Screening and identification of disordered eating in people with type 1 diabetes: A systematic review

Pursey, Kirrilly; Hart, Melissa; Jenkins, Laura; McEvoy, Mark; Smart, Carmel E.

doi:10.1016/j.jdiacomp.2020.107522

Cited by 47 publications

(57 citation statements)

References 109 publications

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“…In line with previous research, scores equal to or higher than 20 were considered as suggesting high risk for DEB ( Saßmann et al, 2015 ; Wisting et al, 2018 , 2019 ). The DEPS-r is the most widely validated DEB tool for adolescents with T1D, and it has been demonstrated to possess high internal reliability and high concurrent/criterion validity when compared to a gold standard clinical interview; it also has convergent validity with significant correlations with other validated measures of eating disorders (i.e., EAT-12, EDI, SCOFF, and EDE-Q) ( Pursey et al, 2020 ). A validated Italian version of the DEPS-r was used in this study ( Pinna et al, 2017 ).…”

Section: Methodsmentioning

confidence: 99%

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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

et al. 2020

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To examine body image problems and their associations with disordered eating behavior in adolescents with type 1 diabetes and well-matched healthy peers. Methods: Using a cross-sectional design, 183 adolescents with type 1 diabetes (13.02-18.05 years) were recruited from diabetes centers in southern Italy and compared to healthy peers matched for age and gender. Participants completed self-report measures of disordered eating behaviors (DEPS-r and EDI-3RF) and a gender-specific body image problem questionnaire (SATAQ-4R). Socio-demographic and clinical data (zBMI, HbA1c, and disease duration) were also collected. Hierarchical multiple linear regression analyses were computed to determine the relative importance of diabetes variables and body image problems on participants' disordered eating behaviors after controlling for demographic variables. Results: Adolescents with type 1 diabetes showed diabetes-specific eating problems in 37.7% of cases and had more eating problem symptoms (assessed as drive for thinness and bulimia) than healthy peers. Male adolescents with type 1 diabetes did not display more body image problems (p > 0.05); females with type 1 diabetes compared to females in the control group were found to be more pressured by family (p = 0.025) but less by media (p = 0.022) to improve their appearance and attain a thin body. zBMI and body image problems contributed to a significant increase in disordered eating behavior risk both in male and female adolescents with diabetes and in healthy peers (zBMI 0.213 < β < 0.426, p < 0.05; body image 0.243 < β < 0.572, p < 0.05).

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Section: Methodsmentioning

confidence: 99%

“…In particular, according to most recent literature reviews (Hanlan et al, 2013;Conviser et al, 2018;Pursey et al, 2020), disordered eating behaviors (DEBs) were more common in youths with T1D compared to healthy peers, and this was significantly associated with poorer glycemic control (Young et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…This may be attributable to the community-based, anonymous nature of the current survey compared to recruitment from diabetes clinics in previous studies. Further, while purging behaviours have frequently been assessed in people with diabetes, the frequency of purging is often unreported, with studies instead relying on global measures of eating disorder psychopathology [16]. Detoxes and extreme weight loss dieting were frequently reported in adolescents with diabetes in this study.…”

Section: Discussionmentioning

confidence: 82%

“…To date, the majority of studies investigating associations between diabetes and eating disorders have been conducted in relatively small samples drawn from clinical diabetes settings or registries [16], which may affect representativeness of the samples and generalisability to the broader population. Findings have also been mixed with regards to the impact of disordered eating on metabolic status [17] and very few studies have investigated community-based and population samples [18,19].…”

Section: Introductionmentioning

confidence: 99%

Diabetes and disordered eating behaviours in a community-based sample of Australian adolescents

et al. 2020

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Background: People with diabetes have been shown to be at risk for disordered eating compared to their nondiabetic peers. However, the majority of studies have been conducted in relatively small samples drawn from clinical diabetes settings or registries. Community-based samples are required to better understand disordered eating behaviours in this population. In a large community-based population sample of Australian adolescents, this study aimed to (1) investigate disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers and (2) test associations between disordered eating behaviours and insulin restriction. Methods: Secondary school students (n = 4854; mean (SD) age 14.4 (1.6) years; 47% boys) completed an online survey, including self-reported presence of diabetes, demographics, weight status, substance use, insulin restriction and disordered eating behaviours. Clinically meaningful cutoffs for disordered eating behaviours were generated for analysis. Results: Disordered eating behaviours, specifically self-induced vomiting (diabetes 19.2%, no diabetes 3.3%; p < 0.001), laxative use (diabetes 15.4%, no diabetes 2.1%; p < 0.001), use of cigarettes (diabetes 26.9%, no diabetes 4.3%; p < 0.001) and other drugs (diabetes 28.9%, no diabetes 4.0%; p < 0.001), cleanse/detox (diabetes 30.8%, no diabetes 10.5%; p < 0.001) and extreme weight loss diets (diabetes 13.5%, no diabetes 4.7%; p < 0.003) were higher in those reporting a diagnosis of diabetes. In addition, 17% of those with diabetes reported frequent insulin restriction (≥ once per week), and insulin restriction was associated with more frequent disordered eating behaviours. Conclusion: There was a high rate of disordered eating behaviours in adolescents with diabetes compared to their peers without diabetes. The findings of this study may have the potential to inform future health promotion, prevention, and early intervention approaches for those with comorbid diabetes and disordered eating behaviours. Future longitudinal studies are required to evaluate disordered eating behaviours in those with diabetes over time in community-based samples.

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“…Second, people with T1D speci cally are considered to be at an increased risk in general for psychological di culties, such as behavioral disorders, anxiety symptoms, and psychological distress [12][13][14][15]. They are also at risk for disordered eating behaviors (DEBs)-i.e., mild to extreme dieting behavior, including caloric restriction, skipping meals, binge eating attacks, unhealthy behaviors for weight control, and/or use of insulin restriction for intentional calorie purging [16,17]; these behaviors are reported more in youths with T1D compared to healthy peers [18][19][20][21][22] and are signi cantly associated with poorer glycemic control [23]. It has been assumed that speci c elements of diabetes and its treatment (i.e., dietary restrictions, recurring weight variation, focus and attention to the body, food preoccupation, continuous attention to food intake, meal planning, counting carbohydrates, etc.)…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 lockdown on disordered eating behaviors in youths with type 1 diabetes: Analysis of cross-sectional survey data.

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Chianese

Zanfardino

et al. 2020

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Background: Recent research indicates that patients with type 1 diabetes (T1D) are at higher risk for disordered eating behaviors (DEBs) than their peers without diabetes. The present study aimed at examining the impact of the COVID-19 lockdown on DEBs in a sample of Italian children and adolescents with T1D and in matched-pair healthy controls.Methods: 138 children and adolescents with T1D (aged 8.01-19.11 years, 65 boys) attending a Southern Italian diabetic service and 276 age- and gender-matched healthy peers voluntarily completed a cross-sectional online survey of eating behaviors (ChEAT and Eat-26), anthropometric characteristics, and clinical characteristics. Results: 8.69% (N=12) of participants with T1D and 13.4% (N=37) of controls had ChEAT/EAT-26 scores indicating presence of DEBs, with no differences between patients—whether children (total ChEAT score F(1, 157)=.104, p=.748) or adolescents (total EAT-26 score F(1, 255)=.135, p=.731)—and healthy peers. zBMI values were lower than those measured in the latest diabetes visit (p<.0001), while HbA1c values remained unchanged (p=.110). In both groups, adolescents had lower Oral Control scores than children (T1D: F(1, 138)= 20.411, p<.0001, η2 =.132, controls: F(1, 276)=18.271, p<.0001, η2 =.063); additionally, gender (female) and age were found to be significant predictors of several ChEAT/EAT-26 scores.Discussion: Psychological conditions in relation to DEB symptoms of children and adolescents with T1D were not aggravated by lockdown conditions. Results indicated DEBs as more of a female adolescent developmental issue rather than as a result of the challenges of living with a chronic illness aggravated by outbreak. Possible effects of parental pressure on their children’s eating behaviors in the context of home confinement and of using a non-diabetes-specific measure to assess DEBs are discussed.

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Screening and identification of disordered eating in people with type 1 diabetes: A systematic review

Cited by 47 publications

References 109 publications

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

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

Diabetes and disordered eating behaviours in a community-based sample of Australian adolescents

The impact of the COVID-19 lockdown on disordered eating behaviors in youths with type 1 diabetes: Analysis of cross-sectional survey data.

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