Household food insecurity: associations with disordered eating behaviours and overweight in a population-based sample of adolescents

Abstract

Objective: To examine how household food insecurity is related to adolescent weight status and disordered eating. Design: Cross-sectional, population-based study. Adolescents self-reported unhealthy weight control behaviours, binge eating and meal frequency; weight status was measured. Household food insecurity was assessed by asking parents to respond to the validated six-item US Household Food Security Survey Module. Setting: Adolescents surveyed within Minneapolis/St. Paul public middle and high schools completed surveys at school, and their parents/guardians were surveyed by mail during the 2009–2010 academic year. Participants: Ethnically/racially diverse, primarily low-income adolescents (mean age: 14·4 years, range: 10–22 years) and their parents/guardians (n 2285 dyads). Results: More than one-third (38·9 %) of the adolescents experienced past-year household food insecurity, 43·2 % reported disordered eating and 39·6 % were overweight. Generalised regression models showed that food insecure (FI) compared with food secure (FS) adolescents had higher prevalence of overweight (FI: 42·3 % v. FS: 37·9 %, P = 0·039), lower breakfast consumption (FI: 4·1 times/week v. FS: 4·4 times/week, P = 0·005) and greater use of unhealthy weight control behaviours (FI: 49·0 % v. FS: 39·5 %, P < 0·001) in unadjusted models. Models adjusted for parental education, ethnicity/race, sex and age found that food insecurity was associated with higher prevalence of unhealthy weight control behaviours (FI: 44·5 % v. FS: 37·8 %, P = 0·007), but not with weight status or other eating behaviours. Conclusions: These results suggest that food insecurity may be an independent risk factor for unhealthy weight control behaviours, indicating a need to approach these intersecting issues in a comprehensive manner.

Disordered eating in a population‐based sample of young adults during the COVID‐19 outbreak

“…These findings provide further support for an established need to develop interventions to reach emerging adults experiencing financial difficulties (Becker, Middlemass, Gomez, & Martinez‐Abrego, 2019; Tester, Lang, & Laraia, 2016). Moreover, the present finding is consistent with findings from EAT 2010, wherein adolescents experiencing food insecurity reported a higher rate of UWCBs relative to those who did not experience food insecurity (Hooper, Telke, Larson, Mason, & Neumark‐Sztainer, 2020). While the present study did not support an association between food insecurity and binge eating, previous research with the EAT 2010–2018 cohort suggests that food insecurity may be positively associated with binge eating (Larson, Laska, & Neumark‐Sztainer, 2020).…”

Food Insecurity and Pediatric Obesity: a Double Whammy in the Era of COVID-19

“…Since this review, new analyses have been added to the mixed literature base. In a recent study, though there was a higher prevalence of overweight in food-insecure children, this was no longer significant after adjustment for other demographic factors [37]. Adding to the literature base suggesting a positive association, one study at a weight management clinic found that children from food-insecure households (N = 822) had higher BMI percentiles than those from food-secure households [59], and an analysis from the 2011 Kindergarten Cohort 2011 of the Early Childhood Longitudinal Study (ECLS) showed that first-grade food insecurity is an independent risk factor for longitudinal increases in BMI z-score in first through third grades [60].…”

“…While participants in all groups had anecdotes about overeating in their children, only respondents in the food-insecure groups described food-hiding, night-time eating episodes, and binge-type eating behaviors [36]. In an analysis of middle and high school adolescents who participated in two studies in Minnesota-EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activity Among Teens)-the prevalence of unhealthy weight control behaviors was higher among adolescents who were food-insecure (44.5%) compared to food-secure peers (37.8%, p < 0.001), after adjusting for parental education, race/ethnicity, sex, and age [37]. In related analysis of adolescents in Project EAT over time, food insecurity in early/ middle adolescence (EAT-I) predicted increased risk of binge eating 5 years later during late adolescence/early adulthood (EAT-II) [38].…”

Food insecurity and its associations with bulimic-spectrum eating disorders, mood disorders, and anxiety disorders in a nationally representative sample of U.S. adults

“…While eating disorders were historically believed to occur most commonly in affluent populations, eating disorders are now recognized to affect individuals across all socioeconomic strata [ 22 ]. Moreover, in recent years, individuals living in food-insecure households have demonstrated higher levels of overall eating disorder pathology [ 14 , 15 ], more eating disorder symptoms such as binge eating [ 14 , 15 , 23 , 24 ] and compensatory behaviors (e.g., self-induced vomiting, laxative use) [ 14 , 15 , 25 ], and greater likelihood of meeting diagnostic criteria for bulimia nervosa [ 17 ] and binge-eating disorder [ 16 ] as assessed via self-administered questionnaire. However, no studies to date have examined the association between food insecurity and eating disorders using eating disorder data gleaned via diagnostic interview, which offers important advantages over self-administered questionnaire data (e.g., the opportunity for interviewers to probe for thoughtful responses [ 26 ]), and most prior studies have utilized convenience samples.…”