Body Image Dissatisfaction among Pediatric Patients with Inflammatory Bowel Disease

J Pediatr. 2020 Aug:223:68-72.e1. doi: 10.1016/j.jpeds.2020.04.045.


Objectives: To determine risk factors for body image dissatisfaction among pediatric patients with inflammatory bowel disease (IBD).

Study design: We performed a cross-sectional study of children aged 9-18 years in the IBD Partners Kids & Teens cohort. Participants completed surveys including demographics, disease characteristics and activity indices, and psychosocial outcomes measured by IMPACT-III questionnaires. We defined body image dissatisfaction if participants answered "I look awful" or "I look bad." Bivariate analyses assessed associations between body image dissatisfaction and demographic, disease-related and psychosocial factors; logistic regression models evaluated associations between risk factors and body image dissatisfaction.

Results: IMPACT-III was completed by 664 patients, with 74 (11.1%) reporting body image dissatisfaction. Patients with body image dissatisfaction were more likely to be female (P < .01), older (median age 15 vs 13 years, P < .01), and diagnosed with IBD at an older age (12 vs 10 years, P < .01). Those with body image dissatisfaction had greater body mass index percentile (P = .02), more active disease (P < .01), more current steroid use (P < .01), and more depression and anxiety (P < .01). Female sex (OR 2.31; 95% CI 1.22-4.39), depression (OR 4.73; 95% CI 2.41-9.26), and anxiety (OR 5.42; 95% CI 2.48-11.80) were independently associated with body image dissatisfaction.

Conclusions: In this cohort, risk factors for body image dissatisfaction include female sex, older age at diagnosis, active disease, current steroid use, greater body mass index, and comorbid mood disorder. Interventions targeting modifiable risk factors for body image dissatisfaction may improve quality of life in pediatric patients with body image dissatisfaction.

Keywords: Crohn's disease; body image dissatisfaction; health-related quality of life; patient-reported outcomes; ulcerative colitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety / complications
  • Anxiety / psychology
  • Body Dissatisfaction / psychology*
  • Case-Control Studies
  • Child
  • Cross-Sectional Studies
  • Depression / complications
  • Depression / psychology
  • Female
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / psychology*
  • Male
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires