Body Image Dissatisfaction among Pediatric Patients with Inflammatory Bowel Disease

Abstract

Objectives To determine risk factors for body image dissatisfaction among pediatric patients with inflammatory bowel disease (IBD). Study design We performed a cross-sectional study of children aged 9-18 years in the IBD Partners Kids & Teens cohort. Participants completed surveys including demographics, disease characteristics and activity indices, and psychosocial outcomes measured by IMPACT-III questionnaires. We defined body image dissatisfaction if participants answered "I look awful" or "I look bad." Bivariate analyses assessed associations between body image dissatisfaction and demographic, disease-related and psychosocial factors; logistic regression models evaluated associations between risk factors and body image dissatisfaction. Results IMPACT-III was completed by 664 patients, with 74 (11.1%) reporting body image dissatisfaction. Patients with body image dissatisfaction were more likely to be female (P < .01), older (median age 15 vs 13 years, P < .01), and diagnosed with IBD at an older age (12 vs 10 years, P < .01). Those with body image dissatisfaction had greater body mass index percentile (P = .02), more active disease (P < .01), more current steroid use (P < .01), and more depression and anxiety (P < .01). Female sex (OR 2.31; 95% CI 1.22-4.39), depression (OR 4.73; 95% CI 2.41-9.26), and anxiety (OR 5.42; 95% CI 2.48-11.80) were independently associated with body image dissatisfaction. Conclusions In this cohort, risk factors for body image dissatisfaction include female sex, older age at diagnosis, active disease, current steroid use, greater body mass index, and comorbid mood disorder. Interventions targeting modifiable risk factors for body image dissatisfaction may improve quality of life in pediatric patients with body image dissatisfaction.

Illness stigma, body image dissatisfaction, thwarted belongingness and depressive symptoms in youth with inflammatory bowel disease

“…First, the percentage of youth with clinically elevated levels of depressive symptoms and the concomitant psychosocial challenges observed in the present study emphasize the need for routine screening of social and emotional difficulties during IBD clinic visits [26,27]. Importantly, because female participants in our sample were more likely to endorse both body image concerns and depressive symptoms, it is important that medical and behavioral health professionals be made aware of the potential unique body image-related emotional challenges faced by female youth with IBD [11,12]. Even though age was not related to the primary variables, it will be important for future research to examine ways to best implement body image and depression interventions across age groups.…”

“…Zero-order correlations and t -tests were also conducted to determine potential demographic and disease covariates. Previous research has indicated that both BMI and steroid medications can impact body image dissatisfaction [11]; therefore, we included BMI and steroid medication status as covariates in the primary analyses. Additional preliminarily correlation analyses examined the zero-order associations among the key study variables.…”

“…Indeed, findings indicate that children and adolescents with chronic illnesses have less positive body images than healthy youth, and it is suspected that body image may play a significant role in IBD adjustment because the potential for undesirable physical changes is compounded by the stress associated with physical maturation, emotional development and body image acquisition during this time [9,10]. Not surprisingly, body image concern/ dissatisfaction has demonstrated significant associations with depressive symptoms in youth with IBD [11,12]. However, the psychosocial sequelae of IBD that may contribute to body image dissatisfaction and the mechanism(s) by which body image dissatisfaction impacts depressive symptoms remain understudied areas in this population [13,14].…”

Quality of life in Malaysian children with inflammatory bowel disease: An understudied population

“…Children with poorly controlled IBD resulting in stunted growth or delayed puberty tended to have lower self-esteem than their healthy peers. 6 The physical, social and emotional well-being of children with IBD are often adversely impacted in addition to clinical symptoms and functional limitations. [7][8][9] It has become essential to assess the potential impact of chronic, relapsing disease on the overall wellbeing and the health-related quality of life (HRQoL) in these children.…”

Applying Telemedicine to Multidisciplinary Pediatric Inflammatory Bowel Disease Care

“…In addition to requiring the care of a pediatric gastroenterologist, they also require ongoing preventative care from a primary care provider, and frequently require consultations with other pediatric subspecialists to address comorbid conditions and complications of IBD therapies [4]. In the psychosocial sphere, patients with IBD are at increased risk for mood and body image concerns, as well as academic, social and family distress [5][6][7][8][9][10][11]. For this reason, a multidisciplinary team including nurses, dietitians, social workers, and psychology providers is essential to care for the entire patient and his or her family.…”