Original Article

Obesity and Severe Obesity in Children with Autism Spectrum Disorder: Prevalence and Risk Factors

Authors: Du Pham, MD, Sofia Silver, MD, Sierra Haq, MD, S. Shahrukh Hashmi, MD, PhD, Mona Eissa, MD, PhD

Abstract

Objective: Research suggests a high prevalence of obesity in children with autism spectrum disorders (ASDs), but the prevalence of severe obesity and its association with risk factors unique to this population remain undetermined. This study sought to compare the prevalence of severe obesity in children with ASDs to that of the general population and investigated associated risk factors for obesity in this population.

Methods: A chart review was done on 592 patients with ASDs seen between 2013 and 2017 at a center in Houston, Texas. The prevalence of obesity in the study population was compared with 2013–2016 national data. Univariable, multivariable, and stratified analyses were performed to determine the association between risk factors and body mass index.

Results: The prevalence of obesity and severe obesity in our study population was similar to those reported in the general population. When stratified by age, children with ASDs ages 6 to 11 years had a significantly higher prevalence of severe obesity than the general population.

Conclusions: The prevalence of severe obesity in children with ASDs was higher with increasing age, and in the 6- to 11-year-old age group, was significantly higher than in the general population. Healthcare providers should address diet and exercise early as part of a comprehensive management plan for children with ASDs.

 

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References

1. Ogden CL, Carroll MD, Kit BK, et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311:806-814.
2. Ogden CL, Fryar CD, Hales CM, et al. Differences in obesity prevalence by demographics and urbanization in US children and adolescents, 2013-2016. JAMA 2018;319:2410-2418.
3. Reilly JJ, Methven E, McDowell ZC, et al. Health consequences of obesity. Arch Dis Child 2003;88:748-752.
4. Goran MI, Ball GDC, Cruz ML. Cardiovascular endocrinology 2: obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab 2003;88:1417-1427.
5. Bixler EO, Vgontzas AN, Lin HM, et al. Sleep disordered breathing in children in a general population sample: prevalence and risk factors. Sleep 2009;32:731-736.
6. Taylor ED. Orthopedic complications of overweight in children and adolescents. Pediatrics 2006;117:2167-2174.
7. Hill AP, Zuckerman KE, Fombonne E. Obesity and autism. Pediatrics 2015;136:1051-1061.
8. Singh AS, Mulder C, Twisk JWR, et al. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 2008;9:474-488.
9. MacMahon S, Baigent C, Duffy S, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009;373:1083-1096.
10. Jungheim ES, Travieso JL, Carson KR, et al. Obesity and reproductive function. Obstet Gynecol Clin North Am 2012;39:479-493.
11. Zheng Z, Zhang L, Li S, et al. Association among obesity, overweight and autism spectrum disorder: a systematic review and meta-analysis. Sci Rep 2017;7:1-9.
12. Schreck KA, Williams K. Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Res Dev Disabil 2006;27:353-363.
13. Evans EW, Must A, Anderson SE, et al. Dietary patterns and body mass index in children with autism and typically developing children. Res Autism Spectr Disord 2012;6:399-405.
14. Broder-Fingert S, Brazauskas K, Lindgren K, et al. Prevalence of overweight and obesity in a large clinical sample of children with autism. Acad Pediatr 2014;14:408-414.
15. Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Am Diet Assoc 2013;110:238-246.
16. Richdale AL. Sleep problems in autism: prevalence, cause, and intervention. Dev Med Child Neurol 1999;41:60-66.
17. Dev DA, McBride BA, Fiese BH, et al. Risk factors for overweight/obesity in preschool children: an ecological approach. Child Obes 2013;9:399-408.
18. De Vinck-Baroody O, Shui A, Macklin EA, et al. Overweight and obesity in a sample of children with autism spectrum disorder. Acad Pediatr 2015;15:396-404.
19. Schopler E, Van Bourgondien ME, Wellman GJ, et al. The Childhood Autism Rating Scale (CARS2). Los Angeles:Western Psychological Services; 2010.
20. Curtin C, Bandini LG, Perrin EC, et al. Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review. BMC Pediatr 2005;5:48.
21. Zuckerman K, Hill A, Guion K, et al. Overweight and obesity: prevalence and correlates in a large clinical sample of children with autism spectrum disorder. J Autism Dev Disord 2014;44:1708-1719.
22. Chen AY, Kim SE, Houtrow AJ, et al. Prevalence of obesity among children with chronic conditions. Obesity (Silver Spring) 2010;:18:210-213.
23. Curtin C, Anderson SE, Must A, et al. The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children’s Health. BMC Pediatr 2010;10:11.
24. Phillips KL, Schieve LA, Visser S, et al. Prevalence and impact of unhealthy weight in a national sample of US adolescents with autism and other learning and behavioral disabilities. Matern Child Health J 2014;18:1964-1975.
25. Egan AM, Dreyer ML, Odar CC, et al. Obesity in young children with autism spectrum disorders: prevalence and associated factors. Child Obes 2013;9:125-131.
26. Flegal KM, Wei R, Ogden CL, et al. Characterizing extreme values of body mass index-for-age by using the 2000 Centers for Disease Control and Prevention growth charts. Am J Clin Nutr 2009;90:1314-1320.
27. Kelly AS, Barlow SE, Rao G, et al. Severe obesity in children and adolescents: Identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation 2013;128:1689-1712.