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Depression, appearance concerns predicted disturbed eating behavior in girls with diabetes
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Early interventions that stress self-worth and personal image may help adolescent girls with diabetes develop positive feelings about themselves.
Researchers in Toronto identified predictors of the onset of disturbed eating behavior in 126 girls with type 1 diabetes aged 9 to 13 years. Each girl completed the Children’s Eating Disorder Examination Survey interview and four follow-up assessments during five years. The researchers defined disturbed eating behavior as “dieting for weight control, binge eating, self-induced vomiting or the use of diuretics, laxatives, insulin omission or intense exercise for weight control,” according to the abstract.
Prospective study data revealed that 45 of the 101 girls who did not have disturbed eating behavior at baseline developed the behavior during follow-up. Logistic regression revealed a model that was significantly associated with onset of disturbed eating behavior. Depression, weight and shape concerns, higher BMI and lower global and physical appearance-based self-worth predicted onset of disturbed eating behavior. According to the researchers, this model accounted for 48.2% of the variance compared with girls who did not develop disturbed eating behavior. – by Katie Kalvaitis
Diabetes Care. 2008;31:1978-1982.
This study is one of the first longitudinal studies examining and tracking the development of disturbed eating behavior in girls with type 1 diabetes. It is a well-designed study that relied on a standardized diagnostic interview and reliable self-report measures to establish changes in eating behavior over time. What makes this study unique is that it was not examining full-blown diagnoses of eating disorders. Rather, it focused on the subtler and more widespread problem of disturbed eating behaviors, which already have been shown to increase risk of developing serious medical complications of diabetes at a younger age and shorter disease duration.
By establishing some of the factors that predicted the development of disturbed eating behaviors — namely BMI percentile, weight and shape concerns, lower self-esteem both globally and specifically related to appearance, and symptoms of depression — this study offers the field more ideas about who is at heightened risk and who may need to be referred for evaluation and treatment before an eating disorder becomes established.
– Ann Goebel-Fabbri, PhD
Instructor in Psychiatry, Harvard Medical School
Investigator, Section on Behavioral and Mental Health, Joslin Diabetes
Center