Body Image Dissatisfaction Is Increased in Inflammatory Bowel Disease Compared to Healthy Matched Controls but Not Diseased Controls: A Case-Control Study from New Zealand

<b>Background</b>: Body image dissatisfaction is elevated in inflammatory bowel disease (IBD) as well as other chronic diseases. The aim of this study was to determine if the higher rate of body image dissatisfaction in IBD is specific to IBD or characteristic of chronic disease in general by comparing body image dissatisfaction in IBD patients with age- and gender-matched healthy individuals and those with type 1 diabetes mellitus (T1DM). <b>Methods</b>: In this New Zealand-based case-control study conducted in a secondary care hospital, consecutive IBD patients aged 16 years and older were matched 1:1 with healthy individuals and T1DM patients based on age and gender. However, availability of controls resulted in a slightly different number of pairs for each comparison between groups. Demographics were documented, and participants completed the Body Image Disturbance Questionnaire (BIDQ), RAND SF-36 Quality of Life measures, and Hospital Anxiety and Depression Scale (HADS). <b>Results</b>: Forty-five matched pairs compared IBD patients to healthy controls, while 38 compared IBD patients to T1DM patients. BIDQ scores were higher for IBD patients than healthy controls (2.05 vs. 1.58, <i>p</i> = 0.004) but not significantly different from T1DM patients (2.03 vs. 1.72, <i>p</i> = 0.09). No differences were seen in BMI, smoking, or relationship status across groups. IBD patients had higher depression scores than controls (mean 6.51 vs. 3.87, <i>p</i> = 0.002) but similar anxiety scores (5.51 vs. 4.89, <i>p</i> = 0.258). A 1-point BIDQ increase in IBD patients was associated with a 4.6-fold increase in depression (<i>p</i> = 0.025), after adjusting for clinical and demographic factors. <b>Conclusions</b>: Body image dissatisfaction is prevalent in IBD patients and may be a common feature across chronic diseases. Body image dissatisfaction strongly associates with depression, highlighting the importance of addressing it in IBD management.