The nature and prevalence of eating disorders and eating disturbance in adolescents with cystic fibrosis.

Abstract

Cystic fibrosis (CF) is a life-threatening genetic disorder that is associated with respiratory and digestive problems and consequently inadequate nutrition and poor growth. Good nutrition is considered vital as low weight has a detrimental and potentially fatal impact upon health status in the CF population. Research has consistently revealed eating difficulties throughout childhood in the CF population but few studies have examined formal eating disorders or eating disturbance in adolescents with CF, despite clear evidence to support the notion of a developmental continuum between eating disturbance and eating disorders in the general population.1 Adolescents with CF appear to experience many of the risk factors that have been documented within the eating disorder literature, for example, eating difficulties in childhood,2 low self-esteem3 and life-stressors, including the experience of bereavement.4 The very nature of CF requires a preoccupation with food, exercise and weight, all of which are fundamental characteristics of patients with eating disorders, and thus CF may be a risk factor in itself. Adolescents with CF have been found to subscribe to the same cultural values regarding shape and weight as their non-CF peers.5 Previous studies that have attempted to examine whether or not the adolescent CF population may be at risk of developing eating disorder symptomatology appear to have a number of methodological limitations, particularly the use of self-report measures, which are unable to provide formal diagnoses, making it difficult to draw any firm conclusions.6–11 Further, such studies do not appear to have examined symptomatology if it has not met diagnostic criteria. Because eating disorders pose a particular threat to longevity in people with CF, the nature and prevalence of eating disorder symptomatology in this population requires clarification. The aim of this study was therefore to improve upon previous research designs by utilizing a semi-structured interview specifically designed to assess and diagnose eating disorder symptomatology in an adolescent population, thus examining both diagnostic difficulties and difficulties of lower frequency and severity.