Weight Control Practices and Disordered Eating Behaviors Among Adolescent Females and Males With Type 1 Diabetes
Associations with sociodemographics, weight concerns, familial factors, and metabolic outcomes
- Dianne Neumark-Sztainer, PHD1,
- Joan Patterson, PHD1,
- Alison Mellin, PHD1,
- Diann M. Ackard, PHD2,
- Jennifer Utter, MPH1,
- Mary Story, PHD1 and
- Joseph Sockalosky, MD3
- 1Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota
- 2Private Practice, Golden Valley, Minnesota
- 3Children’s Hospitals and Clinics, St. Paul, Minnesota
OBJECTIVE—This study examines the prevalence of specific weight control practices/disordered eating behaviors and associations with sociodemographic characteristics, BMI and weight perceptions, family functioning, and metabolic control among adolescent females and males with type 1 diabetes.
RESEARCH DESIGN AND METHODS—The study population included 70 adolescent females and 73 adolescent males with type 1 diabetes who completed the AHEAD (Assessing Health and Eating among Adolescents with Diabetes) survey. Data on BMI and glycosylated hemoglobin (HbA1c) were drawn from medical records.
RESULTS—Unhealthy weight control practices were reported by 37.9% of the females and by 15.9% of the males. Among the females, 10.3% reported skipping insulin and 7.4% reported taking less insulin to control their weight. Only one male reported doing either of these behaviors. Weight control/disordered eating behaviors were not associated with age, parental level of education, family structure, or race/ethnicity. Higher levels of weight dissatisfaction tended to be associated with unhealthy weight control/disordered eating; associations with BMI were inconsistent. Family cohesion was negatively associated with disordered eating among females (r = −0.52; P < 0.001) and males (r = −0.41; P < 0.001), but correlations with other measures of family environment (control, independence, and responsibility for diabetes management) were not significant. Correlations between disordered eating and HbA1c levels were significant among females (r = 0.33; P < 0.01) and males (r = 0.26; P < 0.05).
CONCLUSIONS—Special attention is needed for youth with weight concerns and those from less cohesive families to assist in the development of healthy diabetes management behaviors.
- AHEAD, Assessing Health and Eating among Adolescents with Diabetes
- DEPS, Diabetes Eating Problems Survey
- DFRQ, Diabetes and Family Responsibility Questionnaire
- EAT, Eating Among Teens Survey
- FES-R, Family Environment Scale-Revised
Address correspondence and reprint requests to Dianne Neumark-Sztainer, PhD, MPH, RD, Division of Epidemiology, University of Minnesota, 1300 South 2nd St. #300, Minneapolis, MN 55454. E-mail:.
Received for publication 4 December 2001 and accepted in revised form 30 April 2002.
D.M.A. holds stock in Pfizer, Medtronic, and Genentech.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- DIABETES CARE