Relative food abundance predicts greater binge-eating symptoms in subsequent hours among young adults experiencing food insecurity: Support for the "feast-or-famine" cycle hypothesis from an ecological momentary assessment study

Abstract

Food insecurity (FI) may increase risk for binge eating through a "feast-or-famine" cycle, where fluctuations in food availability correspond to alternating periods of food restriction and opportunities for binge eating, but research on this topic is limited. To clarify the relationship between food availability and binge eating in the context of FI, this study examined the association between momentary food security level and subsequent binge-eating symptoms among individuals in food-insecure households and investigated how this association differs by factors that may modify the extent to which food availability fluctuates. Ecological momentary assessment data were collected in 2020-2021 from 75 young adults (M_age = 25.3 ± 1.8 years; 72% female; 72% Black, Indigenous, or a Person of Color) in the United States who had experienced past-month household FI. For 14 days, participants reported four times per day on food security and eating episodes, and binge-eating symptoms were assessed for each reported eating episode. About 35% of the variance in momentary food security ratings was accounted for by within-person variability over time. A significant within-person association was observed in multilevel analyses, indicating that instances of greater food security relative to one's average level predicted greater subsequent binge-eating symptoms. Moderation analyses revealed that this association was significant only among individuals reporting use of food assistance programs, high engagement in resource trade-off coping strategies (e.g., skipping bill payments to buy food), or low food security-related self-efficacy. Overall, findings offer support for the "feast-or-famine" cycle hypothesis as an explanation for the link between FI and binge eating, emphasize the importance of identifying approaches to promote more stable access to adequate food, and suggest potential intervention targets to reduce risk for binge eating in populations experiencing FI.

Keywords: Binge eating; Ecological momentary assessment; Food assistance; Self-efficacy; Young adults; food Insecurity.

Figure 1.

Study participant flow diagram Note. EMA = ecological momentary assessment. Usable EMA data was defined as a minimum of two pairs of within-day data points, specifically with each pair of data points representing food security level at one signal and binge-eating symptoms at a subsequent signal within the same day.

Figure 2.

Adjusted within-person associations between momentary food security level and subsequent binge-eating symptoms, by statistically significant food security-related moderators Note. SNAP = Supplemental Nutrition Assistance Program; WIC = Special Supplemental Nutrition Program for Women, Infants, and Children. The dashed vertical reference line represents the null value. Models were adjusted for between-person food security level, time lag between assessments, time of day, age, gender, race/ethnicity, and parent status. Error bars represent 95% confidence intervals. High and low levels are defined as one standard deviation above and below the mean, respectively.