Several studies have indicated that the prevalence of unhealthy body weight in individuals with autism spectrum disorder (ASD) is high. It is unclear whether factors related to the weight status of children and adolescents with ASD are the same or different from factors associated with the weight status of typically developing children (TDC). The objective of this review was to identify key factors associated with the higher rates of unhealthy weight observed in individuals with ASD and create a structural model, which could be used for future autism intervention research. This review summarizes the current state of knowledge on the genetic basis of obesity in ASD, special treatment (behavioral and medical, including diet and psychotropic medications), psychological (depression and anxiety) as well as somatic comorbid disorders such as feeding problems, sensory processing disorders, gastrointestinal problems and sleep disorders, physical activity and sedentary behaviors, loneliness and social isolation, and family functioning (maternal depression and stress).
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Al-Towairqi W Alosaimi W AlZaidi S Helmy F AlSherif E. 2015. Depression among mothers of autistic spectral disorder children. Int J Contemp Pediatr 2(2):119–26.
Al-Zaid FS Alhader AA Al-Ayadhi LY. 2014. Altered ghrelin levels in boys with autism: a novel finding associated with hormonal dysregulation. Sci Rep 4:6478.
American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC.
Askari J Hassanbeigi A Khosravi HM Malek M Hassanbeigi D Pourmovahed Z et al. 2013. The relationship between obesity and depression. Procedia – Soc Behav Sci 84:796–800.
Bauman ML. 2010. Medical comorbidities in autism: Challenges to diagnosis and treatment. Neurotherapeutics 7:320–37.
Bandini LG Anderson SE Curtin C Cermak S Evans EW Scampini R et al. 2010. Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr 157(2):259–64.
Brandler WM Antaki D Gujral M Kleiber ML Whitney J Maile MS et al. 2018. Paternally inherited cis-regulatory structural variants are associated with autism. Science 360 (6386):327–31.
Broder-Fingert S Brazauskas K Lindgren K Iannuzzi D van Cleave J. 2014. Prevalence of overweight and obesity in a large clinical sample of children with autism. Acad Pediatr 14(4):408–14.
Cacioppo JT Hawkley LC Norman GJ Berntson GG. 2011. Social isolation. Ann NY Acad Sci 1231:17–22.
Chen X Beydoun MA Wang Y. 2008. Is sleep duration associated with childhood obesity? A systematic review and meta-analysis. Obesity 16(2):265–74.
Corvey K Menear KS Preskitt J Goldfarb S Menachemi N. 2016. Obesity physical activity and sedentary behaviors in children with an Autism Spectrum Disorder. Matern Child Health J 20(2):466–76.
Croen LA Zerbo O Qian Y Massolo ML Rich S Sidney S et al. 2015. The health status of adults on the autism spectrum. Autism 19(7):814–23.
Curtin C Anderson SE Must A Bandini L. 2010. The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children’s Health. BMC Pediatrics 10(11).
Curtin C Bandini LG Perrin E. Tybor DJ Must A. 2005. Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review. BMC Pediatrics 5(48).
DeFilippis M. 2018. Depression in Children and Adolescents with Autism Spectrum Disorder. Children 5(9).
Devnani PA Hegde AU. 2015. Autism and sleep disorders. J Pediatr Neurosci 10(4): 304–07.
Foxx RM. 2008. Applied behavior analysis treatment of autism: the state of the art. Child Adolesc Psychiatr Clin N Am 17(4):821–34.
Gal E Cermak SA Ben-Sasson A. 2007. Sensory processing disorders in children with autism. Nature assessment and intervention. In: RL Gabriels and DE Hill. Growing up with autism. Working with school-aged children and adolescents. New York: Guilford Press 95–123.
Granich J Lin A Hunt A et al. 2016. Obesity and associated factors in youth with an autism spectrum disorder. Autism 20:916–26.
Gentry JA Luiselli JK. 2008. Treating a child’s selective eating through parent implemented feeding intervention in the home setting. J Dev Phys Disabil 20(1):63–70.
Grzadzinski R Huerta M Lord C. 2014. DSM-5 and autism spectrum disorders (ASDs): an opportunity for identifying ASD subtypes. Molecular Autism 4(12).
Guh DP Zhang W Bansback N Amarsi Z Birmingham CL Anis AH. 2009. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Pub Health 9(88).
Happe F Charlton RA. 2012. Aging in autism spectrum disorders: a mini-review. Gerontology 58:70–8.
Hazen EP Stornelli JL O’Rourke JA Koesterer K. McDougle CJ. 2014. Sensory symptoms in autism spectrum disorders. Harv Rev Psychiatry 22(2):112–24.
Healy S Aigner CJ Haegele JA 2019. Prevalence of overweight and obesity among US youth with autism spectrum disorder. Autism 23(4):1046–50.
Ho W Spiegel BMR. 2008. The relationship between obesity and functional gastrointestinal disorders: causation association or neighter? Gastroenterol Hepatol 4(8):572–8.
Jose A Gupta S Gulati S Sapra S. 2017. Prevalence of depression in mothers of children having ASD. Current Medicine Research and Practice 7(1):11–5.
Kasari S Sterling L. 2014. Loneliness and social isolation in children with Autism Spectrum Disorders. In: RJ Caplan and JC Bowker editors. The handbook of solitude: psychological perspectives in social isolation social withdrawal and being alone. 1st edition. Los Angeles: John Wiley & Sons.
Kim E-K Neggers YH Shin C-S Kim E Kim E.M. 2009. Dyslipidemia in children with autism. Reprod Toxicol 28:135–6.
Ledford JR Gast DL. 2006. Feeding problems in children with Autism Spectrum Disorders: A review. Focus Autism Dev Dis 21(3):153–66.
Lerthattasilp T Charernboon T MD Chunsuwan I Siriumpunkul P. 2015. Depression and burden among caregivers of children with Autistic Spectrum Disorder. J Med. Assoc Thai 98 Suppl. 2:45–51.
Levy SE Pinto-Martin JA Bradley CB Chittams J Johnson SL Pandey J et al. 2019. Relationship of weight outcomes co-occurring conditions and severity of Autism Spectrum Disorder in the study to explore early development. J Pediatr 205:202–9.
Lisik MZ. 2014. Molecular aspects of a autism spectrum disorders. Psychiatr Pol 48(4):689–700.
Macdonald M Esposito P Ulrich D. 2011. The physical activity patterns of children with autism. BMC Res Notes 4 (422).
Marí-Bauset S Llopis-González A Zazpe I Marí-Sanchis A Suárez-Varela MM. 2016. Nutritional impact of a gluten-free casein-free diet in children with Autism Spectrum Disorder. J Autism Dev Disord 46(2):673–84.
Matson JL Kozlowski AM. 2011. The increasing prevalence of autism spectrum disorders. Res Autism Spect Dis 5(1):418–25.
McCloughen A Foster K 2011. Weight gain associated with taking psychotropic medication: an integrative review. Int J Ment Health Nurs 20(3):202–22.
Mills JL Hediger ML Molloy CA Chrousos GP Manning-Courtney P Yu KF et al. 2007 Elevated levels of growth-related hormones in autism and autism spectrum disorder. Clin Endocrinol (Oxf) 67:230–37.
Mulloy A Lang R O’Reilly M Sigafoos J Lancioni G Rispoli M. 2010. Gluten – free and casein free diets in the treatment of autism spectrum disorders: A systematic review. Res Autism Spect Dis 4:328–39.
Newschaffer CJ. Kresch Curran L. 2003. Autism: an emerging public health problem. Public Health Rep 118(5):393–9.
Nonogaki K Nozue K Oka Y. 2007. Social isolation affects the development of obesity and type 2 diabetes in mice. Endocrinology 148(10):4658–66.
O’Connor SG Maher JP Belcher BR Leventhal AM Margolin G Shonkoff ET et al. 2017. Associations of maternal stress with children’s weight-related behaviours: a systematic literature review. Obesity Reviews: 18(5):514–25.
Pan C-Y. 2008. Objectively measured physical activity between children with autism spectrum disorders and children without disabilities during inclusive recess settings in Taiwan. J Autism Dev Dis 38(7):1292–301.
Pinto D Pagnamenta AT Klei L Anney R Merico D Regan R. 2010. Functional impact of global rare copy number variation in autism spectrum disorders. Nature 466(7304):368–72.
Piskorz-Ogórek K Ogórek S Cieślińska A Kostyra E. 2015. Autism in Poland in comparison to other countries. Polish Annals of Medicine 22(1):35–40.
Pisula E Porębowicz-Dörsmann A. 2017. Family functioning parenting stress and quality of life in mothers and fathers of Polish children with high functioning autism or Asperger syndrome. PloS One 12(10).
Pleban FT Barney D Burke R. 2014. Physical activity in children with Autism Spectrum Disorders: considerations for educational program administration. Eur J Sport 5(1):15–26.
Rai D Culpin I Heuvelman H Magnusson CMK Carpenter P Jones et al. 2018. Association of autistic traits with depression from childhood to age 18 years. JAMA Psychiatry 75(8):835–43.
Raport of the National Autism Spectrum Disorder (ASD) Surveillance System. Autism Spectrum Disorder among Children and Youth. 2018.
Roy B Ghosh S Sathian B Banerjee I. 2016. Genetic basis of obesity: a review. J Biomed Sci 3(2):24–8.
Rosser Sandt DD Frey GC. 2005. Comparison of physical activity levels between children with and without Autism Spectrum Disorders. Adapt Phys Act Q 22:146–59.
Sebat J Lakshmi B Malhotra D Troge J Lese-Martin C Walsh T et al. 2007. Strong association of de novo copy number mutations with autism. Science 316(5823): 445–9.
Sharma JR Arieff Z Sagar S Kaur M. 2012. Autism and obesity: prevalence molecular basis and potential therapies. Autism Insights 4:1–13.
Sitek A Rosset I Strapagiel D Majewska M Ostrowska-Nawarycz L Żądzińska E. 2014. Association of FTO gene with obesity in Polish schoolchildren. Anthropol Rev 77(1):33–44.
Strahan BE. 2015. Food selectivity in obese adolescents with Autism Spectrum Disorder. J Child Adolesc Behav 3(6).
Strang JF Kenworthy L Daniolos P Case L Wills MC Martin A et al. 2012. Depression and anxiety symptoms in children and adolescents with Autism Spectrum Disorders without intellectual disability. Res Autism Spect Dis 6(1):406–412.
Suarez MA. 2012. Sensory processing in children with autism spectrum disorders and impact on functioning. Pediatr Clin N Am 59(1):203–14.
Suchowierska W Walczak P. 2013. Knowledge about autism among Polish pediatricians. Postępy Nauk Medycznych 26(1):58–64.
Tate EB Wood W Liao Y Dunton GF. 2015. Do stressed mothers have heavier children? A meta-analysis on the relationship between maternal stress and child body mass index. Obes Rev: 16(5):351–61.
The Icd-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. 1992. Geneva: World Health Organization.
Trambacz S. Gołaska P. 2013. Stosowanie diety bezglutenowej i bezkazeinowej w terapii dzieci z autyzmem – moda czy konieczność? Przegląd literatury naukowej i popularnonaukowej. Standardy Medyczne Pediatria10:338–45 (in Polish).
Trambacz-Oleszak S Krzyżaniak A Szafrańska-Komarowska I Kaczmarek M. 2018. Body weight status is not a predictive factor of depressive symptoms in Polish adolescents aged 13–18 years. Anthropol Rev 81(4):351–63.
Uchino S Waga C. 2013. SHANK3 as an autism spectrum disorder-associated gene. Brain Dev 35(2):106–10.
Wang J Gong J Li L et al. 2018. Neurexin gene family variants as risk factors for autism spectrum disorder. Autism Res 11:37–43.
Wong HHL Smith RG. 2006. Patterns of complementary and alternative medical therapy use in children diagnosed with autism spectrum disorders. J of Aut Dev Dis 36:901–9.
Xiong N Ji C Li Y et al. 2009. The physical status of children with autism in China. Res Dev Disabil 30:70–6.
Zuckerman KE Hill AP Guion K Voltolina L Fombonne E. 2014. Overweight and obesity: prevalence and correlates in a large clinical sample of children with autism spectrum disorder. J Autism Dev Disord 44(7):1708–19.