Learning disability and obesity: a case report of challenges and reasonable adjustments


Background When anxious, patients with learning disabilities may display challenging behaviour. The prevalence of obesity in patients with learning disabilities is rising and can increase the complexity of management. Reasonable adjustments are often necessary in order for treatment to be successful.

Case report A 41-year-old male patient with a severe learning disability, autism and obesity was referred to the dental hospital for dental treatment. The patient frequently demonstrated physically challenging behaviour, particularly when in unfamiliar environments. In order for the patient to access care, a multidisciplinary team (MDT) approach with a number of reasonable adjustments was required. The patient was then able to receive treatment under general anaesthesia (GA) from not only the special care dentistry team, but also additional medical specialties.

Discussion A holistic approach to care is important in this patient group in order to reduce health inequalities. Clinicians should be aware of their role in the screening and referral of patients with obesity.

Conclusion Reasonable adjustments and a team approach are essential to the dental management of patients with learning disabilities. Management is becoming increasingly complex as obesity continues to be a growing problem among this group.

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The authors would like to thank staff at the Royal London Hospital for their help with this case and the other patients we see with learning disabilities; namely Dr Barry Clifton (consultant anaesthetist) and his team, Patricia Handley (lead nurse for learning disabilities), our ENT and ophthalmology/orthoptic colleagues and all the staff in the day stay unit.

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Correspondence to Joanna Dick.

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Dick, J., Clough, S. Learning disability and obesity: a case report of challenges and reasonable adjustments. Br Dent J 227, 19–24 (2019). https://doi.org/10.1038/s41415-019-0468-3

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