Disordered eating behaviours and their associated factors in adults with type 2 diabetes: A multicentre cross-sectional study

ABSTRACT

Introduction: Dietary and weight control in type 2 diabetes (T2D) can place psychological strain on patients, increasing the risk of disordered eating behaviours (DEBs).This study aimed to determine the level of DEBs using the validated Eating Disorder Examination Questionnaire (EDE-Q) and its associated sociodemographic, clinical and mental health factors in adults with type 2 diabetes in Malaysia.
Methods: We conducted a multicentre cross-sectional study in four government primary care clinics among 412 patients with T2D. DEBs were assessed using the Malay EDE-Q 6.0, while depression and anxiety were evaluated using the Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 (GAD-7), respectively. Multivariable linear regression was performed on the square-root transformed EDE-Q global score to identify independent associated factors.
Results: The mean EDE-Q global score was 1.01±1.09, with shape concern being the highestscoring subscale. Higher DEB levels were associated with younger age (B=–0.01, 95% confidence interval [CI]=–0.02 to –0.01, P<0.001), higher body mass index (BMI) (B=0.02, 95% CI=0.02 to 0.03, P<0.001), higher GAD-7 score (B=0.05, 95% CI=0.03 to 0.08, P<0.001) and higher educational level (secondary [B=0.21, 95% CI=0.07 to 0.35, P=0.003] and tertiary education [B=0.31, 95% CI=0.13 to 0.48, P<0.001]). The Chinese participants had lower EDE-Q scores than the Malay participants (B=–0.18, 95% CI=–0.31 to –0.04, P=0.012).
Conclusion: Overall DEB level is low, however, risks are higher among patients who are younger, are more educated, have a higher BMI and have greater anxiety. Targeted identification of these high-risk groups facilitates early interventions to prevent adverse complications.