Health behaviors and disordered eating in adolescents and young adults with spina bifida: results from a national survey.
Colleen Stiles-Shields, Grayson N Holmbeck
PMID 30978107WHAT IT FOUND
Adolescents and young adults with spina bifida reported higher rates of purging and restricting than typically developing peers.
This risk extended to males and those with lower body mass index, meaning weight-based screening alone misses those already underweight or healthy.
Key findings
01Both males and females with spina bifida endorsed significantly higher purging and restricting behaviors compared to norms for typically developing peers.
02Disordered eating behaviors were associated with having a shunt and a desire to lose weight, even among participants who were already in the underweight-to-healthy BMI range.
03Younger age and lower BMI were correlated with higher scores on disordered eating measures, contrary to the expectation that obesity drives these behaviors in this population.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was recruited online through a specific advocacy group, likely selecting for higher-functioning, health-conscious, and connected individuals, which may not represent the broader spina bifida population. BMI was calculated from self-reported height and weight, which is less accurate than clinical measurement, and standard BMI cut-points may underestimate body fat in people with spina bifida due to differences in body composition. The study design is cross-sectional, so it cannot determine whether disordered eating behaviors caused the observed health patterns or vice versa. The majority of participants were Caucasian and young adults, limiting the generalizability of findings to younger adolescents and other racial or ethnic groups.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not assume that patients with spina bifida who have a healthy or low BMI are at low risk for eating disorders. The study found that purging and restricting were more common in those with lower BMIs and younger age, meaning weight-based screening alone will miss the most at-risk individuals.