medwireNews: The presence of diabetes distress and body dissatisfaction may warn of a high risk for disordered eating in adolescents with type 1 diabetes, show data from the Diabetes MILES Youth–Australia study.
Both of these factors “are heavily understudied in relation to disordered eating and type 1 diabetes,” say Emanuala Araia (Deakin University, Geelong, Victoria, Australia) and co-researchers.
Their findings, which appear in Pediatric Diabetes, are based on data from 477 adolescents (aged 13–19 years) who participated in the national survey. They were aged an average of 16 years and 62% were female.
In addition to diabetes distress and body dissatisfaction, the team found that anxiety symptoms, resilience, and glycated hemoglobin (HbA1c) were also significantly associated with disordered eating in their final regression model.
These variables explained 71% of the variance in the participants’ disordered eating symptoms, measured using the 16-item Diabetes Eating Problem Survey-Revised (DEPS-R), with diabetes distress and body dissatisfaction making the largest contributions.
When the researchers used the BMI Silhouette Matching Test to assess body dissatisfaction, they found that although males and females reported similar perceived actual body sizes, girls had a significantly lower perceived ideal body size than boys.
Consequently, girls’ perceived actual body size was an average of 4.8 kg/m2 larger than what they considered to be ideal, whereas for boys it was just 0.6 kg/m2. Furthermore, body dissatisfaction correlated with all measured psychologic variables in girls, but not boys, although it was predictive of disordered eating in both sexes.
“It is possible that males and females may differ in the magnitude of body dissatisfaction reported but not in the level that body dissatisfaction affects disordered eating,” say the study authors, although they stress that prospective research is needed to confirm if body satisfaction directly contributes to disordered eating.
Other factors included in the regression analysis comprised age, female sex, BMI, and general emotional wellbeing, but these were not significant in the final model.
Araia and team note that the persistence of HbA1c in the final model “further strengthen[s] the importance of examining glycaemic outcomes when screening for disordered eating.”
They suggest that focusing on elevated HbA1c, diabetes distress, and body dissatisfaction “may aid in early identification of potential disordered eating behaviours.”
The researchers say: “Moving forward, longitudinal studies are required to map how these factors predict changes over time, specifically during more difficult developmental phases, such as adolescence to young adulthood.
“The overarching goal remains on how to intervene before these problems emerge, increase in severity and/or progress to more enduring disordered eating.”
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