Food Insecurity is Associated with Maladaptive Eating Behaviors and Objectively Measured Overeating

Abstract

Objective: The association between food insecurity and obesity may be partially explained by overeating in response to unpredictable food availability cycles. The aim of this study was to measure objective food intake in food insecure individuals. Methods: 82 volunteers (53m; BMI 29±7; 38±12y) were admitted to our inpatient Clinical Research Unit and completed the Food Security Short Form (FSSF), Three-Factor Eating Questionnaire and Gormally Binge Eating Scale and body composition assessment (DXA). After 5d of weight maintaining diet, participants self-selected food from an ad libitum vending machine paradigm for 3d. Mean daily intake (kcal), macronutrient intake, and percentage of weight maintaining energy needs (%WMEN) were calculated. Results: Based on FSSF cutoffs, food insecure participants (n=46; 56%) had higher body weight ( p =.04), FFM ( p =.05), disinhibition ( p =.008), hunger ( p =.02) and binge eating scores ( p =.02), but not cognitive restraint ( p =.37) compared to food secure individuals. They overate more kcal ( p =.001), %WMEN ( p =.003), fat ( p =.003) and carbohydrates ( p =.004) during the vending machine paradigm, continued to increase their hourly rate of kcal (group×time, β=37.7 cumulative kcal/hour, p <.0001) and ate more total kcal across the 72-hours (β=47.09 kcal/hour, p =.003). Conclusion: Food insecurity may amplify susceptibility to weight gain via overeating during times of unlimited food access.

Hunger in the household: Food insecurity and associations with maternal eating and toddler feeding

“…15 In addition, food insecurity has been associated with greater ad libitum intake in adults. 16,17 Together, these findings suggest that mothers in food insecure households may experience cycles of highly restrained eating when food is scarce, followed by unrestrained (or disinhibited) eating when food is available. 16,17 However, the transient nature of household food insecurity may obscure associations with restrained eating.…”

“…In 2017, 16.4% of US households with children under age 6 years experienced food insecurity at some point during the year. 1 Household food insecurity, defined as inadequate access among all household members to a nutritious diet at all times, 1 has both cognitive and behavioral implications for parents (eg, worrying about running out of food, skipping meals due to financial constraints) 1 and negatively affects child health and development.…”

Food Insecurity and Eating Disorders: a Review of Emerging Evidence

“…Similarly, food pantry clients with severe food insecurity were more likely to report binge eating than those with marginal food security in the initial study by Becker and colleagues (16.4% versus 7.9%) [ 45 ••], as well as in their replication study (26.6% versus 11.9%) [ 46 •]. Additionally, adults with food insecurity have been found to experience greater binge eating severity than those with food security, with a medium effect size (η 2 = 0.08), as well as to objectively overeat more calories in a controlled ad libitum food intake paradigm than those with food security [ 51 ]. Existing research among adolescents, however, has not indicated an association between food insecurity and binge eating cross-sectionally [ 52 ••], and while food insecurity during adolescence was found to predict 40% greater risk of new-onset binge eating 5 years later in one study, the difference was not statistically significant [ 53 ].…”

“…The studies reviewed above represent the extent of the existing empirical literature on food insecurity and ED pathology that we identified since database inception via searches of MEDLINE and PsycINFO in July 2020. Overall, we identified a total of fourteen studies quantitatively examining the link between food insecurity and either overall ED pathology, disordered eating behaviors, or ED diagnoses [ 34 , 42 – 44 , 45 ••, 46 •, 48 – 51 , 52 ••, 53 , 55 ••, 56 ••], eleven of which were published since 2017 [ 42 , 43 , 45 ••, 46 •, 48 , 50 , 51 , 52 ••, 53 , 55 ••, 56 ••]. Although this body of research is still small, it has grown tremendously in recent years relative to the limited attention this topic previously garnered.…”

“…To assess food insecurity, most studies used some form of the U.S. Household Food Security Scale (HFSS), which has demonstrated reliability and convergent validity [ 59 , 60 ] but relies upon retrospective recall, the impact of which on validity has not been evaluated. Some studies used the 18-item full version of the HFSS [ 44 ], the 10-item adult version [ 43 , 50 ], or the six-item short form [ 49 , 51 , 52 ••, 55 ••, 56 ••]. Other studies used the HFSS-derived two-item Hunger Vital Sign [ 42 ], a different pair of HFSS items [ 48 ], a single HFSS item [ 53 ], or the Radimer/Cornell Food Insecurity Measure [ 34 , 45 ••, 46 •].…”