The evaluation of body image in children with type 1 diabetes: A case-control study

Abstract

This study evaluated the body image perception in children with type 1 diabetes in order to identify symptoms of disordered eating behaviours early. Children with type 1 diabetes and controls showed underestimation and dissatisfaction with body size. The patients, especially girls, were more accurate in their perception of body size than the control group. The study sheds light on some of the underlying factors that may contribute to the development of disordered eating behaviours in adolescence. The causes of the differences of perception of body size are discussed.

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

“…Overall, the current findings corroborate the existing research on general and T1D populations supporting the association between body image problems and DEBs ( Colton et al, 1999 ; Striegel-Moore and Debra, 2002 ; Fairburn and Harrison, 2003 ; Striegel-Moore and Bulik, 2007 ; Kichler et al, 2008 ; Troncone et al, 2016 , 2018 ; Amaral and Ferreira, 2017 ; Falcão and Francisco, 2017 ; Girard et al, 2018 ; Verbist and Condon, 2019 ; Araia et al, 2020 ).…”

“…Results from previous studies have been inconclusive as to whether adolescents with T1D are more likely to have body image problems compared with other adolescents. Several researchers found that youths with diabetes more frequently reported concerns and dissatisfaction about their bodies ( Colton et al, 1999 ; Neumark-Sztainer et al, 2002 ; Kichler et al, 2008 ; Shaban, 2010 ; Kaminsky and Dewey, 2013 ; Philippi et al, 2013 ; Pinquart, 2013 ; Kaminsky and Dewey, 2014 ; Troncone et al, 2016 , 2018 ). In contrast, and more in line with the findings of this study, other studies have found no significant differences in body image problems between adolescents with T1D and healthy peers ( Striegel-Moore et al, 1992 ; Meltzer et al, 2001 ; Ackard et al, 2008 ; Kaminsky and Dewey, 2013 ; Falcão and Francisco, 2017 ).…”

“…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.)…”