Food insecurity &amp; dietary restraint in a diverse urban population

Middlemass, Keesha M.; Cruz, Jéssica Reco; Gamboa, Alexandra; Johnson, Clara; Taylor, Brigitte; Gomez, Francesca; Becker, Carolyn Black

doi:10.1080/10640266.2020.1723343

Cited by 48 publications

(44 citation statements)

References 39 publications

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“…Longitudinal and qualitative studies are also needed to determine the degree to which existing explanatory models of the development and maintenance of EDs apply to or need to be altered to address the experiences of those living with FI (e.g., transdiagnostic model of EDs; Fairburn, Cooper, & Shafran, 2003). For instance, results from Middlemass et al (2018), as noted above, suggest that those living with FI restrict their food intake to stretch food to make it last, to save food for children, or because they do not have sufficient resources to buy sufficient food. Thus, models may need to be expanded to account for intentional dietary restriction, which once again correlated with ED pathology in this study, when it is undertaken for economic reasons versus weight and shape concerns.…”

Section: Discussionmentioning

confidence: 99%

“…Research with the EDDS-4, which was designed to assess the core ED diagnoses in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM–IV ) supports its internal consistency, convergent validity with ED risk factors, criterion validity with interview-based diagnoses, sensitivity to change, and predictive validity (Stice, Fisher, & Martinez, 2004). However, we used the updated EDDS-5 because it assesses night eating, which is a form of overeating, and because K. M. Middlemass et al (2018), who has extensive experience with marginalized, low-income populations, thought the EDDS-5 was somewhat easier to understand.…”

Section: Methodsmentioning

confidence: 99%

“…Post hoc tests were conducted only if we found a significant omnibus test. Further, we investigated whether any-reason dietary restraint correlated with ED pathology in this sample so as to potentially replicate findings from Middlemass et al (2018).…”

Section: Methodsmentioning

confidence: 99%

“…Instead, participants had the opportunity to explain why they restricted their intake in an open-ended format. A secondary qualitative analysis (Middlemass et al, 2018) indicated that those living with FI rarely reported restricting for weight and shape reasons (< 3%); instead, they reported restricting intake to stretch food to make it last, to save food for children, or because they did not have sufficient resources to buy sufficient food. Nonetheless, dietary restraint still correlated with ED pathology.…”

mentioning

confidence: 99%

“…Third, we hypothesized that dietary restraint would significantly correlate with ED pathology per Middlemass et al (2018). Fourth, we hypothesized that a greater percentage of those participants with the most severe FI would meet criteria for clinically significant ED pathology, depression, and anxiety.…”

mentioning

confidence: 99%

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Eating Disorder Pathology Among Individuals Living With Food Insecurity: A Replication Study

Becker

Middlemass

Gomez

et al. 2019

Clinical Psychological Science

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Eating disorders (EDs) are stereotypically associated with thin, White, affluent women and girls. One result of the ED stereotype has been a relative dearth of ED research with marginalized communities. The aim of this study was to replicate recent findings showing an association between the severity of food insecurity (FI) and increased ED pathology. Participants included 891 clients of an urban food bank. Results were consistent with the findings of previous research; participants in the most severe FI group reported significantly higher levels of ED pathology, dietary restraint, anxiety, and depression. Findings provide further evidence that the thin, White, affluent, female ED stereotype offers a flawed portrait and highlight the need for additional psychological research that focuses on marginalized populations to address disparities in access to care. Both scholars and clinicians need to move away from the stereotypical portrait of who is and is not at risk for developing an ED.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Eating Disorder Pathology Among Individuals Living With Food Insecurity: A Replication Study

Becker

Middlemass

Gomez

et al. 2019

Clinical Psychological Science

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Patient perceptions of the relationship between food insecurity and eating disorder treatment: A qualitative exploration

Frayn

Trainor

Lin

et al. 2021

Intl J Eating Disorders

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Introduction: Independently, food insecurity (FI) and binge-spectrum eating disorders (B-ED) are widespread problems; moreover, FI is associated with elevated binge-eating symptoms. However, extant research has not explored how FI may contribute to the development of B-ED symptoms, nor potential impacts of FI on eating disorder treatment. Method: This study aimed to qualitatively examine (1) mechanisms by which FI impacts B-ED development and maintenance, (2) effects of past and/or present FI on ED treatment, and (3) participant recommendations for addressing FI in future B-ED treatment. Fourteen individuals who completed B-ED treatment and endorsed FI completed a 30-min interview about their experiences.Results: Participants reported that FI contributed to binge eating by maintaining dietary restraint-binge-eating cycle and by leading them to use food as a coping mechanism or for emotional comfort, both in past and present situations. Present FI interfered with treatment, particularly with adhering to treatment recommendations and food purchasing choices, however, participants did not report any impact of past FI on B-ED treatment.Participants reported that rarely was FI addressed as part of treatment; most participants suggested that future treatments work to (1) assess and problem solve present FI to minimize interference and (2) assess and understand the influence of past FI on current symptoms to validate the function of behavior.Discussion: These findings provide qualitative support that FI may reinforce B-ED symptoms and present FI may interfere with treatment. This study emphasizes the need for assessment and consideration of FI as a factor when treating individuals with B-EDs.

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Food insecurity is associated with eating disorders independent of depression and anxiety: Findings from the 2020–2021 Healthy Minds Study

Zickgraf

Hazzard

O'Connor

2022

Intl J Eating Disorders

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Objective To examine the association between food insecurity and eating disorder (ED) risk independent of co‐occurring anxiety/depression. Method Data were provided by 121,627 undergraduate/graduate students who participated in the 2020–2021 Healthy Minds Study (HMS). Participants responded to questionnaire measures of food insecurity and risk for EDs, depression, and anxiety. Established cut‐offs were used to identify students with food insecurity and probable psychopathology. Separate modified Poisson regressions adjusted for age, gender, race/ethnicity, and socioeconomic background examined the association between food insecurity and each form of psychopathology. The association between food insecurity and probable ED was then examined in a regression further adjusted for probable depression and anxiety. Results Food insecurity was significantly associated with all three forms of psychopathology when examined separately (prevalence ratios ranged from 1.41 to 1.54, all p’s < .001). When accounting for probable depression/anxiety, food insecurity was significantly associated with 1.19 times greater prevalence of a probable ED (p < .001). Discussion The association between food insecurity and EDs was replicated in a large, national sample of university students. To our knowledge, this is the first study to examine the independence of this relationship after adjusting for depression/anxiety. This finding supports the hypothesis that specific mechanisms, rather than general psychological distress, likely underlie the food insecurity–ED relationship.

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Food insecurity & dietary restraint in a diverse urban population

Cited by 48 publications

References 39 publications

Eating Disorder Pathology Among Individuals Living With Food Insecurity: A Replication Study

Eating Disorder Pathology Among Individuals Living With Food Insecurity: A Replication Study

Patient perceptions of the relationship between food insecurity and eating disorder treatment: A qualitative exploration

Food insecurity is associated with eating disorders independent of depression and anxiety: Findings from the 2020–2021 Healthy Minds Study

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