Weight-Loss Practices and Weight-Related Issues among Youth with Type 1 or Type 2 Diabetes

  1. Jean M. Lawrence, MPH,ScD,MSSA (Jean.M.Lawrence{at}kp.org)1,
  2. Angela D. Liese, PhD, MPH2,3,
  3. Lenna Liu, MD, MPH4,
  4. Dana Dabelea, MD, PhD5,
  5. Andrea Anderson, MS6,
  6. Giuseppina Imperatore, MD, PhD7 and
  7. Ronny Bell, PhD6
  1. 1Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA
  2. 2Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
  3. 3Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC
  4. 4Children's Hospital and Regional Medical Center, Seattle, WA
  5. 5Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, CO
  6. 6Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
  7. 7Division of Diabetes Translation, NCCDPHP, Centers for Disease Control and Prevention, Atlanta, GA

    Abstract

    Objective. To describe the weight-loss practices and weight-related issues reported by youth with diabetes, according to gender and diabetes type.

    Research Design and Methods. 1,742 female and 1,615 male youth 10-21 years with type 1 or type 2 diabetes completed a SEARCH study visit where height, weight and GHb were measured. A survey assessed weight-related issues and weight-loss practices.

    Results. Although more common in youth with type 2 diabetes, youth with type 1 diabetes also reported weight-related concerns and had elevated BMI. Among youth who had ever tried to lose weight (n=1,646), healthy weight-loss practices; diet (76.5%) and exercise (94.8%); were the most common, while unhealthy practices; fasting (8.6%), using diet aids (7.5%), vomiting or laxative use (2.3%), and skipping insulin doses (4.2%); were less common. In gender-specific multivariable models including age, race/ethnicity, diabetes type, BMI category, and glycemic control, obese females and overweight/obese males were more likely to report ever practicing any unhealthy weight-loss practice than normal weight youth. These practices were associated with poor glycemic control for females but not males. All unhealthy weight-loss practices except fasting were more common in females than males. Dieting, fasting, and using diet aids were all more common in youth with type 2 diabetes than those with type 1 diabetes.

    Conclusions. Given the prevalence of overweight and obesity among youth with type 1 or type 2 diabetes, health care professionals caring for youth with diabetes need to pay particular attention to identifying youth, particularly females, with unhealthy weight-loss practices.

    Footnotes

      • Received April 13, 2008.
      • Accepted September 4, 2008.

    This Article

    1. Published online before print September 22, 2008, doi: 10.2337/dc08-0719
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