Abstract
Accuracy of body size estimation may impact motivation to adhere to treatment recommendations and health-related quality of life (HRQOL) in youth with cystic fibrosis (CF), but this has not yet been investigated. Thus, the goal of the current study was to examine accuracy of body size estimation in youth with CF, and associations with HRQOL, lung functioning, and dietary intake. Fifty-four youth diagnosed with CF (M = 13.61 years) completed the Figure Rating Scale, the Cystic Fibrosis Questionnaire–Revised, and a 24-h diet recall interview. Cohen’s Weighted Kappa Coefficient evaluated agreement between body size estimation and BMI percentile. Binary logistic regression analyses examined associations between body size accuracy and HRQOL, lung functioning, and dietary intake. A less than adequate agreement was found between youth body size estimation and BMI percentile. Most participants overestimated body size (69.8%). Body Image HRQOL, but neither lung functioning nor dietary intake, was significantly associated with body size estimation accuracy. Working with patients to improve perceptions of body size may also improve HRQOL scores and allow for discussion about treatment goals related to body size.
Similar content being viewed by others
References
Abbott, J., Conway, S., Etherington, C., Fitzjohn, J., Gee, L., Morton, A., … Webb, A. K. (2000). Perceived body image and eating behavior in young adults with cystic fibrosis and their healthy peers. Journal of Behavioral Medicine, 23, 501–517.
Bucks, R. S., Hawkins, K., Skinner, T. C., Horn, S., Seddon, P., & Horne, R. (2009). Adherence to treatment in adolescents with cystic fibrosis: The role of illness perceptions and treatment beliefs. Journal of Pediatric Psychology, 34, 893–902. https://doi.org/10.1093/jpepsy/jsn135.
Calvo-Lerma, J., Hulst, J. M., Asseiceira, I., Claes, I., Garriga, M., Colombo, C., & Ribes-Koninckx, C. (2017). Nutritional status, nutrient intake and use of enzyme supplements in paediatric patients with Cystic Fibrosis: A European multicentre study with reference to current guidelines. Journal of Cystic Fibrosis, 16, 510–518. https://doi.org/10.1016/j.jcf.2017.03.005.
Christoph, M. J., Jarrett, E. S., Gower, A. L., & Borowsky, I. W. (2018). Weight status and weight perception in relation to mental distress and psychosocial protective factors among adolescents. Academic Pediatrics, 18, 51–58.
Cohen, J. (1968). Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. Psychological Bulletin, 70, 213–220. https://doi.org/10.1037/h0026256.
Cohn, L. D., Adler, N. E., Irwin, C. E., Jr., Millstein, S. G., Kegeles, S. M., & Stone, G. (1987). Body-figure preferences in male and female adolescents. Journal of Abnormal Psychology, 96, 276–279.
Conviser, J. H., Fisher, S. D., & McColley, S. A. (2018). Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review. International Journal of Eating Disorders, 51, 187–213. https://doi.org/10.1002/eat.22831.
Edwards, N. M., Pettingell, S., & Borowsky, I. W. (2010). Where perception meets reality: Self-perception of weight in overweight adolescents. Pediatrics, 125, e452–e458. https://doi.org/10.1542/peds.2009-0185.
Essayli, J. H., Murakami, J. M., Wilson, R. E., & Latner, J. D. (2017). The impact of weight labels on body image, internalized weight stigma, affect, perceived health, and intended weight loss behaviors in normal-weight and overweight college women. American Journal of Health Promotion, 31, 484–490. https://doi.org/10.1177/0890117116661982.
Fan, M., & Jin, Y. (2015). The effects of weight perception on adolescents’ weight-loss intentions and behaviors: Evidence from the youth risk behavior surveillance survey. International Journal of Environmental Research and Public Health, 12, 14640–14668. https://doi.org/10.3390/ijerph121114640.
Frisen, A. (2007). Measuring health-related quality of life in adolescence. Acta Paediatrica, 96, 963–968. https://doi.org/10.1111/j.1651-2227.2007.00333.x.
Goodman, E., Hinden, B. R., & Khandelwal, S. (2000). Accuracy of teen and parental reports of obesity and body mass index. Pediatrics, 106, 52–58.
Helms, S. W., Christon, L. M., Dellon, E. P., & Prinstein, M. J. (2017). Patient and provider perspectives on communication about body image with adolescents and young adults with cystic fibrosis. Journal of Pediatric Psychology, 42, 1040–1050. https://doi.org/10.1093/jpepsy/jsx055.
Modi, A. C., & Quittner, A. L. (2003). Validation of a disease-specific measure of health-related quality of life for children with cystic fibrosis. Journal of Pediatric Psychology, 28, 535–545.
Palermo, T. M., Harrison, D., & Koh, J. L. (2006). Effect of disease-related pain on the health-related quality of life of children and adolescents with cystic fibrosis. Clinical Journal of Pain, 22, 532–537. https://doi.org/10.1097/01.ajp.0000210996.45459.76.
Phillipou, A., Rossell, S. L., Gurvich, C., Castle, D. J., Troje, N. F., & Abel, L. A. (2016). Body image in anorexia nervosa: Body size estimation utilising a biological motion task and eyetracking. European Eating Disorders Review, 24, 131–138. https://doi.org/10.1002/erv.2423.
Quittner, A. L., Buu, A., Messer, M. A., Modi, A. C., & Watrous, M. (2005). Development and validation of The Cystic Fibrosis Questionnaire in the United States: A health-related quality-of-life measure for cystic fibrosis. Chest, 128, 2347–2354. https://doi.org/10.1378/chest.128.4.2347.
Quittner, A. L., Sawicki, G. S., McMullen, A., Rasouliyan, L., Pasta, D. J., Yegin, A., & Konstan, M. W. (2012). Psychometric evaluation of the Cystic Fibrosis Questionnaire-Revised in a national sample. Quality of Life Research, 21, 1267–1278. https://doi.org/10.1007/s11136-011-0036-z.
Raper, N., Perloff, B., Ingwersen, L., Steinfeldt, L., & Anand, J. (2004). An overview of the USDA’s Dietary Intake Data System. Journal of Food Composition and Analysis, 17, 545–555.
Saxton, J., Hill, C., Chadwick, P., & Wardle, J. (2009). Weight status and perceived body size in children. Archives of Disease in Childhood, 94, 944–949. https://doi.org/10.1136/adc.2009.162578.
Simon, S. L., Duncan, C. L., Horky, S. C., Nick, T. G., Castro, M. M., & Riekert, K. A. (2011). Body satisfaction, nutritional adherence, and quality of life in youth with cystic fibrosis. Pediatric Pulmonology, 46, 1085–1092. https://doi.org/10.1002/ppul.21477.
Stunkard, A. J., Sorensen, T., & Schulsinger, F. (1983). Use of the Danish Adoption Register for the study of obesity and thinness. Research Publications: Association for Research in Nervous and Mental Disease, 60, 115–120.
Talamayan, K. S., Springer, A. E., Kelder, S. H., Gorospe, E. C., & Joye, K. A. (2006). Prevalence of overweight misperception and weight control behaviors among normal weight adolescents in the United States. ScientificWorldJournal, 6, 365–373. https://doi.org/10.1100/tsw.2006.70.
Thompson, J. K., & Altabe, M. N. (1991). Psychometric qualities of the figure rating scale. International Journal of Eating Disorders, 10, 615–619.
Tiggemann, M. (2004). Body image across the adult life span: Stability and change. Body Image, 1, 29–41. https://doi.org/10.1016/S1740-1445(03)00002-0.
Truby, H., & Paxton, A. S. (2001). Body image and dieting behavior in cystic fibrosis. Pediatrics, 107, E92.
Truby, H., & Paxton, S. J. (2008). The Children’s Body Image Scale: Reliability and use with international standards for body mass index. British Journal of Clinical Psychology, 47, 119–124. https://doi.org/10.1348/014466507x251261.
USDA. (2004). Food and nutrient database for dietary studies. Beltsville, MD: Agricultural Research Service, Food Surveys Research Group.
Walters, S. (2001). Sex differences in weight perception and nutritional behaviour in adults with cystic fibrosis. Journal of Human Nutrition & Dietetics, 14, 83–91.
Wertheim, E. H., & Paxton, S. J. (2012). Body image development: Adolescent girls. In T. Cash (Ed.), Encyclopedia of body image and human appearance (pp. 187–193). Oxford: Academic Press.
Xu, F., Cohen, S. A., Greaney, M. L., & Greene, G. W. (2018). The association between US adolescents’ weight status, weight perception, weight satisfcation, and their physical activity and dietary behaviors. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph15091931.
Funding
This work was supported by the Center for Pediatric Psychology and Family Studies at the University of Florida and The Blue Foundation for a Healthy Florida.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Stacey L. Simon, Kaitlyn A. Ferris, Kristine Durkin, Kristin Riekert, and Christina Duncan declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Human and Animal Rights
This article does not contain any studies with animals performed by any of the authors.
Informed Consent
Informed consent and child assent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Simon, S.L., Ferris, K.A., Durkin, K. et al. Accuracy of Body Size Estimation in Youth with Cystic Fibrosis and Association with Health-Related Quality of Life. J Clin Psychol Med Settings 27, 459–466 (2020). https://doi.org/10.1007/s10880-019-09677-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10880-019-09677-5