Journal of Behavioral Medicine

, Volume 22, Issue 1, pp 59–74 | Cite as

The Role of Body Dissatisfaction and Bingeing in the Self-Esteem of Women with Type II Diabetes

  • Pam Carroll
  • Marika Tiggemann
  • Tracey Wade


This study investigated the impact of body dissatisfaction and binge eating on self-esteem in women with Type II diabetes. The relationship of body dissatisfaction and bingeing to perceived blood glucose control was also assessed. Questionnaires were completed by a total of 215 women: 125 women with Type II diabetes and 90 comparison women, who were roughly matched for age, education, and ethnicity. When actual weight (BMI) was statistically controlled, there was no difference between the groups in body dissatisfaction or bingeing behavior. The women with diabetes, however, had significantly lower self-esteem. Further, bingeing made a significant contribution to their self-esteem, in contrast to the women without diabetes. For the women with diabetes, body dissatisfaction and bingeing were also related to perceived blood glucose control, although only bingeing remained significant when both variables were entered into the regression equation. It was concluded that diabetes broadens the domains of body dissatisfaction which are related to self-esteem.



Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Anderson, L. A., James, G. R., Zeimer, D. C., and Phillips, L. S. (1997). Diabetics in urban African Americans: Body image, satisfaction with size, and weight change attempts. Diabetes Educ. 23: 301-308.Google Scholar
  2. Altabe, M., and Thompson, J. K. (1993). Body image changes during early adulthood. Int. J. Eat. Disord. 11: 397-402.Google Scholar
  3. Australian Diabetes Foundation (1986). Diabetes in Australia 1986, Author, Canberra.Google Scholar
  4. Bachman, J. G., and O'Malley, P. M. (1977). Self-esteem in young men: A longitudinal analysis of the impact of education and occupational attainment. J. Person. Soc. Psychol. 35: 365-380.Google Scholar
  5. Ben-Tovim, D. I., and Walker, M. K. (1991). Women's body attitudes: A review of measurement techniques. Int. J. Eat. Disord. 10: 155-167.Google Scholar
  6. Bernbaum, M., Albert, S. G., Duckro, P. N., and Merkel, W. (1993). Personal and family stress in individuals with diabetes and vision loss. J. Clin. Psychol. 49: 670-677.Google Scholar
  7. Butler, F. R., Secundy, M. G., and Romberg, E. E. (1994). Health care utilization patterns of hypertensive and diabetic African American elderly. J. Cult. Divers. 1: 74-78.Google Scholar
  8. Cash, T. F. (1990). The psychology of physical appearance: Aesthetics, attributes and images. In Cash, T. F., and Pruzinsky, T. (eds.), Body Image, Guilford, New York, pp. 51-79.Google Scholar
  9. Cash, T. F., Winstead, B. A., and Janda, L. H. (1986). The great American shape-up: Body image survey report. Psychol. Today 20: 30-37.Google Scholar
  10. Fairburn, C. G., and Cooper, P. J. (1989). Eating disorders. In Hawton, K., Salkovskis, P., Kirk, J., and Clark, D. M. (eds.), Cognitive Behaviour Therapy for Psychiatric Problems: A Practical Guide, Oxford University Press, Oxford, pp. 277-314.Google Scholar
  11. Fairburn, C. G., and Cooper, Z. (1993). The Eating Disorder Examination (EDE). In Fairburn, C. G., and Wilson, G. T. (eds.), Binge Eating: Nature, Assessment and Treatment, Guilford Press, New York.Google Scholar
  12. Fairburn, C. G., Norman, P. A., Welch, S. A., O'Connor, M. E., Doll, H. A., and Peveler, R. C. (1995). A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Arch. Gen. Psychiatry 52: 304-312.Google Scholar
  13. Fallon, A. E., and Rozin, P. (1985). Sex differences in perceptions of desirable body shape. J. Abnorm. Psychol. 94: 102-105.Google Scholar
  14. Foster, D. W. (1994). Diabetes mellitus. In Isselbacher, K. J., Braunwald, E., Wilson, J. D., Martin, J. B., Fauci, A. S., and Kasper, D. L. (eds.), Harrison's Principles of Internal Medicine, McGraw-Hill, New York, pp. 979-2006.Google Scholar
  15. Franzoi, S. L., and Shields, S. A. (1984). The Body Esteem Scale: Multidimensional structure and sex differences in a college population. J. Person. Assess. 48: 173-178.Google Scholar
  16. Garner, D. M. (1991). Eating Disorders Inventory-2, Psychological Assessment Resources, Odessa, FL.Google Scholar
  17. Garner, D. M., Olmsted, M. A., and Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int. J. Eat. Disord. 2: 15-34.Google Scholar
  18. Garrow, J. S., and Webster, J. (1985). Quetelet's index (W/H2) as a measure of fatness. Int. J. Obesity 9: 147-153.Google Scholar
  19. Harter, S. (1985). Processes underlying the construction, maintenance and enhancement of the selfconcept in children. In Suls, J., and Greenwald, A. G. (eds.), Psychological Perspectives on the Self, Vol. 3, Erlbaum, Hillsdale, NJ, pp. 137-181.Google Scholar
  20. Lowe, M. R., Gleaves, D. H., DiSimone-Weiss, R. T., Furgueson, C., Gayda, C. A., Kolsky, P. A., Neal-Wadden, T., Nelsen, L. A., and McKinney, S. (1996). Restraint, dieting and the continuum model of bulimia nervosa. J. Abnorm. Psychol. 105: 508-517.Google Scholar
  21. Lustman, P. J., Griffiths, L. S., Gavard, J. A., and Clouse, R. E. (1992). Depression in adults with diabetes. Diabetes Care 15: 1631-1639.Google Scholar
  22. McAllister, R., and Caltabiano, M. L. (1994). Self-esteem, body-image and weight in non eatingdisordered women. Psychol. Reports 75: 1339-1343.Google Scholar
  23. Peveler, R. C., Fairburn, C. G., Boller, I., and Dunger, D. (1992). Eating disorders in adolescents with IDDM: A controlled study. Diabetes Care 15: 1356-1360.Google Scholar
  24. Pliner, P., Chaiken, S., and Flett, G. L. (1990). Gender differences in concern with weight and physical appearance over the life span. Person. Soc. Psychol. Bull. 16: 263-273.Google Scholar
  25. Polivy, J., and Herman, C. P. (1985). Dieting and bingeing: A causal analysis. Am. Psychol. 40: 193-201.Google Scholar
  26. Rodin, J., Silberstein, L., and Striegel-Moore, R. (1985). Women and weight: A normative discontent. In Sonderegger, T. B. (ed.), Psychology and Gender: Nebraska Symposium on Motivation, 1984, University of Nebraska Press, Lincoln.Google Scholar
  27. Rosenberg, M. (1965). Society and Adolescent Self-image, Princeton University Press, Princeton, NJ.Google Scholar
  28. Rozin, P., and Fallon, A. (1988). Body image, attitudes to weight, and misperceptions of figure preferences of the opposite sex: A comparison of men and women in two generations. J. Abnorm. Psychol. 97: 342-345.Google Scholar
  29. Shoemaker, C., van Strien, T., and van der Staak, C. (1994). Validation of the Eating Disorders Inventory in a nonclinical population using transformed and untransformed responses. Int. J. Eat. Disord. 15: 387-393.Google Scholar
  30. Silberstein, L. R., Striegel-Moore, R. H., Timko, C., and Rodin, J. (1988). Behavioral and psychological implications of body dissatisfaction: Do men and women differ? Sex Roles 19: 219-232.Google Scholar
  31. Steel, J. (1996). Eating disorders in young diabetic women. Pract. Diabetes Int. 13: 64-67.Google Scholar
  32. Steel, J. M., Young, R. J., Lloyd, G. G., and Clarke, B. F. (1987). Clinically apparent eating disorders in young diabetic women associated with painful neuropathy and other complications. Br. Med. J. 294: 859-862.Google Scholar
  33. Steel, J. M., Young, R. J., Lloyd, G. G., and MacIntyre, C. C. A. (1989). Abnormal eating attitudes in young insulin-dependent diabetics. Br. J. Psychiatry 155: 515-521.Google Scholar
  34. Stevens, C., and Tiggemann, M. (1998). Women's body figure preferences across the life span. J. Genet. Psychol. 159: 94-102.Google Scholar
  35. Striegel-Moore, R. H., McAvay, G., and Rodin, J. (1986a). Psychological and behavioural correlates of feeling fat in women. Int. J. Eat. Disord. 5: 935-947.Google Scholar
  36. Striegel-Moore, R. H., Silberstein, L. R., and Rodin, J. (1986b). Toward an understanding of the risk factors for bulimia. American Psychologist 41: 246-263.Google Scholar
  37. Striegel-Moore, R. H., Nicholson, A. J., and Tamborlane, W. V. (1992). Prevalence of eating disorder symptoms in preadolescent and adolescent girls with IDDM. Diabetes Care 15: 1361-1368.Google Scholar
  38. Thomas, C. D., and Freeman, R. J. (1990). The Body Esteem Scale: Construct validity of the female subscales. J. Person. Assess. 54: 204-212.Google Scholar
  39. Thompson, J. K., and Altabe, M. (1991). Psychometric qualities of the figure rating scale. Int. J. Eat. Disord. 10: 615-619.Google Scholar
  40. Tiggemann, M. (1992). Body-size dissatisfaction: Individual differences in age and gender, and relationship with self-esteem. Person. Indiv. Diff. 13: 39-43.Google Scholar
  41. Tiggemann, M. (1994). Gender differences in the interrelationships between weight dissatisfaction, restraint, and self-esteem. Sex Roles 30: 319-330.Google Scholar
  42. Tiggemann, M. (1996). “Thinking” vs “ feeling” fat: Correlates of two indices of body image dissatisfaction. Austral. J. Psychol. 48: 21-25.Google Scholar
  43. Tiggemann, M. (1997). Dieting in moderation: The role of dietary restraint in the relationship between body dissatisfaction and psychological well-being. J. Health Psychol. 2: 501-507.Google Scholar
  44. Wing, R. R. (1995). Treatment of obesity in diabetic patients. In Brownell, K. D., and Fairburn, C. G. (eds.), Eating Disorders: A Comprehensive Handbook, Guilford Press, New York, pp. 520-523.Google Scholar
  45. Wing, R. R., Marcus, M. D., Epstein, L. H. Blair, E. H., and Burton, L. R. (1989). Binge eating in obese patients with Type II diabetes. Int. J. Eat. Disord. 8: 671-679.Google Scholar
  46. Wing, R. R., Marcus, M. D., Blair, E. H., Epstein, L. H., and Burton, L. R. (1990). Depressive symptomology in obese adults with Type II diabetes. Diabetes Care 13: 170-172.Google Scholar

Copyright information

© Plenum Publishing Corporation 1999

Authors and Affiliations

  • Pam Carroll
  • Marika Tiggemann
  • Tracey Wade

There are no affiliations available

Personalised recommendations