Sex differences in weight perception and nutritional behaviour in adults with cystic fibrosis

Introduction Good nutritional status in cystic fibrosis (CF) is associated with improved clinical status and survival. In some conditions where dietar y and pharmacological treatment are important (e.g. diabetes), a combinatio n of eating disorders and failure of treatment compliance has been reported . Cases of eating disorders have been reported in CF. Societal pressures on young women to remain slim may compromise optimum clinical management as w omen are content to remain underweight. Objective To determine whether women have different perception of their wei ght than men with CF and whether this manifests in different nutritional be haviour. Methods Confidential postal questionnaire to 1870 adults with CF in 1994 kn own to the Association of Cystic Fibrosis Adults (UK). Participants were as ked their own weight and height, and their perception of their weight. Very underweight was defined as <85% ideal body weight, underweight as 85-94%, normal weight as 95-104%, overweight as 105-114% and very overweight as 115 % and over. Results A significantly higher proportion of women than men who are very un derweight (29% vs. 11%) or underweight (41% vs. 15%) saw themselves as bein g of normal weight or overweight. Conversely, a significantly higher propor tion of men than women who were normal weight (42% vs. 19%) saw themselves as underweight. All P-values < 0.01. A significantly higher proportion of people who perceived themselves to be underweight were taking oral or enteral food supplements compared with thos e who did not (77% vs. 30%, P < 0.05). Multiple logistic regression showed that perception of self as underweight was the strongest predictor of takin g oral or enteral food supplements (adjusted odds ratio 2.42), even after a djustment for age, sex, overall severity score, body mass index, and seeing a dietitian in the last year. Conclusion Young women with CF tend to overestimate their weight, and young men with CF underestimate their weight when compared with their actual bod y weight. Perception of self as underweight is. reflected in nutritional be haviour, being a significant predictor of taking oral and enteral food supp lements. People working with young patients with CF should be aware of thes e sex differences in weight perception, and work with young women and young men with CF to achieve a realistic perception of body weight and realistic nutritional goals. There is a need for further research into body image, w eight perception, eating behaviour and adherence to pancreatic enzyme suppl ementation and oral and enteral food supplementation in young patients with CF.