Epidemiology and correlates of weight worry in the multinational Diabetes Attitudes, Wishes and Needs study^*

ABSTRACT

Objective: This study examined the epidemiology of worry about weight among adults with diabetes and whether this weight worry was associated with worse quality of life and diabetes self-management.

Research design and methods: Participants were 5088 adults with type 1 or type 2 diabetes from the multi-national DAWN study. Random samples of approximately 500 were obtained from each of 11 countries/regions in Asia, Australia, Europe, and North America. All measures were self-reported data obtained during structured interviews. High weight worry was represented by the highest level of agreement with the statement ‘I feel very anxious about my weight.’

Results: One-quarter (25.1%) of respondents reported high weight worry. Using multivariate logistic regression to assess independent relationships, high weight worry was significantly (p < 0.05) more common among respondents who were women, less educated, had type 2 diabetes and more comorbidities, were diagnosed more recently and reported weight gain with diabetes. Using multivariate logistic regression to control for confounding factors, high weight worry was significantly (p < 0.05) associated with most of the adverse outcomes examined, including lower self-rated health, poorer reported regimen adherence and diabetes control, more diabetes-related distress, poorer psychological well-being, and more psychological treatment.

Limitations: The cross-sectional, correlational analysis could not assess causal relationships among patient reported outcomes, and the study did not include objective outcome measures.

Conclusions: High weight worry was common among adults with diabetes and associated with several adverse outcomes, including multiple indicators of diabetes-related distress, poor physical and psychological well-being, and regimen non-adherence. These findings suggest that healthcare providers should assess and address weight worry among their patients with diabetes.

Key words: :

• Diabetes
• Psychological well-being
• Regimen adherence
• Weight-related cognitions

Transparency

Declaration of funding

This study was funded by an unrestricted grant from Novo Nordisk which also provided access to the DAWN data files.

Declaration of financial/other relationships

M.P. has disclosed that he has received research grants from Amylin, MannKind, Medtronic and Novo Nordisk; consulting fees from Amylin, Animas, MannKind, Medtronic and Novo Nordisk; and speaking honoraria from Novo Nordisk. He has disclosed that he serves on Novo Nordisk advisory panels. S.S. has disclosed that he is an employee of Novo Nordisk. R.L. has disclosed that he has received consulting fees from Lilly, Novo Nordisk, GlaxoSmithKline and Novartis; and speaking honoraria from Lilly and Novo Nordisk. He has disclosed that he serves on advisory panels for Lilly, Novo Nordisk, Novartis and GlaxoSmithKline.

All peer reviewers receive honoraria from CMRO for their review work. Reviewer 1 has disclosed that he/she has received financial compensation from Takeda Pharmaceuticals for a speaking engagement. Reviewer 2 has disclosed that he/she has no relevant financial relationships.

Acknowledgment

The authors disclosed that they received no assistance in preparing this paper and are responsible for all data analyses and interpretations.

Notes

* The data in this paper were presented at the meeting of European Association for the Study of Diabetes, Amsterdam, September 17–20, 2007: Peyrot M and Skovlund S. The association of weight worry with quality of life and diabetes self-management, Diabetologia 2007; 50 (Suppl 1): S436