Body Image and Dieting Behavior in Cystic Fibrosis

Abstract

ABSTRACT. Objective. To examine the relationship between pulmonary function, nutritional status, body image, and eating attitudes in children with cystic fibrosis (CF) compared with healthy controls.Method. Seventy-six children with CF (39 girls) and 153 healthy control children (82 girls) were recruited. All children were between 7 and 12 years of age. After being weighed and measured, participants undertook a structured 1-to-1 interview. Four measures were used to assess body image: body size (perception and satisfaction) were ascertained using the Children's Body Image Scale (CBIS), which uses photographs of children of various body mass index (BMI) representative of the range of BMI percentiles for children 7 to 12 years of age. Body size satisfaction was measured by the response to the questions, "Do you think your body is 1) much too thin, 2) too thin, 3) just right, 4) too fat, and 5) much too fat?" Body weight satisfaction was measured by the question, "Would you like your body to be 1) much thinner, 2) a little bit thinner, 3) stay the same, 4) a little bit fatter, and 5) much fatter?" Global self-esteem was measured using the children's version of the Rosenberg Self-Esteem Scale and Body Esteem Scale using a 24-item scale. Dieting behavior was measured by asking directly about previous weight control behaviors, use of the Dutch Eating Behavior-Restraint Scale (DEBQ-R), and, in children who acknowledged previous dieting behavior, the Children's Eating Attitude Test (ChEAT) was additionally administered.Results. Both girls and boys with CF had significantly reduced BMI percentiles compared with control children. Boys with CF did not have a significantly different BMI compared with girls with CF. There were significant positive correlations between forced expiratory volume in 1 second (FEV 1 ) (% of predicted) and BMI percentile in girls (r ‫؍‬ .35) and boys (r ‫؍‬ .50) with CF. Body image perceptions in boys and girls with CF were examined in relation to the healthy control group using 2 (CF and control groups) by 2 (male and female) analysis of variance. The interaction effect was examined to explore the prediction that girls compared with boys with CF would have greater acceptance of their body shape and less desire to become larger. There were no differences between groups or sex in body esteem. On the CBIS body dissatisfaction score, children with CF were significantly more likely to perceive their ideal body size as a little larger than their current size while control children desired a smaller body size than their current size. CF children had a significantly lower mean score for body size satisfaction (an item assessing perception being too thin) and a significantly higher mean score on body weight satisfaction. There was a significant main effect of gender for only 1 measure, difference between the CBIS body dissatisfaction score, with girls being more likely to nominate a smaller ideal than their current figure. There were no significant interaction effects.Of children with CF and a low BMI (<1...

Developing a measure of eating attitudes and behaviours in cystic fibrosis

“…That is, the measure will be helpful in identifying any disturbance in EABs associated with weight loss or low weight maintenance in people with CF, given the negative health implications of this. The low prevalence of disturbed EABs found within this community CF sample is also consistent with the lower prevalence of EDs [1] and disturbed EABs [2,4,5] found in CF compared to control samples.…”

“…Eating disorders (EDs) or disturbed eating attitudes or behaviours (EABs) have been reported in young people [1][2][3] and adults [4][5][6] with Cystic Fibrosis (CF) and may contribute to poor nutritional status, which is associated with poor growth and delayed puberty [7], reduced lung function [8] and decreased survival [9]. It will be valuable to assess disturbances in EABs in the CF population; however, existing self-report measures of disturbed EABs (i.e.…”

Assessment of agreement between parents and children on health‐related quality of life in children with cystic fibrosis

“…Girls scored higher than boys, which could be explained by the fact that girls are less or feel less ‘pushed’ into eating than boys; in media and fashion magazines girls are often illustrated as thin and skinny. Truby and Paxton (2001) reported similar results and concluded that adolescent girls with CF are generally not unhappy with their posture and do not necessarily wish to be any fatter and may not be motivated to eat the high‐energy diet recommended.…”

Health-related quality of life of Spanish children with cystic fibrosis

“…Overall, children had a favourable body image (median HRQOL score of 88.9). Probably, most children did not consider themselves as ‘too thin’, but rather slender as compared to their peers, which may have contributed to their overall satisfaction with body image [30]. The HRQOL scores on the domain of body image decreased with age, after adjustment for sex.…”