Food Insecurity

Food insecurity is often defined as a lack of access to healthy, safe, and affordable foods that promote optimal health and well-being. The numbers vary, but one estimate is that more than 34 million people, including 13 million children, have food insecurity each year in the US (What is Food Insecurity? | Feeding America).

Jason Nagata MD, and a group at the University of California-San Francisco, have linked food insecurity in adolescents to a higher risk of developing binge eating and binge eating disorder (BED), or BED and other specified eating disorders (OSFED-BED) (Int J Eat Disord.2023. 56:1233).

Nagata’s study was designed to find an association between food insecurity and binge eating in a national cohort of 9- to 14-year-old children. Logistic regression analyses estimated the associations between food insecurity at two time points: at baseline, year 1, and at year 2 (exposure). At the 2-year follow-up, the authors also reviewed binge eating, subclinical BED (OSFED-BED), and the outcome of BED, based on results from the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5). The KSADS-5 is a semi-structured interview designed to detect affective disorders such as depression, bipolar disorder, and anxiety disorder among children and adolescents.

Results at follow-up

The prevalence of food insecurity at the beginning of the study was 15.8%. At 2-year follow-up, 1.7% of the adolescents had been diagnosed with BED or OSFED-BED. In the case of binge eating, 6.2% of the study group reported binge eating. The researchers reported that food insecurity was associated with 1.6 higher odds of developing BED or OSFED-BED, and 1.31 higher odds of having binge eating symptoms.

Dr. Nagata and colleagues recommend that clinicians consider adding food insecurity to their regular screening programs for patients with eating disorders. Another suggestion is that clinicians help provide access to adequate food support.