Eating disorders in adolescents with IDDM. A controlled study.

Area of Science:

• Endocrinology
• Psychiatry
• Adolescent Medicine

Background:

• Adolescents with Insulin-Dependent Diabetes Mellitus (IDDM) face unique challenges regarding body image and weight management.
• Disordered eating behaviors and clinical eating disorders are prevalent in the general adolescent population, but their prevalence in adolescents with IDDM requires specific investigation.

Purpose of the Study:

• To determine the prevalence of clinical eating disorders and disordered eating behaviors in adolescents with IDDM.
• To compare these prevalence rates with a matched sample of non-diabetic control subjects.
• To explore the association between disordered eating, weight control behaviors, and glycemic control in adolescents with IDDM.

Main Methods:

• A cross-sectional survey was conducted on 76 adolescents with IDDM and age- and sex-matched non-diabetic controls.
• Eating disorder features were assessed using a standardized research interview adapted for diabetic patients (EDE).
• Glycemic control was evaluated through GHb assay.

Main Results:

• Adolescent girls with IDDM were heavier and dieted more intensively for weight control compared to non-diabetic girls.
• Clinical eating disorders were not more common in adolescent girls with IDDM than in controls.
• Nine percent of IDDM girls met criteria for "Eating disorder not otherwise specified," and 15% misused insulin for weight control. No such behaviors were observed in boys.

Conclusions:

• Adolescent girls with IDDM exhibit increased weight concerns and intensive dieting, but not higher rates of clinical eating disorders.
• Insulin misuse for weight control is present in IDDM adolescents, irrespective of a clinical eating disorder diagnosis.
• Disordered eating behaviors in adolescents with IDDM are associated with impaired glycemic control.