Obesity in Adolescents with Autism Spectrum Disorders BRANDY STRAHAN, PHD, RN Assistant Professor.
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Transcript of Obesity in Adolescents with Autism Spectrum Disorders BRANDY STRAHAN, PHD, RN Assistant Professor.
![Page 1: Obesity in Adolescents with Autism Spectrum Disorders BRANDY STRAHAN, PHD, RN Assistant Professor.](https://reader035.fdocuments.us/reader035/viewer/2022062718/56649e675503460f94b6396f/html5/thumbnails/1.jpg)
Obesity in Adolescents with Autism Spectrum Disorders
BRANDY STRAHAN, PHD, RNAssistant Professor
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Introduction• Adolescent obesity has tripled in the
past three decades.• Contributes to serious health problems• Centers for Disease Control and
Prevention (CDC) defines obesity as:• 70% remain obese through adulthood• Vulnerability of children with
developmental disabilities such as ASD
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Purpose• Provide a general background related to
obesity in adolescence with specific emphasis on obesity in the ASD population
• Illustrate in a case study the special challenges related to treating an obese adolescent with ASD
• Describe current interventions to address obesity in typically developing (TD) adolescents and discuss how these interventions could be used with adolescents with ASD
• Discuss suggestions for future research regarding the prevention and reduction of obesity in this vulnerable population
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Obesity in TD Adolescents• Predominant health crisis in
America’s youth• Life expectancy rates • National Health and Nutrition
Examination Survey (NHANES)• Development of comorbidities• Complications magnified in
adolescents with ASD
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Obesity in Adolescents with ASD • Autism – developmental disorder
under broad category of ASD• Hallmark characteristics include
impairments in the following areas:• Social interaction• Communication• Behavior control• Typically appear prior to age 3
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Obesity in Adolescents with ASD • No cure• Treatment options may help with
day-to-day functioning• Caregivers focus on problematic
features• Less concern for adverse health
behaviors and weight, physical activity and eating patterns, and over consumption of junk food
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Obesity in Adolescents with ASD • May not encourage exercise due to
motor impairments such as:• Poor motor skills• Uneven developmental
milestone acquisition• Low muscle tone• Postural instability
• Obesity in ASD population is 30.4% compared to 23.6% in TD adolescents.
• Important to understand unique challenges of adolescents
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Case Study• Henry (pseudonym) is a 14 year-
old Caucasian adolescent diagnosed with ASD and is obese.
• Height – 69 inches• Weight – 247 lbs.• Tanner Stage IV• BMI – 36.5 (above 99th percentile
for sex and age)
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Case Study• Attends public school with a daily
physical education class (PE, 30 minutes)
• No other active recreational activities
• Trouble performing skills necessary to successfully participate in class activities
• Watches television at home• No other playmates except
parents and younger brother (10 year old with ASD and is obese)
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Case Study• Diet:• Variety of fruits and vegetables• Relies on favorites – chicken nuggets
and hot dogs• Parents offer lean proteins and complex
carbohydrates• New foods are refused• Exposure to new foods incites a tantrum
causing Henry to leave the table• Parents must choose-unhealthy,
uneventful dinner or healthy dinner accompanied by an argument and tantrum.
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Case Study• Inactivity not the only contributor to
weight• Prescribed medication of Risperdal • Antipsychotic• Treats common features such as
aggression and mood swings• Side effect of weight gain
• Continual unhealthy weight gain• Parents encourage healthier food
choices and physical activity• No empirically based dietary/lifestyle
intervention for obese adolescents with ASD
• Potential to become obese adult with increased morbidity and mortality
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Interventions for Obese Adolescents • Extensive body of literature on the
prevention and treatment of obesity in TD adolescents• Increased activity levels, reduced
television hours, and improved nutrition decrease obesity and improve health outcomes
• Mentoring adolescents in community and school based programs
• Nutrition and aerobic/strength training
• Active video gaming
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Interventions for Obese Adolescents • All studies employed experimental
design with physical activity intervention aimed at:• Reducing weight or BMI• Decreasing the amount of weight
gained during the study• Decreasing body fat percentages
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Interventions for Obese Adolescents • Randomized controlled trials
(RTCs, home or community based) used a variety of physical activity interventions:• Individual aerobic activity• Nutrition and strength training• Active video gaming• Group exercises• Activity combined with reduced
caloric intake and healthier choices
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Limitations of Reviewed Studies • Standardized measures• Multiple points of comparison• Longitudinal studies since
maintaining weight loss is much more challenging
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Implications of Future Research • Direct and adequate comparisons
are limited due to:• Wide range of methodologies• Various physical activities• Numerous physiological
measurements• Sample variety• Variation in study length• Confounding effects
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Unique Challenges of ASD • Food selectivity• Schedule rigidity• Social impairments• Problematic features versus health
behaviors and weight gain• Motor impairment
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Discussion• Findings represent a powerful way to
induce weight loss in obese adolescents with ASD.
• Active video gaming may be a solution since male adolescents with ASD spend 41% of free time playing video games.
• Combining community and home based interventions may prove to be the most promising avenue for research and long term effects.
• There exists a need for more research that accounts for unique challenges of adolescents with ASD and ensures success with this population.
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Conclusion• Adolescent obesity is an epidemic.• Obesity present in adolescents
with developmental disabilities such as ASD.
• Parents, such as Henry’s, need to understand how to better manage the disorder as well as prevent further health related complications
• Research is needed that addressed the needs of this vulnerable population.