Food Insecurity and Eating Disorders

Life is unpredictable. Unexpected expenses like layoffs, medical emergencies, or home repairs can force families to choose between buying food or paying their bills. The U.S. Department of Agriculture (USDA) estimates that 10.2% of American households experienced food insecurity in 2021. The percentage translates to more than 34 million people, including 9 million children. These millions of Americans are at risk of experiencing the serious physical and psychological consequences of food insecurity, including eating disorders. 

In this blog, we will examine the topic of food insecurity and its connection to eating disorders, as well as what we can do to help those affected. 

What is Food Insecurity?

Food insecurity describes a lack of consistent access to enough food for every member of a household. The issue disproportionally affects marginalized communities, including people of color, people with disabilities, and low-income households. In addition, low-income neighborhoods tend to have fewer supermarkets and grocery stores, which can leave them with lower-quality food options. 

According to the USDA, food security exists on a spectrum that ranges from high to low food security, or food insecurity. Here are several statistics on those affected by food insecurity:

• Over 53% of lower-income households in 2020 were food insecure (USDA)
• Black and Hispanic households have higher rates of food insecurity compared to the national average (USDA)
• Food insecurity affects 33% of households that have an adult with a disability that aren’t receiving disability benefits (Cahill & Samuel, 2021)

There is a misconception that food insecurity only affects low and middle-income countries. In reality, it affects high-income countries like the United States as well (Hazzard, Loth, Hooper, & Becker, 2020). 

What causes food insecurity? There are a variety of factors, including:

• Unemployment or low income
• Lack of affordable housing
• Chronic health conditions and/or lack of health insurance
• System racism and discrimination

How Food Insecurity and Eating Disorders are Connected

Food insecurity can result in not only physical health consequences—like type 2 diabetes and hypertension—but mental health effects as well. The mental health consequences of this issue can include anxiety, depression, and eating disorders. 

When a person does not know where their next meal will come from, it makes sense that their relationship with food may be negatively affected. Typically, a household experiencing low food security has one or more people that have reduced their food intake, with the adults’ intake commonly affected before the children’s. “Among adults, food insecurity is cross-sectionally associated with higher levels of overall ED pathology, binge eating, compensatory behaviors, binge-eating disorder, and bulimia nervosa,” according to a 2020 study published in Current Psychiatry Reports.

The various periods of food deprivation and food access associated with food insecurity may contribute to disordered eating and eating disorders. The physiological and behavioral effects can be similar to dieting and trigger overeating. Overeating can occur as a result of the body not knowing when its next meal might come. This can then lead a person to exhibit compensatory behaviors because they are concerned about what overeating will do to their body size and shape (Stinson et al., 2018; West et al., 2019)

In summary, food insecurity can lead to the following cycle: prolonged hunger, bingeing when food becomes available, and then performing compensatory behaviors—such as self-induced vomiting or excessive exercise—to “make up” for the binge. 

Food Insecurity Support

As a provider, it is essential to consider screening for food insecurity in those with eating disorders and for eating disorders in those experiencing food insecurity. Both experiences often come with stigma and shame. With this in mind, it is essential to approach the conversation with empathy. Note instances of food insecurity in the patient’s electronic health record (EHR) and have resources at hand. Below are some federal resources you can provide: 

• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Nutritionally tailored food packages for pregnant, breastfeeding, and postpartum women, infants, and children up to age five
• The Emergency Food Assistance Program (TEFAP): Emergency food distributed through local food pantries and organizations
• Supplemental Nutrition Assistance Program (SNAP): Monthly benefits for purchasing food using an EBT card

Systemic inequality and structural barriers are at the heart of the food insecurity issue. Organization and political reform are necessary to make real change. Here are some ideas for how you can help:

• Donate to a local food bank
• Start a community garden in your neighborhood
• Volunteer with Meals on Wheels
• Organize or volunteer at a food drive
• Sponsor a family through Family-to-Family

Recovery Support

For patients experiencing an eating disorder and food insecurity, extra support is needed. Once these individuals are able to obtain the food they need on a consistent basis, they need guidance to incorporate that food into their treatment and recovery. These patients are served best by a multidisciplinary care team that takes into account their unique triggers and experiences when preparing them to manage their recovery at home. 

If you are concerned about an eating disorder in a patient experiencing food insecurity, Veritas Collaborative is here to help. Submit a referral online or by calling 1-855-875-5812 today.