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Weight management interventions for youth with autism spectrum disorder: a systematic review

Abstract

Background and objective

In response to the elevated levels of overweight and obesity among children with autism spectrum disorder (ASD), this article provides a systematic review of the extant empirical literature reporting the effect of weight management interventions (including exercise, diet, and medication) for youth with ASD.

Design

A systematic review of published studies. The databases CINAHL, Web of Science, ERIC, Pubmed, and PsychINFO were searched, revealing 12 studies that were eligible for review.

Results

Of the included studies, half (n = 6) demonstrated significant weight loss; including comprehensive (n = 3), pharmaceutical (n = 2), and exercise (n = 1) interventions. Of relevance, and concern, was that only one of the included studies was determined to be of strong research quality, with the majority (n = 8) determined as being of weak study quality. Furthermore, studies included highly heterogeneous treatment approaches, study designs, and sample characteristics.

Conclusions

This review demonstrates the potential of interventions (particularly individualized, comprehensive, and multidisciplinary team- based interventions) to effectively impact on weight among youth with ASD. It is imperative to rigorously test these interventions in individuals with ASD given the rates of obesity in this population and complications that ensue.

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References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edn. Washington, DC: Author; 2013. https://doi.org/10.1176/appi.books.9780890425596

  2. Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, et al. Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveillance Summaries. 2018 Apr 27;67:1.

    Article  Google Scholar 

  3. Broder-Fingert Sarabeth, Brazauskas Karissa, Lindgren K, Iannuzzi Dorothea, Van Cleave J. Prevalence of overweight and obesity in a large clinical sample of children with autism. Acad Pediatr. 2014;14:408–14. https://www.academicpedsjnl.net/article/S1876-2859(14)00135-1/abstract. Accessed April 6, 2018.

    Article  Google Scholar 

  4. Gillette ML, Borner KB, Nadler CB, Poppert KM, Stough CO, Romine RS, et al. Prevalence and health correlates of overweight and obesity in children with autism spectrum disorder. Journal of Developmental & Behavioral Pediatrics. 2015 Sep 1;36:489–96.

  5. Matheson BE, Douglas JM. Overweight and obesity in children with autism spectrum disorder (ASD): a critical review investigating the etiology, development, and maintenance of this relationship. Rev J Autism Dev Disord. 2017;4:142–56. https://doi.org/10.1007/s40489-017-0103-7.

    Article  Google Scholar 

  6. Hill A, Zuckerman K, Fombonne E. Obesity and autism. Pediatrics. https://doi.org/10.1542/peds.2015-1437

    Article  Google Scholar 

  7. Must A, Phillips S, Curtin C, Bandini LG. Barriers to physical activity in children with autism spectrum disorders: relationship to physical activity and screen time. J Phys Act Heal. 2015;12:529–34. https://doi.org/10.1123/jpah.2013-0271.

    Article  Google Scholar 

  8. Must A, Eliasziw M, Phillips SM, Curtin C, Kral TV, Segal M, et al. The effect of age on the prevalence of obesity among US youth with autism spectrum disorder. Childhood Obesity. 2017 Feb 1;13:25–35.

    Article  Google Scholar 

  9. Curtin C, Anderson SE, Must A, Bandini L. 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 Pediatr. 2010;10:11 https://doi.org/10.1186/1471-2431-10-11.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Whitlock EP, O’Connor EA, Williams SB, Beil TL, Lutz KW. Effectiveness of weight management interventions in children: a targeted systematic review for the USPSTF. Pediatrics. 2010;125:e396–418. https://doi.org/10.1542/peds.2009-1955.

    Article  PubMed  Google Scholar 

  11. O’Connor EA, Evans CV, Burda BU, Walsh ES, Eder M, Lozano P. Screening for obesity and intervention for weight management in children and adolescents. JAMA. 2017;317:2427 https://doi.org/10.1001/jama.2017.0332.

    Article  PubMed  Google Scholar 

  12. Snethen JA, Broome ME, Treisman P, Castro E, Kelber ST. Effective weight loss for children: a meta-analysis of intervention studies 2002-2015. World Evid-Based Nurs. 2016;13:294–302. https://doi.org/10.1111/wvn.12156.

    Article  Google Scholar 

  13. Meguid N, Anwar M, Zaki S, Kandeel W, Ahmed N, Tewfik I. Dietary patterns of children with autism spectrum disorder: a study based in Egypt. Open Access Maced J Med Sci. 2015;3:262 https://doi.org/10.3889/oamjms.2015.051.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Levin A, Scher A. Sleep problems in young children with autism spectrum disorders: a study of parenting stress, mothers’ sleep-related cognitions, and bedtime behaviors. CNS Neurosci Ther. 2016;22:921–7. https://doi.org/10.1111/cns.12651.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ferguson BJ, Marler S, Altstein LL, Lee EB, Akers J, Sohl K, et al. Psychophysiological associations with gastrointestinal symptomatology in autism spectrum disorder. Autism Research. 2017 Feb;10:276–88.

    Article  Google Scholar 

  16. Walls M, Broder-Fingert S, Feinberg E, Drainoni M-L, Bair-Merritt M. Prevention and management of obesity in children with autism spectrum disorder among primary care pediatricians. J Autism Dev Disord. 2018. https://doi.org/10.1007/s10803-018-3494-0

    Article  Google Scholar 

  17. Moher D, Liberati A, Tetzlaff J, Altman D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. https://www.journal-surgery.net/article/S1743-9191(10)00040-3/abstract. Accessed April 6, 2018.

    Article  Google Scholar 

  18. Thomas BH, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. World Evid-Based Nurs. 2004;1:176–84. https://doi.org/10.1111/j.1524-475X.2004.04006.x.

    Article  CAS  Google Scholar 

  19. Anagnostou E, Aman MG, Handen BL, Sanders KB, Shui A, Hollway JA, et al. Metformin for treatment of overweight induced by atypical antipsychotic medication in young people with autism spectrum disorder: a randomized clinical trial. JAMA psychiatry. 2016 Sep 1;73:928–37.

    Article  Google Scholar 

  20. Ptomey LT, Sullivan DK, Lee J, Goetz JR, Gibson C, Donnelly JE. The use of technology for delivering a weight loss program for adolescents with intellectual and developmental disabilities. J Acad Nutr Diet. 2015;115:112–8. https://doi.org/10.1016/j.jand.2014.08.031.

    Article  PubMed  Google Scholar 

  21. Gephart EF, Loman DG. Use of prevention and prevention plus weight management guidelines for youth with developmental disabilities living in group homes. J Pediatr Heal Care. 2013;27:98–108. https://doi.org/10.1016/j.pedhc.2011.07.004.

    Article  Google Scholar 

  22. Lourenco C, Esteves D, Corredeira R, Seabra A. Children with autism spectrum disorder and trampolinetraining. Wulfenia J. 2015;22:1–11.

    Google Scholar 

  23. Pan CY. The efficacy of an aquatic program on physical fitness and aquatic skills in children with and without autism spectrum disorders. Res Autism Spectr Disord. 2011;5:657–65. https://doi.org/10.1016/j.rasd.2010.08.001.

    Article  Google Scholar 

  24. Pitetti KH, Rendoff AD, Grover T, Beets MW. The efficacy of a 9-month treadmill walking program on the exercise capacity and weight reduction for adolescents with severe autism. J Autism Dev Disord. 2007;37:997–1006. https://doi.org/10.1007/s10803-006-0238-3.

    Article  PubMed  Google Scholar 

  25. Gillette ML, Stough CO, Beck AR, Maliszewski G, Best CM, Gerling JK, et al. Outcomes of a weight management clinic for children with special needs. Journal of Developmental & Behavioral Pediatrics. 2014 May 1;35:266–73.

    Article  PubMed  Google Scholar 

  26. Handen BL, Anagnostou E, Aman MG, Sanders KB, Chan J, Hollway JA, et al. A randomized, placebo-controlled trial of metformin for the treatment of overweight induced by antipsychotic medication in young people with autism spectrum disorder: open-label extension. Journal of the American Academy of Child & Adolescent Psychiatry. 2017 Oct 1;56:849–56.

  27. Hinckson EA, Dickinson A, Water T, Sands M, Penman L. Physical activity, dietary habits and overall health in overweight and obese children and youth with intellectual disability or autism. Res Dev Disabil. 2013;34:1170–8. https://doi.org/10.1016/j.ridd.2012.12.006.

    Article  PubMed  Google Scholar 

  28. Pona AA, Dreyer Gillette ML, Odar Stough C, Gerling JK, Sweeney BR. Long-term outcomes of a multidisciplinary weight management intervention for youth with disabilities. Child Obes. 2017;13:chi.2016.0334. https://doi.org/10.1089/chi.2016.0334.

    Article  Google Scholar 

  29. Strahan BE, Elder JH. Video game playing effects on obesity in an adolescent with autism spectrum disorder: a case study. Autism Res Treat. 2015;2015:1–7. https://doi.org/10.1155/2015/128365.

    Article  Google Scholar 

  30. Irby MB, Kolbash S, Garner-Edwards D, Skelton JA. Pediatric obesity treatment in children with neurodevelopmental disabilities: A case series and review of the literature. Infant Child Adolesc. Nutr. 2012;4:215–21.

    Article  Google Scholar 

  31. Epstein LH, Squires S. The Stoplight Diet for Children: An Eight-Week Program for Parents and Children. Little, Brown; 1988. http://agris.fao.org/agris-search/search.do?recordID=US201300449156. Accessed April 10, 2018.

  32. Holcomb MJ, Pufpaff LA, McIntosh DE. Obesity rates in special populations of children and potential interventions. Psychol Sch. 2009;46:797–804. https://doi.org/10.1002/pits.20418.

    Article  Google Scholar 

  33. Williams PGail, Dalrymple Nancy, Neal J, Williams P, Gail Nancy. Dalrymple, and Jamie Neal. Pediatr Nurs. 2000;26:259.

    PubMed  CAS  Google Scholar 

  34. Maayan L, Correll CU. Management of antipsychotic-related weight gain. Expert Rev Neurother. 2010;10:1175 https://doi.org/10.1586/ern.10.85.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Coury DL, Anagnostou E, Manning-Courtney P, Reynolds A, Cole L, McCoy R, et al. Use of psychotropic medication in children and adolescents with autism spectrum disorders. Pediatrics. 2012 Nov 1;130(Supplement 2):S69–76.

    Article  PubMed  Google Scholar 

  36. Dattilo AM, Birch L, Krebs NF, Lake A, Taveras EM, Saavedra JM. Need for early interventions in the prevention of pediatric overweight: a review and upcoming directions. J Obes. 2012;2012. https://doi.org/10.1155/2012/123023

    Article  Google Scholar 

  37. Egan AM, Dreyer ML, Odar CC, Beckwith M, Garrison CB. Obesity in young children with autism spectrum disorders: prevalence and associated factors. Child Obes. 2013;9:125–31. https://doi.org/10.1089/chi.2012.0028.

    Article  PubMed  Google Scholar 

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Correspondence to Seán Healy.

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Healy, S., Pacanowski, C.R. & Williams, E. Weight management interventions for youth with autism spectrum disorder: a systematic review. Int J Obes 43, 1–12 (2019). https://doi.org/10.1038/s41366-018-0233-8

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