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Randomized Controlled Trial
. 2016 Nov;59(5):537-542.
doi: 10.1016/j.jadohealth.2016.06.008. Epub 2016 Aug 23.

I Should but I Can't: Controlled Motivation and Self-Efficacy Are Related to Disordered Eating Behaviors in Adolescents With Type 1 Diabetes

Miriam H Eisenberg  1 , Leah M Lipsky  2 , Katherine W Dempster  2 , Aiyi Liu  3 , Tonja R Nansel  2
Affiliations
Randomized Controlled Trial

I Should but I Can't: Controlled Motivation and Self-Efficacy Are Related to Disordered Eating Behaviors in Adolescents With Type 1 Diabetes

Miriam H Eisenberg et al. J Adolesc Health. 2016 Nov.

Abstract

Purpose: Among adolescents with type 1 diabetes, disordered eating behaviors (DEBs) are more prevalent and have more serious health implications than in adolescents without diabetes, necessitating identification of modifiable correlates of DEB in this population. This study hypothesized that (1) autonomous motivation and (2) controlled motivation for healthy eating (i.e., eating healthfully because it is important to oneself vs. important to others, respectively) are associated with DEB among adolescents with type 1 diabetes. The third hypothesis was that baseline healthy eating self-efficacy moderates these associations.

Methods: Adolescents with type 1 diabetes (n = 90; 13-16 years) participating in a behavioral nutrition intervention efficacy trial reported DEB, controlled and autonomous motivation, and self-efficacy at baseline, 6, 12, and 18 months. Linear-mixed models estimated associations of controlled and autonomous motivation with DEB, adjusting for treatment group, body mass index, socioeconomic status, age, and gender. Separate models investigated the interaction of self-efficacy with each motivation type.

Results: Controlled motivation was positively associated with DEB (B = 2.18 ± .33, p < .001); the association was stronger for those with lower self-efficacy (B = 3.33 ± .55, p < .001) than those with higher self-efficacy (B = 1.36 ± .36, p < .001). Autonomous motivation was not associated with DEB (B = -.70 ± .43, p = .11).

Conclusions: Findings identify controlled motivation for healthy eating as a novel correlate of DEB among adolescents with type 1 diabetes and show that self-efficacy can modify this association. Motivation and self-efficacy for healthy eating represent potential intervention targets to reduce DEB in adolescents with type 1 diabetes.

Keywords: Autonomous motivation; Controlled motivation; Disordered eating behaviors; Insulin restriction; Self-determination theory; Self-efficacy; Type 1 diabetes.

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Conflict of interest statement

Miriam Eisenberg was funded solely by the intramural research program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr. Eisenberg has no corporate affiliations. Dr. Eisenberg has no conflicts of interest to disclose. Leah M. Lipsky was funded solely by the intramural research program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr. Lipsky has no corporate affiliations. Dr. Lipsky has no conflicts of interest to disclose. Katherine Dempster was funded solely by the intramural research program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Ms. Dempster has no corporate affiliations relevant to this manuscript. Mr. Gee has no conflicts of interest to disclose. Aiyi Liu was funded solely by the intramural research program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr. Liu has no corporate affiliations. Dr. Liu has no conflicts of interest to disclose. Tonja R. Nansel was funded solely by the intramural research program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr. Nansel has no corporate affiliations. Dr. Nansel has no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Self-efficacy moderates the influence of controlled motivation on disordered eating behaviors *p<.05, **p<.01, *** p<.001
See this image and copyright information in PMC

References

    1. Hanlan M, Griffith J, Patel N, et al. Eating Disorders and Disordered Eating in Type 1 Diabetes: Prevalence, Screening, and Treatment Options. Current Diabetes Reports. 2013;13:909–916. - PMC - PubMed
    1. Young V. Eating problems in adolescents with Type 1 diabetes: a systematic review with meta-analysis. Diabet Med. 2013;30:189. - PubMed
    1. Goebel-Fabbri A. Disturbed eating behaviors and eating disorders in type 1 diabetes: Clinical significance and treatment recommendations. Current Diabetes Reports. 2009;9:133–139. - PubMed
    1. Neumark-Sztainer D, Patterson J, Mellin A, et al. Weight control practices and disordered eating behaviors among adolescent females and males with type 1 diabetes: associations with sociodemographics, weight concerns, familial factors, and metabolic outcomes. Diabetes Care. 2002;25:1289–1296. - PubMed
    1. Young V, Eiser C, Johnson B, et al. Eating problems in adolescents with Type 1 diabetes: a systematic review with meta-analysis. Diabetic medicine : a journal of the British Diabetic Association. 2013;30:189–198. - PubMed

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