frequency of weight maintenance success, but PWD have a higher current body mass index (BMI) potentially indicating an increased risk for obesity-related complications. The adapted survey demonstrated acceptable test-retest reliability and construct and convergent validity which was used in the IWCR to conclude that PWD participate in less physical activity than PWoD and PWD successful at weight maintenance participate in more physical activity than PWD that regain lost weight. In conclusion, PWD are still at increased risk for obesity-related conditions and more research should investigate the role of physical activity and other factors associated with weight maintenance for PWD, including dietary, environmental, and psychosocial factors.

Available for download on Friday, December 27, 2024