Effect of body image satisfaction on readiness to change for diet, exercise, and medication adherence in patients with type 2 diabetes

Tifini L Preliou Williams, Purdue University

Abstract

Individual body preference, or level of body image satisfaction, is a function of one's sociocultural environment. Body image satisfaction is defined as the way individuals picture their bodies in their minds. In individuals with type 2 diabetes, body image satisfaction may lead to diet, exercise, and medication non-adherence since treatment may cause a change in physical appearance. The objectives of this study were to assess: (1) the impact of individual and sociocultural factors on body image satisfaction and (2) how body image satisfaction impacts readiness to adhere (e.g. progression towards adherence) to prescribed diet, exercise, and medication regimens. A self-administered, 66-item questionnaire was designed to assess factors related to body image satisfaction. The questionnaire measured individual factors (e.g. demographics and weight-related factors [e.g. weight and weight-loss attempts]), sociocultural factors using the Perceived Sociocultural Scale (PSS), and body image satisfaction using the Contour Drawing Rating Scale (CDRS). The PSS is a validated scale containing eight items that assess pressure from sociocultural influences such as friends, family, people whom the respondent has dated, and the media. The validated CDRS contains nine male and nine female schematic body figures/images. Participants are asked to select their ideal and current body sizes from the selection of images. Discrepancy between the two selections of images indicates dissatisfaction with body image while similarity indicates satisfaction. Readiness to adhere to diet, exercise and medication regimens was measured using stages of change algorithms based on the Transtheoretical Model. Data were collected from individuals 18 years or older with type 2 diabetes in two community outpatient clinics in person, and from a community pharmacy via mail. Descriptive statistics were utilized to summarize the data. The first objective was tested utilizing multinomial logistic regression, and the second objective was tested utilizing multinomial logistic and binary logistic regression. In this sample, all of the individual factors (i.e. age, gender, income, and race) and selected sociocultural factors (i.e. body mass index and weight loss attempts) explained about 60 percent of body image satisfaction in the proposed model (Cox and Snell = 0.614 and Nagelkerke = 0.636). Gender (chi-square = 21.203[7], p = 0.003), income (chi-square = 29.784[7], p < 0.000), and body mass index (chi-square = 31.310[7], p < 0.000) had a statistically significant association with body image satisfaction. Specifically, females, individuals with higher incomes, and individuals with higher body mass indexes were more likely to desire a smaller body size as compared to males, individuals with lower incomes, and individuals with lower body mass indexes. As a result of the multinomial logistic regression, the association between body image satisfaction and readiness to adhere to recommended aerobic exercise regimen was supported by this research (chi-square = 54.037[28], p = 0.002). Within the model, body image satisfaction (chi-square = 13.042[4], p = 0.011) and attempting to lose weight within the last six months (chi-square = 11.463[4], p = 0.022) had a statistically significant association with readiness. The model representing an association between body image satisfaction and readiness to adhere to recommended resistance training regimen was supported by this research (chi-square = 42.752[28], p = 0.037). The association between body image satisfaction and readiness to adhere to recommended medication regimen was supported (chi-square = 47.297[28], p = 0.013) containing a statistically significant association between readiness to adhere and age (chi-square = 19.744[4], p = 0.001), body image satisfaction (chi-square = 18.568[4], p = 0.001), and gender (chi-square = 11.006[4], p = 0.026). The association between body image satisfaction and readiness to adhere to recommended aerobic exercise regimen was supported by the binary logistic regression model (chi-square = 22.648[7], p = 0.002). These findings regarding body image satisfaction and readiness to adhere have potential to positively impact the provision of patient education and counseling in individuals with type 2 diabetes.

Degree

Ph.D.

Advisors

Plake, Purdue University.

Subject Area

Pharmacy sciences|Public health

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