Body mass index and disordered eating in adolescent females with type 1 diabetes

Obesity is one of the top ten global health problems as recognized by the World Health Organization and is an epidemic in the United States. Type 1 diabetes is a disease in which disordered eating and overweight can cause significant medical comorbidities. The prevalence of overweight and some eating disorders are greater in adolescent females with type 1 diabetes than in those without the disorder. The development of type 1 diabetes may be affected by elevated body mass index (BMI). In addition, the management of the disorder (and associated risk factors) can be affected by disordered eating as well as elevated BMI. This study aimed to examine the relationship between disordered eating attitudes and behaviors and overweight with a number of self-report variables. These included attitudes toward food, weight and dieting history, and diabetes treatment variables. The purpose of the study was to better understand this population and begin to develop effective interventions. Data were collected at one pediatric endocrinology clinic and three summer camps with the final sample yielding data from 90 females, ages 12-19, with type 1 diabetes. The current sample had a significantly higher BMI that that of a non-diabetic comparison sample. A significant positive relationship was found between eating disorder characteristics and cognitive restraint, BMI, and weight suppression. Those participants who reported a history of dieting scored higher on a measure of eating disorder characteristics than those without a history of dieting. A significant positive relationship was found between BMI and appetitive responsiveness to the food environment, disinhibition, and BMI category at first diagnosis. Participants who reported never being overweight displayed less eating disorder characteristics than those who were overweight prior to diagnosis and those who were overweight after diagnosis. While these results are correlational and not causal, they indicate that there are some easily recognized characteristics of adolescent females with type 1 diabetes that may predict the likelihood of problems with disordered eating attitudes or behaviors or problems with overweight. The data may be used to inform future research, as well as have implications for the development of effective health-related interventions with this population.