Relationship of Weight Outcomes, Co-Occurring Conditions, and Severity of Autism Spectrum Disorder in the Study to Explore Early Development

J Pediatr. 2019 Feb:205:202-209. doi: 10.1016/j.jpeds.2018.09.003. Epub 2018 Oct 9.


Objective: To assess contributing factors to increased obesity risk, by comparing children with autism spectrum disorder (ASD), developmental delays/disorders, and general population controls in weight status, and to examine associations between weight status and presence of co-occurring medical, behavioral, developmental, or psychiatric conditions across groups and ASD severity among children with ASD.

Study design: The Study to Explore Early Development is a multisite cross-sectional study of children, 2-5 years of age, classified as children with ASD (n = 668), children with developmental delays/disorders (n = 914), or general population controls (n = 884). Using an observational cohort design, we compared the 3 groups. Children's heights and weights were measured during a clinical visit. Co-occurring conditions (medical, behavioral, developmental/psychiatric) were derived from medical records, interviews, and questionnaires. ASD severity was measured by the Ohio State University Global Severity Scale for Autism.

Results: The odds of overweight/obesity were 1.57 times (95% CI 1.24-2.00) higher in children with ASD than general population controls and 1.38 times (95% CI 1.10-1.72) higher in children with developmental delays/disorders than general population controls. The aORs were elevated for children with ASD after controlling for child co-occurring conditions (ASD vs general population controls: aOR = 1.51; 95% CI 1.14-2.00). Among children with ASD, those with severe ASD symptoms were 1.7 times (95% CI 1.1-2.8) more likely to be classified as overweight/obese compared with children with mild ASD symptoms.

Conclusions: Prevention of excess weight gain in children with ASD, especially those with severe symptoms, and in children with developmental delays/disorders represents an important target for intervention.

Keywords: autism; obesity.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Autism Spectrum Disorder / diagnosis
  • Autism Spectrum Disorder / epidemiology*
  • Body Weight*
  • Child Development Disorders, Pervasive / diagnosis
  • Child Development Disorders, Pervasive / epidemiology*
  • Child Development*
  • Child, Preschool
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Population Surveillance / methods*
  • Prevalence
  • Retrospective Studies
  • Severity of Illness Index
  • United States / epidemiology