Food Insecurity and Eating Disorders: a Review of Emerging Evidence
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EATING DISORDERS (S WONDERLICH AND S ENGEL, SECTION EDITORS)
Food Insecurity and Eating Disorders: a Review of Emerging Evidence Vivienne M. Hazzard 1
&
Katie A. Loth 2 & Laura Hooper 3 & Carolyn Black Becker 4
Accepted: 19 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This review summarizes emerging evidence for the relationship between food insecurity and eating disorder (ED) pathology, outlines priorities for future research in this area, and comments on considerations for clinical and public health practice. Recent Findings 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. Evidence for similar relationships among adolescents has been less robust; however, compared to studies of adults, there have been substantially fewer studies conducted in adolescents to date. Summary Emerging evidence consistently indicates that food insecurity is cross-sectionally associated with bulimic-spectrum ED pathology among adults. Findings emphasize the need for ED research to include marginalized populations who have historically been overlooked in the ED field. Much more research is needed to better understand the relationship between food insecurity and ED pathology and to determine effective ways to intervene. Keywords Eating disorders . Disordered eating . Food insecurity . Health inequities . Marginalized populations . Social determinants of health
Introduction Food insecurity is characterized by limited or uncertain means to access nutritious food in a safe and socially acceptable manner [1]. The food security status of a household exists on a continuum ranging from high food security (i.e., consistent access to adequate food) to very low food security (i.e., reduced food intake among one or more household members, with adults’ intake typically affected before children’s intake) [2, 3]. Food insecurity is a global problem that affects not only This article is part of the Topical Collection on Eating Disorders * Vivienne M. Hazzard [email protected] 1
Sanford Center for Biobehavioral Research, 120 Eighth Street South, Fargo, ND 58103, USA
2
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
3
Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
4
Department of Psychology, Trinity University, San Antonio, TX, USA
low- and middle-income countries, but also high-income countries such as the United States (U.S.) [4]. For instance, after experiencing a substantial rise in levels of food insecurity with the 2007–2009 recession, the U.S. returned to prerecession levels a decade later—with 14.3 million U.S. households (11.1%) determined to be food-insecure in 2018 [3]— only to experience another surge in food insecurity levels with the COVID-19 pandemic [5]. Importantly, recent increases in
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