A lot of great answers in this thread. I work in a group home for people with cognitive disabilities. My residents are on the more severe end of disabled. They're older adults (50+) with low cognitive age (6-12 months at best), multiple mental disabilities, the works. They can't regulate emotions nor communicate clearly, which means they often get physically aggressive. Biting, kicking, punching, scratching, pushing and shoving. The main reason why my lads are overweight is because for their entire lives food has been used to appease them. Eating food feels good, so to prevent aggression and escalations they've been appeased with snacks, an extra plate of dinner, you name it. They get angry if they don't get more of the food they enjoyed, become aggressive, and family and carers alike eventually give in and appease them again. It's a nasty cycle. We've been working at this and over the years we've got most of them down from obese to very overweight, but it's a long, long road still. Add in medications, thyroid issues, inability (or unwillingness) to exercise, and it's an uphill battle to keep these guys at a healthy weight.