Adolescents with Diet-Related Chronic Health Conditions (DRCHCs) and Unique Risk for Development of Eating Pathology

Abstract

Diet-Related Chronic Health Conditions (DRCHCs) are a subset of chronic health illnesses, which presently includes Inflammatory Bowel Disease (IBD), Type 1 Diabetes (T1D), Cystic Fibrosis (CF), and Celiac Disease (CD). Food and diet play integral roles in the management and progression of each condition. The diversity of treatments for DRCHCs encompass therapies that impact diet, weight, and body shape, such as steroids, insulin, and special and/or restrictive diets. Often with efforts to control unwanted side effects of the myriad of treatments, there is poor adherence to prescribed therapies. Given the psychosocial burden of DRCHCs, and the high degree of focus on weight and diet involved in managing each disorder, it is not surprising that those living with DRCHCs may be at risk for developing body image concerns, including poor body image and weight concerns, which may increase the risk for the development of eating pathology. In addition to summarizing current eating pathology risk factors present in DRCHCs, the proposed article builds on previous research by recommending an expansion of the category of DRCHCs to include Type II Diabetes and serious/anaphylactic food allergies, and hypothesizes DRCHC-specific eating pathology risk factors, such as hyper focus on weight, medically-related food restriction, and societal acceptance of thinness despite health issues. The article concludes with clinical recommendations for pediatric medical providers to potentially minimize the negative impact of DRCHC on pediatric patients' medical and psychosocial outcomes.

Assessing the Prevalence of and Risk Factors for Disordered Eating Attitudes and Behaviors in Adolescents With Inflammatory Bowel Disease

“…"), discussing weight while showing visual growth curves, and being mindful about hospital roommate pairing during hospitalizations based on food intake status (eg, not rooming an adolescent who is NPO with an adolescent who can eat without restriction). 2 Although BMI data from the last medical visit were available for roughly half of the study cohort and identified majority as having normal BMI, limited information on the weight and BMI of all participants limited the authors' ability to interpret psychosocial findings in the context of weight status.…”

“…In a review of BID and disordered eating behaviors in pediatric chronic illnesses, 53% and 16% of patients with cystic fibrosis were found to have disordered eating attitudes and disordered eating behaviors, respectively, and patients with type 1 diabetes were more than twice as likely as healthy peers to engage in disordered eating behaviors. 2 A recent study of BID in newly diagnosed pediatric IBD found that older age, worse patient-reported disease status, and greater depressive symptoms were associated with higher levels of BID. 4 The understanding of BID concerns in pediatric IBD beyond initial diagnosis is unknown and remains essential to care planning for medications and surgery.…”

“…1 Medical and psychosocial risk factors for eating pathology and body image concerns also affect youth with IBD, including medical hyperfocus on weight, medically related food restriction, body image uncertainty, and societal praise of thinness despite health issues. 2 Treatment-related risk factors may increase vulnerability to eating pathology and poor body image, including adverse effects of steroids and psychosocial sequelae related to surgery/medical devices (eg, body dissatisfaction after surgery).…”

Psychological Discrepancies found in Children and Adolescents

“…The review article by David et al [6], discussed the correlations between the prevalence of Diet-Related Chronic Health Conditions (DRCHCs) such as, Inflammatory Bowel Disease (IBD), Cystic Fibrosis (CF), and Celiac Disease (CD) and the chances of development of pathological conditions related to eating. The review emphasized on indirect psychological and societal implications of DRCHCs and how they may help in the process of development of eating pathological conditions.…”