Clinical Characteristics Associated With Overweight and Obesity Status in Youth With Autism Spectrum Disorder: A...

The use of second-generation antipsychotics (SGAs) for managing challenging behaviors in youth with autism spectrum disorder (ASD) is increasing, but studies on antipsychotic-induced weight gain in this population remain limited. Overweight/obesity [body mass index (BMI) ≥85th percentile] could increase health complications and health care costs. This study examines clinical factors associated with overweight/obesity in youth with ASD.

Electronic medical records of youth (ages 5 to 17 years) with ASD, seen at a university-affiliated Autism Center from 2018 to 2022, were analyzed.

There were 97 youths with ASD prescribed SGAs and 261 who were not. The rate of overweight/obesity (BMI≥85th percentile) did not differ by SGA use. Youth prescribed SGAs were more likely to have public insurance (63.9% vs. 45.2%, P =0.002) and a comorbid disruptive behavior disorder (DBD) diagnosis (69.1% vs. 24.1%, P <0.001). Youth with overweight/obesity were more likely to have public insurance (61.6% vs. 42.5%, P <0.001) and a DBD diagnosis (46.6% vs. 29.2%, P <0.001). Youth with SGAs and stimulants were less likely to be overweight or obese than youth with SGAs without stimulant co-treatment.

Mean BMI percentile and the rate of overweight/obesity did not differ by SGA use. Public insurance and DBD diagnosis have positive relationships with overweight/obesity, whereas stimulant co-treatment with SGA had a negative relationship. It is important to carefully consider the risks and benefits of SGA use, especially in under-resourced youth and those with disruptive behaviors.