Those who live in food-insecure households, meaning they had limited access to adequate and nutritious food, are at greater risk for the development of disordered eating behaviors, according to new research published in the journal Eating Behaviors.
Food insecurity is a significant issue that affects a large portion of the U.S. population. More than one in ten households in the United States have experienced food insecurity. Households experiencing food insecurity often face fluctuations in food availability throughout the month, leading to a cycle of food restriction and overconsumption known as the "feast-or-famine" cycle.
The authors behind the new research sought to better understand the consequences of this cycle on individuals' eating behaviors and overall health.
"Historically, disordered eating has erroneously been believed to primarily only affect 'Skinny, White, Affluent Girls' - this is now referred to as the SWAG stereotype," explained study author Vivienne M. Hazzard, a postdoctoral researcher at the University of Minnesota School of Public Health. "Unfortunately, that misconception led research and practice in the field to focus on individuals fitting that stereotype for decades, ignoring marginalized communities under the false impression that they are not at risk for disordered eating."
"In recent years, we've realized that many marginalized communities are in fact at quite high risk, but we have decades of catching up to do in terms of understanding what may contribute to disordered eating in these communities and, in turn, how we can most effectively intervene to reduce disordered eating among those who have been ignored in the field for so long. Food insecurity is a factor that disproportionately affects Black, Hispanic, and other racially/ethnically marginalized groups, and it's also a factor that growing evidence suggests may increase risk for disordered eating."
"There hasn't been much research to date, though, looking at the relationship between food insecurity and disordered eating over time, so it hasn't been clear if food insecurity actually predicts the development of future disordered eating, or if they just tend to occur together at one point in time," Hazzard said. "So we wanted to get at that question with this study - to look at these relationships over time - in a diverse sample that doesn't fit the SWAG stereotype."
"We also wanted to look at the role of participation in public food assistance programs (i.e., SNAP, WIC) because in another recent study, we found evidence suggesting that the once-monthly benefit distribution schedule may further contribute to disordered eating in people experiencing food insecurity, but we wanted to see if that held true in another sample."
The researchers analyzed data from a longitudinal cohort study called the Family Matters study. The study included parent/child dyads from low-income and racially and ethnically diverse households in Minnesota. The baseline data was collected through online surveys between 2016 and 2019, and follow-up data was also collected at approximately 18-months. The dataset included information from 1,118 families.
Nearly one-third of parents in the sample lived in food-insecure households. Additionally, 42.8% of the participants reported that their households received benefits from the Supplemental Nutrition Assistance Program (SNAP) and/or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
The study found that household food insecurity was associated with a higher prevalence of all types of disordered eating behaviors examined. The strongest association was observed for binge eating, with participants who experienced food insecurity having 2.69 times the prevalence of binge eating compared to those in food-secure households, even after considering other factors like sociodemographic characteristics.
"Experiencing food insecurity appears to increase the risk of developing disordered eating behaviors ranging from binge eating to restrictive weight-control behaviors (i.e., fasting, skipping meals, or eating very little to control one's weight) and compensatory weight-control behaviors (i.e., vomiting, misusing laxatives, or using diet pills to control one's weight) in adulthood," Hazzard told PsyPost.
Longitudinal analysis showed that household food insecurity was also associated with a higher incidence (risk) of all types of disordered eating behaviors. Similar to the cross-sectional analysis, binge eating had the strongest association. The associations between food insecurity and disordered eating behaviors were generally stronger in longitudinal models compared to cross-sectional models, indicating that food insecurity may increase the risk of developing disordered eating behaviors over time.
"I was surprised that across all the types of disordered eating behaviors we looked at, the links between food insecurity and new disordered eating behaviors 1.5 years later were stronger than the links between food insecurity and disordered eating behaviors at a single point in time," Hazzard said. "We tend to see the opposite pattern in research - it's much more common to see that two things are really strongly linked at the same time point, but that the link weakens over time."
Interestingly, the researchers found that household food insecurity significantly predicted a greater risk of compensatory weight-control behaviors, particularly diet pill use, among participants who were participating in SNAP/WIC. However, there were no significant associations between food insecurity and restrictive or binge-eating behaviors based on SNAP/WIC participation.
"I was definitely surprised that SNAP/WIC participation didn't seem to influence food insecurity's links with binge eating or restrictive behaviors (I thought that SNAP/WIC participation would accentuate the 'feast-or-famine' cycle) but that it did for diet pill use," Hazzard told PsyPost. "We found that food insecurity increased the risk for future diet pill use only among parents in households participating in SNAP/WIC."
"I wasn't expecting that. In the article, we offer some thoughts to try to make sense of this finding, but we also present this finding cautiously, because there were some pretty small numbers involved in that analysis, so this finding would need to be replicated in another study before coming to any real conclusions.".
The study controlled for age, gender, race, ethnicity, nativity, educational attainment, annual household income, and household size. But "we need to see if the surprising findings that I mentioned hold true in other studies, and if they do, we need to figure out what explains those surprising findings," Hazzard said.
"As both food insecurity and disordered eating behaviors like the ones we looked at in this study predict a wide range of adverse physical and mental health outcomes down the road (e.g., type 2 diabetes, depression), it's possible that these disordered eating behaviors may be, at least partly, driving some of the links we see between food insecurity and serious adverse health outcomes," the researcher added.
The study, "Household food insecurity is associated with greater prevalence and 18-month incidence of a range of disordered eating behaviors in a racially and ethnically diverse sample of parents", was authored by Vivienne M. Hazzard, Katie A. Loth, Angela R. Fertig, Amanda C. Trofholz, Junia N. de Brito, Anne C. Doering, and Jerica M. Berge.