Autism associated with excessive weight gain among children

Children with autism spectrum disorder are 41% more likely to develop obesity than typically developing children living in the same geographical regions, according to findings from a systematic review and meta-analysis published in Pediatric Obesity.

“Children with autism appear to be at a higher risk [for] developing overweight and obesity, particularly when living in the United States,” Chanaka N. Kahathuduwa, MBBS, MPhil, PhD, assistant professor in the department of laboratory sciences and primary care at the School of Health Professions and clinical assistant professor in the department of psychiatry at Texas Tech University Health Sciences Center, told Endocrine Today. “Among children with autism, girls, nonwhite children and older children seem to be at greater risk for excessive weight gain.”

Kahathuduwa and colleagues analyzed data from 35 studies published between 1999 and 2018 (median, 2014) that examined the prevalence of overweight and/or obesity among children diagnosed with autism. Mean age of children ranged from 3 to 14 years, with the proportion of girls across studies ranging from zero to 38.23% (21 studies conducted in the U.S.). Researchers used random-effects meta-analyses to assess the pooled prevalence of BMI greater than or equal to the 85th and 95th percentiles for age and sex among children with autism, the relative risk for BMI greater than or equal to the 85th and 95th percentile for age and sex among children with autism. The pooled prevalence estimates were compared with the population prevalence estimates of BMI greater than or equal to the 85th and 95th percentiles for age and sex among children in the United States.

Among the 35 studies that were considered for primary metaanalyses, 31 studies and 30 studies, respectively, were considered for the metaanalysis that examined the prevalence of BMI greater than or equal to the 85th and 95th percentiles for age and sex in children with autism.

Among children with autism, the prevalence of obesity was 22.2%.

Researchers found that children with autism had a 41.1% greater risk (P = .018) for development of obesity than typically developing children. The researchers found that nonwhite race, increasing age, female sex and living in the U.S. were positive moderators of the association between autism and prevalence of overweight or obesity.

“Decisions we make as parents and clinicians in taking care of children with autism may be contributing, at least partially, to excessive weight gain,” Kahathuduwa said. “Clinicians, as well as parents, need to be made aware of this greater risk to prevent our children with autism from being victims of obesity and the devastating complications associated with obesity.”

Kahathuduwa said that the findings only indicate that autism is associated with excessive weight gain.

“Although many factors such as certain genes, brain structure and functional reactivity, food selectivity, limited physical activity and psychotropic medications can be thought of as contributors to this association, we do not have compelling evidence to ‘label’ any of these as causal,” Kahathuduwa said. “Using functional neuroimaging data, we have previously demonstrated unique brain activity patterns in children with autism and overweight or obesity. However, the association between autism and obesity needs to be explored further in both bench and clinical studies.” – by Regina Schaffer

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