What to know about obesity in Down syndrome

A person with Down syndrome may be more likely to develop obesity than someone without it. This is due to additional medical conditions and physiological factors, among other reasons.
A person who has Down syndrome has an extra copy of chromosome 21. Chromosomes are thread-like structures that contain DNA. They determine how a person’s body develops.
Individuals with Down syndrome may develop physical and intellectual difficulties. They may also be at risk of certain conditions, such as heart defects or digestive irregularities.
Read on to learn more about the relationship between Down syndrome and obesity, including risk factors and treatments.
Is obesity more common in Down syndrome? 
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Yes, obesity is more common in people with Down syndrome. A review from 2022 notes that young people with Down syndrome have higher rates of overweight and obesity than young people who do not have the condition.
obesity
Down syndrome
higher rates
An additional review from 2022 states that people with Down syndrome may be more at risk than people who do not have the condition of developing metabolic disorders, such as:
more at risk
metabolic disorders
oxidative stress disorders, such as type 2 diabetes and heart disease
oxidative stress
type 2 diabetes
heart disease
obesity
carbohydrate profile disorders, which involve difficulty with the metabolism of carbohydrates
carbohydrates
lipid disorders
lipid disorders
A study from 2021 looked into the rates of overweight and obesity in 466 people with Down syndrome, autism spectrum disorder (ASD), and other intellectual and developmental disabilities (IDDs).
study from 2021
autism spectrum disorder (ASD)
The researchers noted that people with these conditions have higher rates of overweight and obesity than people who do not have the conditions. They also noted that the study participants with Down syndrome had the highest rates of overweight and obesity, compared with participants who had ASD and other IDDs.
Possible causes of obesity in Down syndrome
The higher rates of obesity in people with Down syndrome have several potential causes.
The National Down Syndrome Society (NDSS) states that hypothyroidism may be a potential cause of obesity in people with Down syndrome.
National Down Syndrome Society (NDSS)
hypothyroidism
Hypothyroidism is a condition in which a person’s thyroid gland does not produce enough thyroid hormone. This may cause a person’s metabolism to slow down, which may result in weight gain.
Around 15% of individuals with Down syndrome have hypothyroidism.
Around 15%
Additionally, the NDSS states that people with Down syndrome may have slower metabolisms in general. This means that their bodies may burn fewer calories while storing more.
calories
A research review from 2024 noted that obesity in people with Down syndrome may be related to increased leptin levels in the body. Leptin is a hormone released by fat cells.
research review from 2024
If a person constantly has high levels of leptin, they may become desensitized to it. This may result in leptin resistance. If a person develops leptin resistance, they may continue to feel hungry even after they have eaten. This may result in overeating and weight gain.
The NDSS notes that people with Down syndrome may eat more calories than they burn from physical activity.
A study from 2017 noted that children with Down syndrome may have a reduced energy expenditure. A person’s energy expenditure is the number of calories they burn in a day. A person with a reduced energy expenditure may require fewer calories. This may lead to a person taking in more calories than they require.
reduced
A study from 2022 found that people with Down syndrome were more likely to experience mental health conditions than people without Down syndrome. These conditions included depression and anxiety disorders.
more likely
mental health conditions
depression
anxiety disorders
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states that binge eating may be associated with depression and anxiety. Binge eating disorder may contribute to obesity.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
binge eating
Additionally, the National Heart, Lung, and Blood Institute (NHLBI) states that antidepressants and antipsychotics may also make someone feel hungry more often, which can lead to increased appetite and weight gain. A person should speak with a healthcare professional if they notice weight gain while taking these medications.
National Heart, Lung, and Blood Institute (NHLBI)
antidepressants
antipsychotics
Risk factors for obesity
The NHLBI lists the following as risk factors for obesity:
risk factors for obesity
lack of physical activity
eating more calories than the body uses
eating too much saturated fat, which is found in foods such as red meat, full fat dairy products, and baked goods
saturated fat
eating foods high in added sugar
added sugar
not getting enough good quality sleep
enough good quality sleep
having high levels of stress
stress
having certain health conditions, such as metabolic syndrome or polycystic ovary syndrome
polycystic ovary syndrome
inheriting genes that increase the risk of obesity
genes
taking certain medications, such as birth control pills, insulin, or beta-blockers
birth control pills
insulin
beta-blockers
environmental factors, such as living in an area with lots of fast food restaurants or inaccessible sidewalks
Treating obesity in Down syndrome
The NDSS suggests that the following strategies may help treat and prevent obesity in a person who has Down syndrome:
NDSS
using healthy ingredients that increase bulk in meals, such as fruits, vegetables, and other sources of fiber
fruits
vegetables
fiber
eating smaller portions
increasing water intake
water
reducing snacking between meals
preparing meals at home
not using food as a reward
A person’s friends or family may also try:
encouraging adults with Down syndrome to monitor their own weight
introducing a daily exercise routine based around the person’s interests or skills
exercise
informing supervisors at work or school about the person’s treatment plan
Certain health conditions may contribute to obesity in a person with Down syndrome.
If a person has hypothyroidism, their doctor may recommend treatment for the condition. If a person notices they gain weight after taking medication for a mental health condition, they may want to speak with their doctor about switching medications or trying other treatments.
Summary
A person who has Down syndrome may be more likely to have obesity than a person who does not.
more likely
Obesity has several possible causes in a person who has Down syndrome. These may include hypothyroidism, increased leptin levels, and reduced energy expenditure.
may include
increased leptin levels
reduced energy expenditure
A person who has Down syndrome and obesity may find eating smaller portions and increasing the amount they exercise beneficial. Additionally, they should consider speaking with their doctor about potential treatments for any underlying conditions they have that may be contributing to obesity.