Food Insecurity Makes Disordered Eating More Likely

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For years, researchers have been emphasizing that the stereotype of the typical eating disorder patient is inaccurate. Many assume that eating disorders primarily affect thin, white women. But people of all races, genders, and body sizes can wrestle with eating disorders. New research published in the journal Eating Behaviors challenges another component of the eating disorder stereotype: the assumption that people who engage in disordered eating tend to be wealthy. In a longitudinal study of a diverse group of families, the researchers demonstrated that food insecurity can make eating disordered behaviors more likely.

In recent years, around 10 percent of U.S. households met the USDA criteria for food insecurity. The USDA defines food-insecure households as those that experience periods of time during which they are “uncertain of having or unable to acquire enough food to meet the needs of all household members because they had insufficient money or other resources for food.”

Having limited resources to purchase food can lead to what researchers call a “feast-or-famine” cycle, with individuals overconsuming when they’re able to do so (e.g., right after receiving one’s paycheck), and restricting their food intake as resources run low. Regardless of whether someone restricts food intake because they’re trying to lose weight or because they simply cannot afford food, the result is the same. Food restriction tends to trigger binge eating. Binge eating, in turn, can prompt unhealthy weight-control behaviors like fasting or purging.

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To assess the extent to which food insecurity might predict engaging in disordered eating behaviors, researchers at the University of Minnesota recruited more than 1,000 parents participating in a larger, longitudinal research study called Family Matters. Families in this sample were diverse in terms of race/ethnicity, which is especially important for this study given that, in the United States, people of color are especially likely to experience food insecurity. Households with children are also more likely to experience food insecurity; all households participating in this study had children. Parents could complete the surveys for this study in English, Hmong, Somali, or Spanish.

Study participants completed a short measure of food insecurity that asked questions about whether the household experienced things like running out of food and not having money to buy more, or not having money to purchase balanced meals. To assess eating disordered behaviors, participants answered yes/no questions about whether, in the past year, they had done things like skipping meals, fasting, using diet pills, engaging in self-induced vomiting, or engaging in periods of binge eating.

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Food insecurity was common among the households who participated in this study—just under one-third were classified as food-insecure. The researchers found clear evidence that household food insecurity was associated with a significantly higher likelihood of engaging in eating disordered behaviors—especially binge eating. It’s important to note that in their analyses, the researchers controlled for a range of demographic variables that might affect patterns of disordered eating, including age, gender, race, education level, income, and household size.

Although results for binge eating were especially strong, food insecurity was associated with an increased likelihood of every disordered eating behavior the researchers examined. This pattern held at both a single time point and over the 18-month time period of the study. Experiencing food insecurity increased the likelihood that a participant would engage in disordered eating behaviors in the future—even when controlling for any disordered eating behaviors they were already engaging in at the beginning of the study.

This new research broadens our understanding of the risk factors for disordered eating by highlighting how financial stress and uncertainty can trigger unhealthy or dangerous patterns of eating. The authors suggest that work to reduce economic insecurity and to improve access to food assistance programs like SNAP or WIC could help to mitigate this pattern.