Obesity and associated factors in youth with an autism spectrum disorder.
One in three youth with autism is overweight—track BMI every visit and replace food rewards with non-edible reinforcers.
01Research in Context
What this study did
Granich et al. (2016) weighed and measured a group of kids with autism aged 2 to 16. They asked parents about height, weight, and family habits. The team wanted to see how many kids carried extra weight and what might explain it.
What they found
About one in three youth with autism was overweight or obese. The only clear link was mom's BMI—heavier moms tended to have heavier kids. No other factor reached significance in this sample.
How this fits with other research
Healy et al. (2019) and Heald et al. (2020) later asked the same question with bigger U.S. surveys. Both found the same one-in-three rate, but they also showed risk climbs as autism severity climbs. The new studies extend Joanna's finding by adding severity and nationwide data.
Brodhead et al. (2019) added motion sensors and found the heavier kids moved less, giving a possible reason for the weight gap. Köse et al. (2021) looked at Turkish kids and flagged edible reinforcers as a big driver—kids who earned snacks for good behavior had four times the obesity risk. Together these papers paint a fuller picture: maternal BMI starts the story, but severity, activity level, and how we use food in therapy all write later chapters.
Li et al. (2016) flips the lens. Their meta-analysis shows moms with obesity are more likely to have a child with autism in the first place. Joanna's study then shows those same moms also predict heavier body weight once the child has autism. The papers look opposite—one asks if mom's weight causes autism, the other if it predicts child obesity—but both point to maternal BMI as a shared risk marker, not a contradiction.
Why it matters
Check BMI at every clinic visit. If the number is high, loop parents in early—mom's weight is a red flag you can ask about without extra tests. Swap edible reinforcers for stickers, tokens, or praise. Schedule short movement breaks before table work. These small shifts cut calories and add steps, and the literature says they matter as much as autism severity does.
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02At a glance
03Original abstract
Weight status on children and youth with autism spectrum disorder is limited. We examined the prevalence of overweight/obesity in children and youth with autism spectrum disorder, and associations between weight status and range of factors. Children and youth with autism spectrum disorder aged 2-16 years (n = 208) and their parents participated in this study. Body mass index was calculated using the Centers for Disease Control and Prevention growth charts and the International Obesity Task Force body mass index cut-offs. The Autism Diagnostic Observation Schedule was administered. Parents completed questionnaires about socio-demographics, diagnosed comorbidities, sleep disturbances, social functioning and medication of youth with autism spectrum disorder. The prevalence of overweight/obesity in participants with autism spectrum disorder was 35%. One quarter of obese children and youth (25.6%) had obese parents. There was a significant association between children and youth's body mass index and maternal body mass index (r = 0.25, n = 199, p < 0.001). The gender and age, parental education, family income, ethnicity, autism spectrum disorder severity, social functioning, psychotropic and complementary medication use of children and youth with autism spectrum disorder were not statistically associated with their weight status. Findings suggest the need for clinical settings to monitor weight status of children and youth with autism spectrum disorder in a bid to manage or prevent overweight/obesity in this population. Incorporating a family system approach to influence health behaviours among children and youth with autism spectrum disorder especially for specific weight interventions is warranted and should be further explored.
Autism : the international journal of research and practice, 2016 · doi:10.1177/1362361315616345