Household food insecurity is associated with greater prevalence and 18-month incidence of a range of disordered eating behaviors in a racially and ethnically diverse sample of parents

Abstract

This study examined cross-sectional and longitudinal associations between household food insecurity (FI) and a range of disordered eating behaviors (DEBs) and explored whether associations differ by Supplemental Nutrition Assistance Program (SNAP)/Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation. Data came from 1120 racially/ethnically diverse parents (M_age = 35.7 ± 7.8 years at baseline) in the Family Matters longitudinal cohort study. Parents reported on household FI and SNAP/WIC participation at baseline, and on past-year restrictive weight-control behaviors (WCBs; e.g., fasting), compensatory WCBs (e.g., self-induced vomiting), and binge eating at baseline and 18-month follow-up. Sociodemographics-adjusted modified Poisson regressions examined baseline household FI in relation to baseline prevalence and 18-month incidence (i.e., new onset) of each type of DEB. Moderation by SNAP/WIC participation was also tested. Household FI affected 29.6 % of participants and was associated with significantly greater baseline prevalence (prevalence ratios ranging from 1.38 to 2.69) and 18-month incidence (risk ratios ranging from 1.63 to 2.93) of each type of DEB examined. The association between household FI and incident compensatory WCBs differed significantly by SNAP/WIC participation, such that household FI significantly predicted new-onset compensatory WCBs at follow-up only among those participating in SNAP/WIC. Results from this study are the first, to our knowledge, to demonstrate that FI is longitudinally associated with restrictive and compensatory DEBs, thereby highlighting FI as a risk factor not only for binge eating, but for a range of DEBs. These findings emphasize the importance of screening for FI in clinical settings and the need to address structural barriers to food security.

Keywords: Binge eating, ethnic and racial minorities; Disordered eating; Food assistance; Food insecurity; Weight-control behaviors.

Figure 1.

New-onset compensatory weight-control behaviors at approximately 18-month follow-up by household food security status and SNAP/WIC participation after adjusting for baseline sociodemographic characteristics (error bars represent standard errors)