Down syndrome is a genetic disorder caused by an extra copy of chromosome 21. Along with causing intellectual disability and physical health issues, this condition may make a person more prone to obesity.

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Down syndrome, also called trisomy 21, affects around 1 in every 700 babies born in the United States. The syndrome is marked by characteristic facial features, problems with fetal development (commonly known as birth defects, which may include hearing loss, heart difficulties, etc.), and intellectual disability.

People with Down syndrome may gain weight for a variety of reasons, leading to obesity and related diseases. Here’s what you need to know about Down syndrome, why it may put people at a higher risk of obesity, and how this complication may be prevented.

Learn more about Down syndrome.

Youth with Down syndrome have higher rates of obesity than those in the general population. Adults with Down syndrome are twice as likely to have obesity and four times as likely to have extreme obesity than their peers who don’t have Down syndrome.

This situation may result from:

  • physiological reasons, like increased levels of leptin, low metabolic rate, and health conditions linked to Down syndrome
  • behaviors, like a lack of physical activity and difficulty eating a balanced diet

People with Down syndrome may also be more likely to have central adiposity – an increased fat accumulation around the waist. Increased belly fat may lead to metabolic syndrome. More specifically, it may lead to higher circulating fatty acids, inflammation, and storage of triglycerides throughout the body.

Physiological factors that contribute to obesity in people with Down syndrome include an increased level of leptin in the body. Leptin is a hormone that fat releases to regulate weight and energy. Weight gain and obesity may result when levels of this hormone are high.

Medical conditions that affect people with Down syndrome may slow metabolism, leading to weight gain. They include hypothyroidism, sleep apnea, and hypotonia.

Other health conditions may also have an impact. For example, vision difficulties in people with Down syndrome, such as glaucoma, visual field defects, etc., may affect eating habits and lower participation in exercise and sports.

Psychiatric conditions, like depression, anxiety, and obsessive-compulsive disorder (OCD), may encourage emotional eating and lower a person’s physical activity. Not only that, but the side effects of medications to treat these conditions may contribute to weight gain, as well.

Treatment to address underlying health conditions can help keep weight in a healthy range:

Lifestyle changes may slow weight gain and promote weight loss:

People with Down syndrome and the following health conditions may be at higher risk of obesity:

Although some medical concerns may put people with Down syndrome at a higher risk of obesity, other factors that contribute come down to diet and exercise. Regular doctor visits and treatment of underlying conditions can identify them before they contribute to weight gain.

Eating a balanced diet, moderating portions, and getting physical activity can prevent weight gain from becoming excessive.

Tips for promoting healthy eating and physical activity


  • do involve the person with Down syndrome in meal planning
  • do offer at least one “safe food” or preferred food per meal
  • do offer fresh produce with every meal
  • do get the whole family involved in movement, like taking walks
  • do reach out to physical therapists, occupational therapists, or other services to encourage exercise
  • do schedule exercise as part of the weekly routine


  • don’t use food as a reward or punishment
  • don’t offer chips and sweets more than a couple of times per week
  • don’t forget that basic tasks (chores, cleaning, errands) can add to daily exercise totals
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Unaddressed, obesity can lead to secondary health conditions, like type 2 diabetes and heart disease. Continued monitoring and management of weight gain in people with Down syndrome may lower these obesity-related complications from childhood through adulthood.

Can people with Down syndrome lose weight?

Although people with Down syndrome may have certain health conditions that lead to weight gain, they can lose weight (if recommended by a doctor) like anyone else with attention to diet and exercise.

What foods should people with Down syndrome avoid?

Fast food and processed foods are choices that may lead to weight gain. It’s a good idea to avoid giving food as a reward.

What’s the obesity rate for people with Down syndrome?

The rate of obesity in youth with Down syndrome is 49%, compared with 39% found in the general population.

People with Down syndrome can lose weight or maintain it by following healthy lifestyle habits. Medical conditions that may contribute to weight gain can be managed with treatment by a physician.

Any situation in which food intake increases and physical activity decreases may lead to excess weight gain. A doctor or dietitian can create an individualized diet and exercise plan that will work best for you.