OtherJournal of autism and developmental disorders2025

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

Emily Hotez, Rebecca K Tsevat, Sha Tao and 8 others

PMID 40381092

WHAT IT FOUND

Autistic Medicaid enrollees aged 15-30 had obesity in 13.2% versus 6.8% of non-autistic enrollees, and four or more health conditions in 14.74% versus 5.12%.

PTSD was also more common (6.37% versus 2.23%). This is association, not proof that autism causes these outcomes.

Key findings

01Autistic Medicaid enrollees had an obesity diagnosis in 13.2% of cases versus 6.8% of non-autistic Medicaid enrollees, and the study reported 2.12 times the odds.

02Autistic Medicaid enrollees had four or more health comorbidities in 14.74% of cases versus 5.12% of non-autistic Medicaid enrollees, and the study reported 2.12 times the odds.

03PTSD was reported in 6.37% of autistic enrollees versus 2.23% of non-autistic enrollees, and autism was associated with greater obesity odds among enrollees without PTSD (2.06 times) and among enrollees with PTSD (1.80 times).

STILL TO COME

How it was doneWhat they found

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What it does not show

The analysis is cross-sectional, so it cannot show that autism, PTSD, obesity, or comorbidities cause one another. The study used Medicaid claims diagnoses, so it does not provide the clinical context for each diagnosis or show whether PTSD was related to autism or to another event. PTSD is often underdiagnosed, and patient financial burden can be a barrier to diagnosis, so the reported PTSD rate may miss true cases and may underestimate stress or trauma. The sample is limited to Medicaid enrollees aged 15 to 30 with at least 12 months of enrollment, so it does not describe people without Medicaid coverage or people with shorter enrollment. The study did not test any therapy, intervention, or functional outcome, so it cannot tell therapists whether treatment changes obesity, PTSD, or comorbidities. The comorbidity index grouped people by 4 or more versus 0 to 3 conditions, which does not show severity, timing, or impact of each condition.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that autism causes obesity, PTSD, or multiple health conditions. The study is a cross-sectional Medicaid claims analysis, so it can show reported associations at the same time period but cannot show cause, timing, or the effect of treatment.

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The study

Participants
627,586 autistic and 1,223,161 non-autistic Medicaid beneficiaries
Certainty of evidence
Low

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    Cite

    Emily Hotez, Rebecca K Tsevat, Sha Tao, et al. Autism, Obesity, and PTSD Among Adolescents and Young Adults: An Analysis of National Medicaid Claims Data. Journal of autism and developmental disorders. 2025.

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