Sociocultural Attitudes Toward Appearance and Attitudes Toward Eating in Adolescents With Type 1 Diabetes: The Importance of Perfectionism

Abstract

Objective: Adolescents managing type 1 diabetes (T1D) are at increased risk of experiencing eating disorders (EDs). Identifying risk factors is essential to develop preventive strategies. This study examines the potential mediation value of self-esteem and the perfectionism associated with EDs in the relationship between sociocultural attitudes toward appearance and eating attitudes related to EDs in a sample of adolescents with T1D. Methods: Forty-six adolescents aged 12-17 years diagnosed with T1D participated in the current study. Sociocultural attitudes toward appearance, perfectionism associated with EDs, and self-esteem were measured. Multiple and simple mediator analyses using the bootstrapping method with bias-corrected confidence estimates were conducted. Results: Our results show that perfectionism associated with eating problems is not only related to sociocultural attitudes toward appearance and eating attitudes, but rather the relationship between these last two variables would be fully mediated by perfectionism. Conclusions: A high degree of perfectionism could be a risk variable when developing potential eating problems in T1D adolescents. Perfectionism and its self-management would be a prominent factor that may help to design interventions developed for adolescents with diabetes who show behaviors that potentially conflict with eating. The clinical implications are discussed.

Keywords: adolescents; eating disorders; perfectionism; type 1 diabetes.

Figure 1

Serial mediation model linking sociocultural attitudes toward appearance (SATAQ total score) and eating attitudes (EAT), in which perfectionism (EDI) and self-esteem (RSES) are the mediator variables. Note: The dashed arrows are nonsignificant. Both the age and the age of diagnosis variables were included in the model as covariates. Standardized and unstandardized regression coefficients are presented sequentially for each direct effect (i.e., β/B). The bootstrapped standard errors are presented in the parenthesis. ⁣^∗p < 0.05; ⁣^∗∗p < 0.01; ⁣^∗∗∗p < 0.001.

Figure 2

Simple mediation model linking the sociocultural attitudes toward appearance (SATAQ total score) and eating attitudes (EAT), in which perfectionism is the mediator variable. Note: The dashed arrows are nonsignificant. The age was included as a covariate in the model. Standardized and unstandardized regression coefficients are presented sequentially for each direct effect (i.e., β/B). The bootstrapped standard errors are presented in the parenthesis. ⁣^∗p < 0.05; ⁣^∗∗p < 0.01; ⁣^∗∗∗p < 0.001.