Changes in body image and onset of disordered eating behaviors in youth with type 1 diabetes over a five-year longitudinal follow-up

Body Image Problems and Disordered Eating Behaviors in Italian Adolescents With and Without Type 1 Diabetes: An Examination With a Gender-Specific Body Image Measure

“…Similarly, empirical evidence has shown that in youths and adults with T1D, the level of satisfaction with their perceptions of body image (along with other factors such as BMI, global and physical appearance-based self-worth, and depression), weight, and shape were associated with higher levels of DEB ( Kichler et al, 2008 ; Troncone et al, 2016 , 2018 ; Verbist and Condon, 2019 ). Body image dissatisfaction was described to be a significant predictor of eating problems in adolescents and young adult participants with T1D ( Falcão and Francisco, 2017 ; Araia et al, 2020 ).…”

“…Specific elements of the illness and its treatment, -i.e., dietary restrictions, recurring weight variation, the subjective perception of living in an unhealthy body, focus and attention on the body, daily need for injections, etc.-are thought to facilitate the development of a negative body image (Colton et al, 1999;Shaban, 2010). Greater body dissatisfaction and an attitude toward body image problems have been reported in several studies on adolescents and young adults with T1D (Neumark-Sztainer et al, 2002;Kichler et al, 2008;Dewey, 2013, 2014;Pinquart, 2013;Troncone et al, 2016Troncone et al, , 2018. However, other evidence showed that adolescents with T1D had healthy body images and found no significant differences between participants (young adults and adolescents) with and without T1D in body image dissatisfaction or in their self-reports of body image (Meltzer et al, 2001;Ackard et al, 2008;Kaminsky and Dewey, 2013;Falcão and Francisco, 2017).…”

“…Specifically, some measures consisted of items assessing dissatisfaction with body shape, weight and shape concerns, level of satisfaction with their physical appearance and significance of physical appearance ( Kichler et al, 2008 ; Olmsted et al, 2008 ; Gawlik et al, 2016 ; Verbist and Condon, 2019 ). Other measures involved gender-specific silhouettes and merely evaluated the participants’ levels of satisfaction with their weight and physical appearance by measuring differences between perceived actual size and ideal size ( Troncone et al, 2016 , 2018 ; Araia et al, 2017 , 2020 ; Falcão and Francisco, 2017 ). It should be pointed out, as emphasized by Pursey et al’s review (2020) about eating disorder measures, that a gender bias across body image measures can be identified: tools are often focused on body image concerns more frequently reported among females compared to males (e.g., drive for thinness, belief of being fat, weight loss concerns), with items specifically evaluating concerns salient for females (e.g., concerns about specific aspect/shape of body parts such as thighs, hips, etc.)…”

Psychological support for adolescents with type 1 diabetes provided by adolescents with type 1 diabetes: The chat line experience

“…Adolescents with type 1 diabetes mellitus (T1DM) are considered to be at an increased risk for psychological difficulties and are consequently described as having lower life satisfaction and health perception than their healthy peers . They are also thought to have higher anxiety symptoms than the general adolescent population, elevated negative emotions arising from living with T1DM and the burden of self‐management, greater incidence of depression, psychological distress, and eating disorders …”

“…1 They are also thought to have higher anxiety symptoms than the general adolescent population, 2 elevated negative emotions arising from living with T1DM and the burden of self-management, 3 greater incidence of depression, psychological distress, and eating disorders. [4][5][6][7] All these psychological problems resulting both from psychosocial demands of adolescent transition and from the chronic-illness burden inherent in this disease appear to increase the risk of poor selfmanagement and to favor poorer health outcomes (eg, poorer glycemic control). 8 Age-specific preventive interventions are needed to find these critical issues, and age-appropriate means should be employed to respond effectively to adolescent's needs.…”