Body Image Perceptions and Elexacaftor/Tezacaftor/Ivacaftor (ETI) Use in Adolescents and Young Adults Living With...

Adolescents and young adults with CF (AYAwCF) are at increased risk of body image concerns due to a historical focus on weight gain, BMI, and adequate nutrition. Societal ideals create even greater risk. Elexacaftor/tezacaftor/ivacaftor (ETI) dramatically improved outcomes in CF, including contributing to weight gain. To date, no research has examined body image and adherence to ETI in AYAwCF. This study examines perspectives of AYAwCF on how body image may relate to ETI adherence.

Participants (n = 52) who were prescribed ETI for at least 6 months completed a series of questionnaires assessing: (1) body image concerns; (2) self-reported adherence to ETI; (3) perceptions related to ETI. Medical outcomes (body mass index [BMI], forced expiratory volume in 1 s [FEV1]), demographic information, and mental health screening data were collected via retrospective chart review.

AYAwCF's perceptions of ETI adherence significantly differed based on body dissatisfaction; those with body dissatisfaction were more likely to endorse their weight and/or body image as a factor impacting ETI adherence, and those who wanted to be smaller were more likely to not want to take ETI due to weight gain. Differences between gender and body dissatisfaction emerged, showing that females more frequently reported wanting a smaller body. Among AYAwCF with elevated anxiety, those with body dissatisfaction had higher levels of anxiety than those without body dissatisfaction. AYAwCF with lower body esteem were more likely to have elevated symptoms of both depression and anxiety.

This cross-sectional, single-site study explored the relationship between body image concerns for AYAwCF since the approval of ETI and their relationship to adherence. Results help identify areas for intervention.