April 20, 2015
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Depression, higher BMI linked to weight-control behaviors in young adults with type 1 diabetes

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Unhealthy and very unhealthy weight-control behaviors may be associated with a higher BMI and more depressive symptoms in emerging adults with type 1 diabetes, according to research in Diabetes Educator.

That link, however, is not related to the changes many young adults experience after graduating high school, including going away to college or living independently from parents, according to researchers.

“Findings from this study did not support the premise that this transitional time, with its many changes, is a vulnerable time for [weight-control behaviors] for emerging adults with type 1 diabetes,” the researchers wrote. “Healthy and unhealthy [weight-control behaviors] were not associated with their new eating contexts for youth in this study.”

Kathleen M. Hanna, PhD, RN, of University of Nebraska Medical Center, Omaha, and colleagues at other institutions analyzed data from 184 typical emerging adults (aged 17 to 19 years at onset of study) with type 1 diabetes. Researchers assessed weight-control behaviors (healthy, unhealthy and very unhealthy), BMI, and living and educational situations (independent or living with parents; enrolled or not enrolled in school) every 3 months for 1 year, as well as impulse control at baseline and at 1 year. Depressive symptoms, glycemic control and sex were measured at baseline only. Generalized linear models incorporated the repeated measures.

Researchers used the Project AHEAD questionnaire to measure weight-control behaviors as healthy (exercising, eating fruits and vegetables, minimizing high-fat foods and sweets), unhealthy (fasting, using food substitutions, smoking) or very unhealthy (taking diet pills, vomiting, skipping insulin doses, using laxatives). A majority of the participants (80% to 81%) were involved in healthy weight-control behaviors, whereas 25% to 34% practiced some unhealthy weight-control behavior and very few (3% to 12%) practiced some very unhealthy weight-control behaviors, according to researchers.

Unhealthy weight-control behaviors were independently associated with a higher BMI (OR = 1.1; 95% CI, 1.01-1.19) and depressive symptoms (OR = 1.08; 95% CI, 1.04-1.14) among adults living independently. Young adults enrolled in school also showed a link between unhealthy weight control and higher BMI (OR = 1.09; 95% CI, 1.01-1.18) and depressive symptoms (OR = 1.08; 95% CI, 1.03-1.13).

Among young adults with very unhealthy weight-control behavior, there was only a small link with depressive symptoms for those living independently (OR = 1.06; 95% CI, 1.01-1.12), and among those enrolled in school (OR = 1.07; 95% CI, 1.01-1.12), according to researchers.

The study results suggest that involvement in unhealthy and very unhealthy weight-control behaviors is associated with certain individual risk factors and not dependent on life changes, such as enrolling in school, according to researchers. Health care professionals should assess non-high-risk emerging adults with type 1 diabetes for their involvement in weight-control behaviors, according to researchers.

“Given that unhealthy [weight-control behaviors] are detrimental to glycemic control, it is essential to identify even the small portion involved in them,” the researchers wrote. – by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.