title: Weight-loss practices and weight-related issues among youth with type 1 or type 2 diabetes.
abstract: OBJECTIVE
  The purpose of this study was to describe the weight-loss practices and weight-related issues reported by youth with diabetes, according to sex and diabetes type.
  
  
  METHODS
  A total of 1,742 female and 1,615 male youth aged 10-21 years with type 1 or type 2 diabetes completed a SEARCH for Diabetes in Youth study visit during which height, weight, and A1C were measured. A survey assessed weight-related issues and weight-loss practices.
  
  
  RESULTS
  Although more common in youth with type 2 diabetes, youth with type 1 diabetes also reported weight-related concerns and had elevated BMI. Among youth who had ever tried to lose weight (n = 1,646), healthy weight-loss practices (diet [76.5%] and exercise [94.8%]) were the most common, whereas unhealthy practices (fasting [8.6%], using diet aids [7.5%], vomiting or laxative use [2.3%], and skipping insulin doses [4.2%]) were less common. In sex-specific multivariable models including age, race/ethnicity, diabetes type, BMI category, and glycemic control, obese females and overweight/obese males were more likely to report ever practicing any unhealthy weight-loss practice than normal-weight youth. These practices were associated with poor glycemic control for female but not male subjects. All unhealthy weight-loss practices except fasting were more common in female than in male subjects. Dieting, fasting, and using diet aids were all more common in youth with type 2 diabetes than in those with type 1 diabetes.
  
  
  CONCLUSIONS
  Given the prevalence of overweight and obesity among youth with type 1 or type 2 diabetes, health care professionals caring for youth with diabetes need to pay particular attention to identifying youth, particularly females, with unhealthy weight-loss practices.
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA. jean.m.lawrence@kp.org
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.forename: Angela D
authors.initials: AD
authors.lastname: Liese
authors.forename: Lenna
authors.initials: L
authors.lastname: Liu
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.forename: Andrea
authors.initials: A
authors.lastname: Anderson
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Imperatore
authors.forename: Ronny
authors.initials: R
authors.lastname: Bell
mesh_terms: D000293:Adolescent; D000367:Age Factors; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity; D050177:Overweight; D012737:Sex Factors; D015431:Weight Loss; D055815:Young Adult