Disordered eating among adolescents with chronic illness and disability: the role of family and other social factors.
OBJECTIVE
To compare prevalence rates of weight-control behaviors among adolescents with and without chronic illness and to explore the role of familial and other social factors on associations between disordered eating and chronic illness.


METHODS
Survey conducted in public schools in Connecticut.


METHODS
A representative statewide population-based sample of 9343 7th-, 9th-, and 11th-grade public school students, of whom 1021 reported a chronic illness.


METHODS
Disordered eating (vomiting, diet pills, and laxatives), dieting, and exercise for weight control; chronic illness status; family structure, family communication, parental caring, parental monitoring, parental expectations, peer support, and sexual and physical abuse.


RESULTS
Adolescents with chronic illness were at greater risk for disordered eating than youth without chronic illness, after controlling for sociodemographic variables (girls: odds ratio, 1.59 [95% confidence interval, 1.19-2.14]; boys: odds ratio, 2.22 [95% confidence interval, 1.49-3.32]). Adolescents with chronic illness were less likely to come from 2-parent families; reported lower levels of family communication, parental caring, and parental expectations; and reported more sexual and physical abuse than youth without chronic illness. Male adolescents with chronic illness were more likely to report low peer support and low parental monitoring. Most of these familial-social factors were also associated with an increased prevalence of disordered eating. After familial-social factors were controlled for, however, associations between disordered eating and chronic illness remained statistically significant.


CONCLUSIONS
Adolescents with chronic illness are at greater risk for disordered eating behaviors than youth without chronic illness. Factors other than the familial-social factors assessed in this study may be contributing to this increased risk. In the clinical setting, youth with chronic illness need to be screened for disordered eating and familial and other social concerns.
Neumark-Sztainer
D
D
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
Story
M
M
Falkner
N H
NH
Beuhring
T
T
Resnick
M D
MD
D000293:Adolescent; D002908:Chronic Disease; D016001:Confidence Intervals; D006233:Persons with Disabilities / Q000523:psychology; D005195:Family Relations; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010287:Parent-Child Relations; D000297:Psychology, Adolescent; D012959:Socioeconomic Factors