Food insecurity and binge‐eating disorder in early adolescence

Abstract

Objective Food insecurity is defined as lack of consistent access to adequate food for healthy living. The objective of this study was to determine the associations between food insecurity and binge‐eating disorder in a national cohort of 9‐ to 14‐year‐old children. Method We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,035, 2016–2020). Logistic regression analyses estimated the associations between food insecurity at baseline, year 1, or year 2 (exposure) and binge eating, subclinical binge‐eating disorder (Other Specified Feeding and Eating Disorder‐Binge‐Eating Disorder [OSFED‐BED]), and binge‐eating disorder (BED) (outcome) based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS‐5) at 2‐year follow‐up. Results The prevalence of food insecurity in the study was 15.8%. At 2‐year follow‐up, 1.71% of the sample received a diagnosis of BED or OSFED‐BED, while 6.62% reported binge eating. Food insecurity was associated with 1.67 higher odds of BED or OSFED‐BED (95% CI 1.04–2.69) and 1.31 higher odds of binge‐eating symptoms (95% CI 1.01–1.71). Discussion Food insecurity in early adolescence is associated with higher odds of developing future binge‐eating and BED or OSFED‐BED. Clinicians may consider assessing for binge eating in adolescents with food insecurity and provide support in accessing appropriate food resources. Public Significance Prior research has shown that food insecurity is associated with disordered eating behaviors, including binge eating in adulthood. This study explored whether food insecurity in early adolescence increases risk for developing binge‐eating disorder (BED). Targeted screening for BED in adolescents experiencing FI, and vice versa, may be warranted.

Racial discrimination is associated with binge-eating disorder in early adolescents: a cross-sectional analysis

“…These findings are consistent with numerous theoretical perspectives including the minority stress model and the affect regulation model [ 19 – 22 ]. Similarly, the findings are also consistent with prior literature on the inequitable distribution if sociodemographic risk factors across race/ethnicity (ie food insecurity), which places individuals at higher risk for BED [ 26 – 28 ]. To further explore these theories, future studies should explore whether these factors (e.g., anxiety, stress, depression, food insecurity) mediate the associations between racial discrimination and BED.…”

“…Given that racial discrimination is associated with depression and anxiety, people who experience discrimination may be at greater risk for BED through this pathway [23][24][25]. A third potential mechanism is that minoritized racial and ethnic groups having increased risks of experiencing racial/ethnic discrimination [26,27] and food insecurity, which may result in an increased risk of BED among people who have experienced discrimination [28].…”

Food Insecurity and Food Addiction in a Large, National Sample of Lower-Income Adults

“…Those with food insecurity may have different interpretations to mYFAS 2.0 questions than those with food security, and our team is currently pursuing this research. Furthermore, our study did not include measures of clinical eating disorders or more broadly, disordered eating behaviors, though studies examining the relationships between food insecurity and eating disorders [ [44] , [45] , [46] ], and disordered eating [ 8 , 36 , 47 ] have previously been published. Future studies may want to examine disordered eating as a moderator of the relationship between food insecurity and food addiction.…”

What medical providers need to elevate outpatient care for adolescents and young adults with binge‐eating disorder: A novel protocol

“…Although recent reviews and studies of large data sets have attempted to quantify prevalence, sex differences, and behavioral health comorbidities in youth with BED, we characterize our outpatient sample of community youth presenting to an adolescent and young adult medicine clinic or EDs program who meet criteria for BED (Bohon, 2019;He et al, 2018;Kjeldbjerg & Clausen, 2023;Lee-Winn et al, 2016;Marzilli et al, 2018;Nagata et al, 2023;van Hoeken & Hoek, 2020). Our sample size is small and likely skewed by regional specificity and presentation for specialized adolescent and/or ED care.…”