While literature on the nuances within eating disorders (EDs) continues to grow, there is still much to be debunked about their development, trajectory, and impact. One area that has been gaining attention in ED research and clinical work is food insecurity. Food insecurity can be defined as a lack of consistent access to enough food to lead a well-nourished and healthy life (Coleman et al., 2014) and has been found to be associated with increases in ED pathology (See a past blog post for a review of a study on this link). Recent works explaining the food insecurity and ED relationship, detailed below, have offered insight to how EDs affect people of low socioeconomic backgrounds across ages and racial/ethnic identities. Increasing knowledge on the relation between food insecurity and EDs can help dismantle harmful stereotypes about who is affected by EDs and increase access to ED resources for those who may be food insecure. As such, this article debunks four common ED myths as it relates to food insecurity:
Myth #1: Only skinny, White, affluent people experience eating disorders
Prevalence of disordered eating is highest among those with high food insecurity, suggesting that affluence does not always correlate with increased likelihood of EDs (Becker et al., 2017). Furthermore, racial/ethnic minority groups tend to be more food insecure in the United States (U.S.) than their White counterparts, and because of the high correlation between food insecurity and EDs, the notion that only White people could develop disordered eating is untrue (Odoms-Young et al., 2018). In addition to being highly correlated with EDs, food insecurity is also highly associated with obesity by way of disordered eating and poor diet, suggesting that EDs can occur at any weight (Adams et al., 2003).
Myth #2: EDs are only an American issue
While there is little research measuring EDs among those experiencing food insecurity outside of the U.S., one can infer that there could be a similar mechanism between EDs and food insecurity occurring transnationally. Food insecurity is a global issue with the highest prevalence rates occurring in Africa, therefore, it is possible that we will see EDs occurring in association with food insecurity (Cafiero et al., 2018). In fact, one study found moderate and severe food insecurity by assessing disordered eating behaviors, such as skipping meals, among Ghanaian older adults in psychological distress (Gyasi et al., 2020). Researchers have also identified purging among Black South African adolescent girls experiencing food insecurity in poverty, further showing that EDs can exist outside of the U.S. (Le Grange et al., 2004).
Myth #3: Disordered eating behaviors are primarily motivated by weight/shape concerns
Gomez and colleagues (2020) found that beauty ideals and weight management are not always the main motivators for disordered eating behaviors, dietary restraint, and loss of control eating. For those who are food insecure, having insufficient money or food and prioritizing other expenses and needs is more related to disordered eating than weight/shape concerns. Approximately 18% of study participants with food insecurity reported restricting food intake due to weight/shape concern (Gomez et al., 2020).
Myth #4: Having secure access to food resolves disordered eating that arose during periods of food insecurity
There is evidence that food insecurity in adolescence lasts over time and predicts future disordered eating even if those individuals are currently food secure (Hazzard et al., 2022). One study found that adults in the U.S. who had completed outpatient treatment for binge eating disorder reported that their current disordered eating is a learned behavior from their past food insecurity even after becoming food secure (Frayn et al., 2022). Evidently, disordered eating resulting from food insecurity does not disappear once a person gains access to food. These findings also debunk the idea that only young girls can have EDs since disordered eating while food insecure as a child appears to continue into or start in adulthood.
For many, our understanding of EDs has been affected by harmful myths. These myths and stereotypes can hinder people from seeking out necessary treatment and services. Dismantling stereotypes is critical for expanding knowledge about EDs, including the link between food insecurity and increased ED behaviors. Spreading factual knowledge can help increase awareness and support people struggling with both EDs and food insecurity.
References
Adams, E. J., Grummer-Strawn, L., & Chavez, G. (2003). Food insecurity is associated with increased risk of obesity in California women. The Journal of Nutrition, 133(4), 1070-1074.
Becker, C. B., Middlemass, K., Taylor, B., Johnson, C., & Gomez, F. (2017). Food insecurity and eating disorder pathology. International Journal of Eating Disorders, 50(9), 1031–1040. https://doi.org/10.1002/eat.22735
Cafiero, C., Viviani, S., & Nord, M. (2018). Food security measurement in a global context: The food insecurity experience scale. Measurement, 116, 146-152.
Frayn, M., Trainor, C., Lin, M., Pitts, A., Drexler, S. A., Patarinski, A. G. G., & Juarascio, A. (2022). Patient perceptions of the relationship between food insecurity and eating disorder treatment: A qualitative exploration. International Journal of Eating Disorders, 55(3), 332–342. https://doi.org/10.1002/eat.23661
Gomez, F., & Perez, M. (2022). Motivation for dietary restraint, and disordered eating among adults experiencing food insecurity in the United States. International Journal of Eating Disorders. https://doi.org/10.1002/eat.23730
Gyasi, R. M., Peprah, P., & Appiah, D. O. (2020). Association of food insecurity with psychological disorders: Results of a population-based study among older people in Ghana. Journal of Affective Disorders, 270, 75-82.
Hazzard, V. M., Hooper, L., Larson, N., Loth, K. A., Wall, M. M., & Neumark-Sztainer, D. (2022). Associations between severe food insecurity and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. Preventive Medicine: An International Journal Devoted to Practice and Theory, 154. https://doi.org/10.1016/j.ypmed.2021.106895
Le Grange, D., Louw, J., Breen, A., & Katzman, M. A. (2004). The meaning of ‘self-starvation’ in impoverished Black adolescents in South Africa. Culture, Medicine, and Psychiatry, 28, 439-461
Odoms-Young, A., & Bruce, M. A. (2018). Examining the Impact of Structural Racism on Food Insecurity: Implications for Addressing Racial/Ethnic Disparities. Family & community health, 41 Suppl 2 Suppl, Food Insecurity and Obesity (Suppl 2 FOOD INSECURITY AND OBESITY), S3–S6. https://doi.org/10.1097/FCH.0000000000000183
By Becca Gwira
Becca is an advanced doctoral student in the counseling psychology doctoral program at Georgia State University, and she works as a research assistant in the Living F.R.E.E. Lab this summer.
