Prevalence and Impact of Unhealthy Weight in a National Sample of US Adolescents with Autism and Other Learning and Behavioral Disabilities

Abstract

We estimated the prevalence of obesity, overweight, and underweight among US adolescents with and without autism and other learning and behavioral developmental disabilities (DDs) and assessed the health consequences of obesity among adolescents with DDs. From the 2008 to 2010 National Health Interview Survey, we selected 9,619 adolescents ages 12–17 years. Parent respondents reported weight, height, presence of DDs and health conditions. We calculated body mass index (BMI) and defined obesity, overweight, and underweight as ≥95th, ≥85th to <95th, and <5th percentiles, respectively, using established criteria. We created mutually-exclusive DD subgroups using the following order of precedence: autism; intellectual disability; attention-deficit-hyper-activity-disorder; learning disorder/other developmental delay. We compared BMI outcomes among adolescents in each DD group versus adolescents without DDs using multivariable logistic regression. Socio-demographic factors and birthweight were included as confounders. Estimates were weighted to reflect the US population. Both obesity and underweight prevalences were higher among adolescents with than without DDs [adjusted prevalence ratios (aPR) 1.5 (1.25–1.75) and 1.5 (1.01–2.20), respectively]. Obesity was elevated among adolescents with all DD types, and was highest among the autism subgroup [aPR 2.1 (1.44–3.16)]. Adolescents with either a DD or obesity had higher prevalences of common respiratory, gastrointestinal, dermatological and neurological conditions/symptoms than nonobese adolescents without DDs. Adolescents with both DDs and obesity had the highest estimates for most conditions. Obesity is high among adolescents with autism and other DDs and poses added chronic health risks. Obesity prevention and management approaches for this vulnerable population subgroup need further consideration.

The Effect of Age on the Prevalence of Obesity among US Youth with Autism Spectrum Disorder

“…The elevated obesity prevalence based on nationally representative samples in children with ASD compared with those without the condition has been previously reported by our group 10 and others 9,18,24,25,35 as well as in school-based and clinical samples. 8,[26][27][28]36 Chen et al reported an obesity prevalence of 21.1% among 10-17-year-olds in the 2003 round of NSCH, similar to our estimates, and consistent with a leveling off in prevalence trends over time seen in other nationally representative samples of US children.…”

Availability of State-Based Obesity Surveillance Data on High School Students with Disabilities in the United States

“…Children with mobility limitations have also been shown to have a higher rate of obesity compared with children without such limitations [19,20]. Children with cognitive limitations such as intellectual disability [21,22], autism [23][24][25][26][27], learning disabilities [19,26], and attention deficit hyperactivity disorder (ADHD) [26,[28][29][30][31] also have an elevated prevalence of obesity. Environmental risk factors contributing to obesity in children in general, such as low socioeconomic status, unhealthy diet, and sedentary lifestyle, may also affect children with disabilities, who may be more susceptible to such factors owing to their physical, cognitive, and other functional limitations [20,21,32].…”

“…Environmental risk factors contributing to obesity in children in general, such as low socioeconomic status, unhealthy diet, and sedentary lifestyle, may also affect children with disabilities, who may be more susceptible to such factors owing to their physical, cognitive, and other functional limitations [20,21,32]. Similar to children without disabilities, children with disabilities who have excess body weight have been shown to be more likely than their healthy weight counterparts to develop additional chronic health conditions [26,33]. Thus, the current and future health consequences of obesity could be more intense for these children, who already have impairments and related functional limitations, than for children without disabilities [20].…”

A Mixed-Methods Analysis of the Effects of a Fundamental Motor Skills Intervention for Children with Autism Spectrum Disorder

“…When considering the prevalence statistics in relation to the national data, the rates for overweight and obesity are similar. However, in some studies, overweight and obesity have been found to be much greater than national data on the general populations (Phillips et al, 2014;Rimmer, Yamaki, Lowry, Wang, & Vogel, 2010;Whiteley, Dodou, Todd, & Shattock, 2004). When considering the variance in rates of overweight and obesity in the context of the great heterogeneity among ASD populations, it is difficult to reach a conclusion about the most accurate account.…”

“…However, when looking closer at studies by Phillips et al (2014), Rimmer et al (2010), and Whiteley et al (2004), among others, rates were based on smaller samples, and data were collected by parental report. Because of these limitations, the authors'…”