Weight status of children and adolescents with autism spectrum disorder: A cross-sectional analysis of primary care electronic medical records and linked health administrative datasets in Ontario, Canada

BackgroundIndividuals with autism spectrum disorder (ASD) may be at increased risk of both obesity and underweight.ObjectiveTo examine the association between ASD and weight status in children and adolescents, adjusting for individual- and neighbourhood-level sociodemographic factors.MethodsWe conducted a cross-sectional study of children and adolescents >= 2 and <= 18 years old using health administrative and demographic data from Ontario, Canada. Using growth measurements from a large primary care database between 2011 and 2016, we categorized weight status using World Health Organization definitions. We defined ASD based on a previously validated algorithm.ResultsWe included 568 children and adolescents with ASD and 32 967 without ASD. Comparing those with ASD to those without ASD, prevalence of underweight was 3.5% versus 1.9%, overweight 19.0% versus 18.2%, obesity 12.9% versus 7.3%, and severe obesity 5.8% versus 2.2%. In the fully adjusted multinomial logistic regression model, ASD remained associated with underweight (adjusted odds ratio [aOR] 2.02; 95% confidence interval [CI] 1.27-3.20), obesity (aOR 1.87; 95% CI 1.44-2.43) and severe obesity (aOR 2.62; 95% CI 1.81-3.80).ConclusionChildren and adolescents with ASD are at increased risk of underweight, obesity, and severe obesity, independent of sociodemographic characteristics. Strategies addressing growth and weight status are warranted in this population.