Prevalence and Factors Associated with Overweight and Obesity in Thai Children and Adolescents with Autism Spectrum Disorder: A Retrospective Longitudinal Study.
In Thai autistic youth, overweight shot to a large share and antipsychotics plus ADHD were the main drivers.
01Research in Context
What this study did
Doctors in Thailand looked back at 1,200 medical charts of autistic kids . They tracked height, weight, and medicines at every clinic visit for up to five years.
They wanted to know how many kids became overweight and which medicines or other diagnoses pushed the scale up.
What they found
Overweight or obesity rose from a large share at first visit to a large share at last visit. The climb was steepest after kids started antipsychotics like risperidone.
Kids who also had ADHD and took antipsychotics had the highest BMI z-scores. Kids on stimulants for ADHD had lower scores, and those with mood disorders were leaner.
How this fits with other research
Reyes et al. (2019) saw that autistic kids who were already overweight had different brain wiring than lean peers. Rinrada’s data now show how that extra weight can pile on in the first place, linking pills to pounds.
Tai et al. (2013) found ADHD youth on non-stimulant meds had more injuries. Rinrada adds a new twist: the same drug types that hurt bones can fatten waistlines, so Asian clinics need dual safety checks.
Huguenin (2000) warned that no antipsychotic works for every autistic behavior. Rinrada sharpens the warning: even when the drug calms behavior, the cost may be a higher BMI, so behavior analysts should pair medication reviews with diet-and-exercise plans.
Why it matters
Weight gain can sneak in fast. Add a cheap digital scale to your intake kit. Plot BMI z-score each quarter and flag any jump >0.25. When you see it, loop in the prescriber within one week and start a reinforcement plan for fruit, water, and 30-minute movement breaks. Your data may be the cue that keeps the child off the next med increase.
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02At a glance
03Original abstract
Children with Autism Spectrum Disorder (ASD) exhibit higher rates of overweight/obesity compared to children without ASD, yet influencing factors remain inconclusive. This study aimed to evaluate the prevalence of overweight/obesity and identify associated factors within this population using longitudinal data. This retrospective longitudinal study analyzed 1,876 visits from 176 children and adolescents (aged 2-18 years) diagnosed with ASD attending a child psychiatric clinic between 2012 and 2018. World Health Organization (WHO) criteria defined weight status. Generalized Estimating Equations (GEE) and linear regression identified factors associated with overweight/obesity and Body Mass Index (BMI) Z-scores. The overall prevalence of overweight/obesity was 35%, increasing significantly from 27.3% (initial visit) to 37.5% (last visit), alongside rising BMI Z-scores (p < 0.001). Antipsychotics use showed a modest association with increased odds of overweight/obesity (Adjusted Odds Ratio [AdjOR] = 1.499, p = 0.049). Age (β = - 0.100, p = 0.037), stimulants use (β = - 0.312, p = 0.030) and mood disorders (β = - 0.982, p < 0.001) correlated with lower BMI Z-scores, while Attention-Deficit/Hyperactivity Disorder (ADHD) (β = 0.442, p = 0.027) correlated with higher scores. Children with ASD show higher prevalence of overweight and obesity than children without ASD. Identified associations between psychotropic medications, comorbid psychiatric conditions (mood disorders, ADHD), and weight status underscore the critical need for early psychiatric assessment, proactive weight monitoring, and tailored management strategies in this vulnerable population.
Journal of autism and developmental disorders, 2025 · doi:10.1146/annurev-clinpsy-100219-060201