Body Image Dissatisfaction in Patients with Inflammatory Bowel Disease

Abstract

Background Despite the fact that the inflammatory bowel diseases (IBD) and their treatments may affect physical appearance, the effect of IBD on body image is poorly understood. The aims of this study were to determine whether body image dissatisfaction (BID) changes over time in patients with IBD and to examine the demographic and disease-related variables associated with decreased body image. Methods Adults aged 18 and above in the Ocean State Crohn's and Colitis Area Registry with at least 2 years of follow-up were eligible for this study. All patients were enrolled within 6 months of IBD diagnosis and followed prospectively. BID was assessed using a modified version of the Adapted Satisfaction With Appearance (ASWAP) questionnaire. Total ASWAP scores and 2 sub-scores were calculated. To assess for changes over time, general linear models for correlated data were used for continuous outcomes and generalized estimating equations were used for discrete outcomes. Results Two hundred seventy-four patients were studied. BID was found to be stable over time among men and women with IBD despite overall improvements in disease activity. No differences were found in BID according to IBD subtype. Female gender, greater disease activity, higher symptom burden, longer duration of steroid use, dermatologic and musculoskeletal manifestations of IBD, and ileocolonic disease location among patients with Crohn's disease were associated with greater BID. Greater BID was associated with lower health-related quality of life (HRQOL). Conclusions BID remains stable in an incident cohort of IBD despite improved disease activity and is associated with lower HRQOL

White Paper AGA: The Impact of Mental and Psychosocial Factors on the Care of Patients With Inflammatory Bowel Disease

“…Other areas of patient concern include patients' body image (physical appearance), 66,67 and an IBD-specific body image scale has been validated. 68 Another focus area is assessing a patient's ability to cope with their disease.…”

The effects of body image impairment on the quality of life of non-operated Portuguese female IBD patients

“…One of the pointed reasons for this discrepancy may be related to issues concerning body image (Muller, Prosser, Bampton, & Andrews, 2010), described as the subjective perception of one's body and the cognitions and emotions associated with it (Kelsay, Hazel, & Wamboldt, 2005). In fact, since both IBD itself (through symptoms like weight loss and abdominal bloating) and its treatment (due to corticosteroids use; McDermott et al, 2015;Saha et al, 2015) impact on body shape and weight, the majority of patients present impaired body image (e.g., Casati et al, 2000;De Rooy et al, 2001;McDermott et al, 2015). This impairment does not seem to be determined by IBD type as literature reveals the same levels of body image impairment for CD and UC patients (Muller et al, 2008;Saha et al, 2015).…”

Adolescents with Diet-Related Chronic Health Conditions (DRCHCs) and Unique Risk for Development of Eating Pathology

“…Adults with IBD have been found to have high body image dissatisfaction [36]. Adults with IBD were at greater risk for body image dissatisfaction if they were female, had overall greater disease activity, reported a higher symptom burden, had an extended steroid treatment, and had extraintestinal manifestations [36].…”

“…While body image dissatisfaction has been described in adult populations, researchers have noted the absence of sensitive screening tools specific to body image dissatisfaction in individuals with IBD [36,39]. Researchers have worked to focus the scientific conversation on pediatric IBD to build an optimal and meaningful model of transitioning pediatric patients into adult medical institutions, with effective and positive health behaviors to maximize adherence and disease management, while also instilling psychological resilience, social competence, and coping strategies into chronic illness care [43].…”