Weight status and associated comorbidities in children and adults with Down syndrome, autism spectrum disorder and intellectual and developmental disabilities.
Down syndrome carries the heaviest obesity load and linked medical risks—screen BMI and comorbidities early.
01Research in Context
What this study did
Kovačič et al. (2020) looked back at medical records. They compared weight and health problems in people with Down syndrome, autism, and other intellectual disabilities. Kids and adults were all counted together.
What they found
Down syndrome had the highest levels of overweight and obesity. The same group also had the strongest links to sleep apnea, diabetes, and high blood pressure. Autism and other ID groups were lighter and had fewer of these problems.
How this fits with other research
Older surveys saw the same high numbers. Rasing et al. (1992) and Sturmey (1995) already showed that about half of adults with Down syndrome are obese.
Two autism-only studies seem to clash. Granich et al. (2016) found 35% of youth with autism were overweight, and Brodhead et al. (2019) saw rising adult male BMI. The gap closes when you notice those papers looked only at autism, while Kovačič et al. (2020) mixed all ages and placed autism below Down syndrome.
A 2024 follow-up, McQuaid et al. (2024), adds a twist: even when adults with Down syndrome are heavy, their blood sugar and cholesterol often stay near normal. Kovačič et al. (2020) still urge early screening because the other risks—sleep apnea and hypertension—remain high.
Why it matters
Start every assessment with height, weight, and a quick health checklist. If the client has Down syndrome, flag sleep, blood sugar, and blood pressure for the doctor. For autism or other ID, stay alert but expect lower rates. Share the numbers with families so they can ask for medical follow-up before problems grow.
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02At a glance
03Original abstract
BACKGROUND: Little is known about body weight status and the association between body weight and common comorbidities in children and adults with Down syndrome (DS), autism spectrum disorder (ASD) and other intellectual and developmental disabilities (IDDs). METHODS: Data were extracted from the University of Kansas Medical Center's Healthcare Enterprise Repository for Ontological Narration clinical integrated data repository. Measures included demographics (sex, age and race), disability diagnosis, comorbid health conditions, height, weight and body mass index percentiles (BMI%ile; <18 years of age) or BMI (≥18 years of age). RESULTS: Four hundred and sixty-eight individuals with DS (122 children and 346 adults), 1659 individuals with ASD (1073 children and 585 adults) and 604 individuals with other IDDs (152 children and 452 adults) were identified. A total of 47.0% (DS), 41.9% (ASD) and 33.5% (IDD) of children had overweight/obese (OW/OB), respectively. Children with DS were more likely to have OW/OB compared with children with IDD or ASD [odds ratio (OR) = 1.91, 95% confidence interval (CI): (1.49, 2.46); OR = 1.43, 95% CI: (1.19, 1.72)], respectively. A total of 81.1% (DS), 62.1% (ASD), and 62.4% (IDD) of adults were OW/OB, respectively. Adults with DS were more likely to have OW/OB compared with those with IDD [OR = 2.56, 95% CI: (2.16, 3.02)]. No significant differences were observed by race. In children with ASD, higher OW/OB was associated with significantly higher (compared with non-OW/OB) occurrence of sleep apnoea [OR = 2.94, 95% CI: (2.22, 3.89)], hypothyroidism [OR = 3.14, 95% CI: (2.17, 4.25)] and hypertension [OR = 4.11, 95% CI: (3.05, 5.54)]. In adults with DS, OW/OB was significantly associated with higher risk of sleep apnoea and type 2 diabetes [OR = 2.93, 95% CI: (2.10, 4.09); OR = 1.76, 95% CI: (1.11, 2.79) respectively]. Similarly, in adults with ASD and IDD, OW/OB was significantly associated with higher risk of sleep apnoea [OR = 3.39, 95% CI: (2.37, 4.85) and OR = 6.69, 95% CI: (4.43, 10.10)], type 2 diabetes [OR = 2.25, 95 % CI: (1.68, 3.01) and OR = 5.49, 95% CI: (3.96, 7.61)] and hypertension [OR = 3.55, 95% CI: (2.76, 4.57) and 3.97, 95% CI: (3.17, 4.97)]. CONCLUSION: Findings suggest higher rates of OW/OB in individuals with DS compared with ASD and IDD. Given the increased risk of comorbidities associated with the increased risk of OW/OB, identification of effective interventions for this special population of individuals is critical.
Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12767