Autism, Obesity, and PTSD Among Adolescents and Young Adults: An Analysis of National Medicaid Claims Data

Autistic individuals disproportionately experience obesity, cardiovascular disease, diabetes, and a range of other adverse health outcomes, relative to both the general population and those with other developmental conditions. These individuals also disproportionately experience Post-Traumatic Stress Disorder (PTSD). Many of these conditions emerge during adolescence and young adulthood (age 15-30). This study analyzed Medicaid claims data (2008-2019) from autistic (n = 627,586; M age = 17.15 [3.55]) and non-autistic (n = 1,223,161; M age 19.35 [4.56]) adolescent and young adults. Using logistic regression and adjusting for demographic and clinical characteristics, this study: (1) evaluated associations between the presence of autism, obesity, and other health co-morbidities using the Adolescent and Young Adult (AYA) Hope Comorbidity Index; and (2) tested PTSD as a moderator in these associations. Compared with non-autistic beneficiaries, autistic beneficiaries demonstrated 2.12 (95% CI: 2.09, 2.15) and 2.12 (95% CI: 2.09, 2.16) times the odds of having obesity and other health comorbidities, respectively. PTSD moderated these associations such that autism status was more strongly associated with obesity and health co-morbidities among those without a PTSD diagnosis compared to those with a PTSD diagnosis. Autistic adolescents and young adults experience higher rates of obesity, health co-morbidities, and PTSD relative to their non-autistic counterparts. Future work is needed to explore measurement of stress and trauma beyond PTSD diagnoses and elucidate the precise association between stress and trauma with adverse health outcomes in this population.