Though less likely to smoke or drink, a new study finds that adults with autism are at higher risk for a slew of health problems ranging from diabetes and obesity to heart failure.

In a review of insurance records for more than 23,000 adults, researchers found that medical and psychiatric issues are much more prevalent in those with autism as compared to individuals without the developmental disorder.

“Nearly all medical conditions were significantly more common in adults with ASD than controls, including diabetes, gastrointestinal disorders, epilepsy, sleep disorders, dyslipidemia, hypertension and obesity,” researchers said in a summary of their findings which are being presented this week at the International Meeting for Autism Research in Atlanta.

“Rarer conditions, such as eating disorders, mechanical falls, vision and hearing impairments, osteoporosis and chronic heart failure were also significantly more common among adults with ASD than controls,” they said.

For the study, researchers at Kaiser Permanente Northern California looked at medical records for 23,188 individuals ages 18 and older enrolled in the insurer’s health plans between 2008 and 2012 to assess the prevalence of psychiatric, behavioral and medical conditions. Of the individuals whose records were studied, 2,108 were diagnosed with autism.

The findings suggest that depression and anxiety are more than twice as common for those on the spectrum while bipolar disorder is eight times as likely and there is a 12-fold increase in the risk of epilepsy for this group.

Nearly a third of those with autism in the study also had obesity or hypertension, conditions that affected less than 20 percent of those without the developmental disorder. At the same time, however, the findings indicate that cancer rates were similar for those with and without autism.

While it’s long been known that children with autism face more medical and psychiatric diagnoses than their peers, this is the first large study to look at how common these issues are in adults.

“Children with autism become adults with autism,” said Lisa Croen who led the study and is director of the Autism Research Program at Kaiser Permanente Northern California. “Doctors caring for adults need to be aware that adults have autism and an adult with autism could be walking through their door.”

Croen said that physicians need better training on how to treat individuals on the spectrum throughout the life span and she said improvements are needed in the hand off from the pediatric to adult medical care systems.

Researchers said that one reason behind the high prevalence of health problems among adults with autism could be that the social and communication difficulties as well as the sensory sensitivities common among this population may lead to diminished preventive care.