Weight loss strategies used by individuals with spinal cord injuries or disorders: Prevalence and associations with health, dietary, and activity factors.

CONTEXT: Individuals with SCI/D with motor paralysis are at increased risk of obesity. They also experience reduced resting metabolic rate, premature chronic conditions, and secondary complications (e.g. pain) that challenge weight management. As such, careful attention to weight-loss strategies such as exercise and diet is needed. This study aims to identify the prevalence of intentional weight-loss strategies among individuals with SCI/D and to examine associations between their use of these strategies and health, dietary, and activity factors. DESIGN: Cross-sectional survey. SETTING: National Veterans Health Administration SCI/D Centers, Midwest Regional SCI Model System of Care, and Shirley Ryan AbilityLab. PARTICIPANTS: Veterans and civilians with SCI/D recruited by mailed invitation letters. INTERVENTIONS: NA. OUTCOME MEASURES: Questions assessing demographic and injury characteristics, chronic health conditions, secondary complications, and dietary and physical activity factors. RESULTS: 301 participants with SCI/D (mean age: 57 years, 67% men, 74% white, and 56% paraplegia) completed the outcome item on weight-loss strategies. 69% of participants reported using weight-loss strategies, with general dieting (40%), restricted-calorie intake (34%), and eliminating specific food categories/types (31%) the most common strategies. Being overweight/obese (OR = 6.93), having diabetes (OR = 7.49), having urinary tract infections (OR = 2.98), preparing meals oneself (OR = 4.01), and having the last eating occasion before 8 pm (OR = 2.52) were associated with the use of weight-loss strategies. CONCLUSION: Weight-loss strategies for individuals with SCI/D are prevalent and are associated with dietary habits and health conditions. These findings highlight opportunities to improve informed and sustainable weight management practices after SCI/D.