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obesity and, subsequently, its cardiometabolic and cognitive impacts. Caregivers play a critical role in managing health, yet their perceptions and behaviors have been poorly characterized. Methods: We performed a cross-sectional online survey of caregivers (n = 764) taking care of 48% females and 52% males with DS, conducted across European populations, predominantly in Spain and France. We assessed perceived obesity, perceived harmfulness of current weight, professional consultation, and confidence in promoting healthy behaviors. Associations were examined using chi-square tests, correlation analysis, and ordinal and logistic regression models. Results: Around one-third (32%) of caregivers perceived their family member with DS with obesity. Perceived obesity changed with age and was more frequently reported in female family members with DS. Awareness of general metabolic risk factors was high among caregivers, but half of respondents were unaware that abdominal fat affects brain health. Consultation with healthcare professionals was uncommon (57% \u201cNever\/Rarely\/Sometimes\u201d) even among those perceived with obesity. Conclusions: Caregivers demonstrate good general awareness about high energy food risks but limited knowledge of the link between obesity and brain health. Enhancing caregiver education and supporting behavioral change could promote healthier lifestyles in families with individuals with DS.<\/jats:p>","DOI":"10.3390\/nu18111727","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:57:43Z","timestamp":1779962263000},"page":"1727","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding Obesity in Individuals with Down Syndrome: Caregiver Perceptions, Awareness, and Motivation"],"prefix":"10.3390","volume":"18","author":[{"given":"Thomas","family":"Cahill","sequence":"first","affiliation":[{"name":"Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Nalesso","sequence":"additional","affiliation":[{"name":"Institut de G\u00e9n\u00e9tique et de Biologie Mol\u00e9culaire et Cellulaire (IGBMC), UMR7104, U1258, Universit\u00e9 de Strasbourg, CNRS, INSERM, 67400 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pat","family":"Clarke","sequence":"additional","affiliation":[{"name":"European Down Syndrome Association, 1210 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0836-6491","authenticated-orcid":false,"given":"Maria","family":"Martinez de Lagran","sequence":"additional","affiliation":[{"name":"Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Strydom","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology, and Neuroscience, King\u2019s College London, London SE5 8AF, UK"},{"name":"South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK"},{"name":"The LonDowns Consortium, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Claude","family":"Potier","sequence":"additional","affiliation":[{"name":"Paris Brain Institute (ICM), Piti\u00e9-Salp\u00eatri\u00e8re Hospital, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7874-3822","authenticated-orcid":false,"given":"Johannes","family":"Beckers","sequence":"additional","affiliation":[{"name":"Institute of Experimental Genetics, Helmholtz Zentrum M\u00fcnchen\u2014German Research Centre for Environmental Health, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany"},{"name":"German Centre for Diabetes Research (DZD), Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany"},{"name":"Chair of Experimental Genetics, School of Life Sciences Weihenstephan, Technische Universit\u00e4t M\u00fcnchen, Altekademie 8, 85354 Freising, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7075-9192","authenticated-orcid":false,"given":"Klaus","family":"Langohr","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neuroscience Research Program, Hospital del Mar Research Institute, 08003 Barcelona, Spain"},{"name":"Department of Statistics and Operations Research, Universitat Polit\u00e8cnica de Catalunya\u2014BarcelonaTECH, 08034 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0540-5053","authenticated-orcid":false,"given":"Pietro","family":"Li\u00f2","sequence":"additional","affiliation":[{"name":"Department of Computer Science and 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