Clinician perspectives on assessing for disordered eating and body image disturbance in adolescents and young adults with cystic fibrosis

Nutrition and behavioral health in cystic fibrosis: Eating and body image

“…The authors acknowledge that, while HEMT's effects on the underlying genetic defect in CF 9 . have made it easier for pwCF to gain weight, this in turn may lead to changes in eating habits and body image disturbance in patients who have always had a previously intense focus on BMI 10 . The recognition that nutritional needs for pwCF may be shifting, and the increasing awareness of body image and/or eating concerns in response to HEMT, are both instrumental in informing multidisciplinary care.…”

“…Further, adolescents and young adults with CF (AYAwCF) begin to experience increased autonomy and independence from the family unit, where meals, calories, and adherence to enzymes are more closely monitored. The combination of increased social comparison, decreased parental monitoring, and sensitivity to bodily changes during this developmental period place AYAwCF at an increased risk for body image concerns and disordered eating, and research over the past several decades has documented that both continue to be a prevalent concern in the CF population 10,12,34,35 …”

“…Although more investigation is needed to better understand how eating and body image concerns present across developmental stages in the context of HEMT, these issues continue to remain a prevalent concern in this population. Sudden weight gain that is commonly experienced among pwCF on HEMT may lead to changes in eating habits and more dissatisfaction with one's body 10 . This occurring in a population of individuals who have experienced a clear focus on their weight and BMI as predictors of health status only exacerbates the likelihood of disordered eating.…”

“…9 have made it easier for pwCF to gain weight, this in turn may lead to changes in eating habits and body image disturbance in patients who have always had a previously intense focus on BMI. 10 The recognition that nutritional needs for pwCF may be shifting, and the increasing awareness of body image and/or eating concerns in response to HEMT, are both instrumental in informing multidisciplinary care. Recommendations now prioritize mutually agreed upon dietary goals based on personal and lifestyle needs, and there is a call for providers to prioritize assessment, collaborative discussion, and treatment of body image and/or eating concerns within the context of multidisciplinary CF clinic visits.…”

“…The combination of increased social comparison, decreased parental monitoring, and sensitivity to bodily changes during this developmental period place AYAwCF at an increased risk for body image concerns and disordered eating, and research over the past several decades has documented that both continue to be a prevalent concern in the CF population. 10,12,34,35 Historically, AYAwCF maintain low body weight more easily than those without CF, but have the added focus on body size, weight, and nutrition as part of frequent CF multidisciplinary visits, making selfscrutiny about their bodies more probable. 15,24 Not surprisingly, the effects of CF disease progression on the body along with deeprooted Western cultural ideals for body shape and size manifest differently among genders.…”