Disordered eating behaviours and body shape dissatisfaction among adolescents with type 1 diabetes: a cross sectional study

J Eat Disord. 2023 Sep 26;11(1):169. doi: 10.1186/s40337-023-00876-y.

Abstract

Background: Disordered eating behaviours (DEBs) are variations in regular eating patterns and behaviours and might include symptoms and behaviours of eating disorder with lower level of severity. Such behaviours are common during adolescence at which time several physical and psychological changes occur favouring unhealthy dietary behaviours. Although the magnitude of DEBs is high among high-income countries, similar data are limited among adolescents with diabetes in low-income countries including Ethiopia. This study aimed to assess the magnitude of DEBs and its relationship with body shape dissatisfaction among adolescents with diabetes on follow-up at selected public hospitals in Addis Ababa, Ethiopia.

Methods: Hospital based cross sectional study was conducted among randomly selected 395 adolescents with diabetes attending public hospitals in Addis Ababa from January to December, 2021. Data were collected using structured pretested standard diabetes eating problem survey revised (DEPS-R) questionnaire, body part satisfaction scale of 8 items, and anthropometric measurements. Descriptive statistics such as median alongside interquartile range was used to describe the continuous variables. Binary bivariable and multivariable logistic regression was used for data analysis. Mann-Whitney U-test and Kruskal-Wallis test were used to evaluate the difference between median scores of independent variables. Adjusted odds ratios (AOR) alongside 95% confidence intervals (CIs) were estimated to measure the strength of association between variables of interest.

Results: The magnitude of disordered eating behaviours within the last 30 days was 43.3%, [95% CI: (38%, 48%)]. In multivariable analysis, body shape dissatisfaction [AOR = 2.21, 95% CI (1.28, 3.82, p = 0.0001)], family history of diabetes mellitus [AOR = 1.59, 95% CI (1.03, 2.47, p = 0.038)], late adolescence period [AOR = 2.10, 95% CI (1.33, 3.34, p = 0.002)], having diabetic complication[AOR = 2.32, 95% CI (1.43, 3.75, p = 0.001)],and being overweight [AOR = 2.25, 95% CI (1.32, 3.82, p = 0.003)] were significantly associated with DEBs.

Conclusions: The magnitude of DEBs was high among the study participants. Body shape dissatisfaction, family history of diabetes mellitus, being in late adolescence period, diabetic complication, and nutritional status of adolescents were significantly associated with DEBs. Therefore, preventive interventions need to be designed by all relevant actors working on health promotion of young population to address factors influencing DEBs among adolescent population with diabetes.

Keywords: Adolescents; Binge eating; Body shape dissatisfaction; Diabetes eating problem survey-revised (DEPS-R); Disordered eating behaviour; Ethiopia; Purging; Type 1 diabetes.

Plain language summary

The World Health Organization (WHO) defined adolescents as individuals in the age bracket of 10–19 years. Biologically, adolescence is a period of development that stretches from the onset of puberty through the termination of growth. This period is a critical link between childhood and adulthood, characterized by significant physical, psychological, and social transitions which carry new risks including the development of disordered eating behaviors among adolescents and opportunities that influence the immediate and future health of young people. This cross-sectional study aimed at assessing the magnitude of disordered eating behaviors and its relationship with body shape dissatisfaction among adolescents with diabetes on follow-up at selected public health facilities. The results showed that the magnitude of disordered eating behaviors is high. Body shape dissatisfaction was found to be statistically significantly associated with disorder eating behaviors during adjusted analysis alongside other attributes which have been identified to have an influence on adolescents’ eating behaviours. A better understanding of the link between individual level attributes and DEBs could help adolescents’ health programmers to launch more conducive interventions targeting the identified risks and researchers to more understand other aspects that could influence the adolescents’ eating behaviors.