Eating disorders in adolescent girls with insulin‐dependent diabetes mellitus: a population‐based case‐control study

Abstract

Engström I, Kroon M, Arvidsson C-G, Segnestam K, Snellman K, Å man J. Eating disorders in adolescent girls with insulin-dependent diabetes mellitus: a population-based case-control study. Acta Paediatr 1999; 88: 175-80. Stockholm. ISSN 0803-5253 In this study the prevalence of eating disorders in a population-based cohort of 89 female patients with type 1 diabetes, 14-18 y of age, was compared with that in age-matched healthy controls. Of all diabetic girls in the study area, 92% participated in the study. The majority were treated with multiple insulin injections and the mean HbA 1c of the participants was 8.4%. On average, diabetic girls were 6.8 kg heavier than the controls. A two-stage design was used. The first consisted of a validated self-report questionnaire, the Eating Disorder Inventory (EDI). Girls who had high scores were then interviewed about eating habits and mental health using a semistructured interview, the BAB-T (Assessment of Anorexia-Bulimia -Teenager version). No cases of anorexia or bulimia nervosa were found, but 15 diabetic patients (16.9%) compared with 2 control girls (2.2%), p`0.01, had disturbed eating behaviour according to the questionnaire. In 6 of these 15 diabetic girls an eating disorder was confirmed at the interview, mainly binge eating and self-induced vomiting. None of the control girls showed an eating disorder. Overweight diabetic girls scored higher on EDI than non-overweight diabetic girls (w 2 = 4.9; p = 0.038). No relationships were found between EDI scores and metabolic control (HbA 1c ), dose of insulin, frequency of hypoglycaemia or diabetic ketoacidosis. & Adolescence, diabetes mellitus, eating disorder, insulin dependent, overweight J Å man,

Psychosocial Factors and Diabetes Mellitus: Evidence-Based Treatment Guidelines

“…The prevalence of bulimia nervosa (BN) in patients with type 1 diabetes mellitus is higher than that of AN, varying between 0.0% [162][163][164] and 3.0% [161] (LE IIa). However, in a systematic review of all controlled studies, (LE Ia) [167] the assumption of a higher prevalence of BN in type 1 diabetic patients as compared with the general population could not be confirmed. In controlled studies among patients with type 1 diabetes, atypical eating disorders ("eating disorders not otherwise specified", EDNOS) varied between 3.0% [161] and 9.0% [165] (LE IIa).…”

“…Regarding diabetes-related complications in patients with eating disorders, results of a meta-analysis (LE Ia) [167] indicate a three-fold increased risk of retinopathy in patients with type 1 diabetes mellitus and BN. Pathological eating behavior that does not exhibit the full picture of an eating disorder according to the ICD criteria [175] likewise represents an increased risk of diabetic microangiopathy (LE IIa) [174].…”

Emotional Dysregulation and Anxiety Control in the Psychopathological Mechanism Underlying Drive for Thinness

“…Drive for thinness is a useful screening tool for ED. It is designed to tap into a core feature, namely excessive concern over dieting and fear of weight gain (24, 25). This subscale was devised on the basis of clinical conceptualizations by Bruch (26) and Russell (27).…”

Low perception of control as a cognitive factor of eating disorders. Its independent effects on measures of eating disorders and its interactive effects with perfectionism and self-esteem

“…We chose the drive for thinness, bulimia, and body dissatisfaction subscales of the Eating Disorders Inventory-version 3 (EDI-3, Garner, 2004) to measure ED. Drive for thinness, in particular, assesses a cardinal feature of ED, and it is useful for screening for ED (Abood & Black, 2000;Engström et al, 1999;Garner, 1991Garner, , 2004. According to Garner (1991Garner ( , 2004, the drive for thinness subscale assesses excessive concern with dieting, preoccupation with weight, and fear of weight gain.…”