Food insecurity is a risk factor for binge eating disorder (BED) and obesity in low-income Americans, according to study results published in the International Journal of Eating Disorders.

Grace Rasmusson, MPH, of the Yale School of Public Health in New Haven, Connecticut, and colleagues , used data from an online survey of 1251 respondents who were divided into three groups: healthy weight (HW), BED, and obesity (OB). One-third of respondents met the criteria for food insecurity, with 18.5% having low food security and 15.3% having very low food security. Of the respondents in the BED group, 17.6% had a body mass index (BMI) <25 kg/m2 (normal weight), 17.6% had a BMI 25-29.9 kg/m2 (overweight), and 64.7% had a BMI ≥30 kg/m2 (obese). By definition, all respondents in the OB group had a BMI ≥30 kg/m2 and all respondents in the HW group had a BMI between 18.5 and 24.9 kg/m2.

Food insecurity was present in all 3 study groups, but low and very low food security was highest in respondents in the BED group, in which 28.24% reported low food security and 18.82% reported very low food security. Younger participants and respondents with less education were more likely to be food insecure as well. Participants in the OB group were also more likely to report food insecurity, with an odds ratio (OR) of 1.56 for low food security and an OR of 1.55 for very low food security. Respondents in the BED and OB groups were significantly more likely to report food insecurity than participants in the HW group. Neither sex nor race/ethnicity were risks factors for BED or obesity.

The investigators noted this is the first study to investigate food insecurity as a risk factor for recurrent binge-eating episodes. Binge eating disorder is believed to occur because of cycles of restriction and binge-eating, whether that restriction is caused by outside forces or self-imposed dieting. They also noted the association between food insecurity and obesity, with BMI significantly greater in individuals with very low food insecurity than in individuals with food security.

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The researchers suggested evaluating food insecurity in individuals seeking treatment for BED, as patterns associated with food insecurity can complicate BED treatment. They also called for future clinical research focused on the development of preventive interventions in low-income and food-insecure individuals.

The study is limited by the self-reported nature of the data.

Reference

Rasmusson G, Lydecker JA, Coffino JA, White MA, Grilo CM. Household food insecurity is associated with binge-eating disorder and obesity [published online December 19, 2018]. Int J Eat Disorder. doi:10.1002/eat.22990