Food insecurity is associated with eating disorders independent of depression and anxiety: Findings from the 2020-2021 Healthy Minds Study

Why is this research important?

This study examined the association between food insecurity and risk of having an eating disorder. The authors examined data provided by more than 120,000 university students. Approximately one-third of university students who participated in the study experienced food insecurity within the past 12 months. The authors found that independent of co-occurring anxiety or depression, food insecurity was significantly associated with a greater risk of an eating disorder. That is, regardless of whether a person has depression or anxiety, the presence of food insecurity is associated with a higher chance of that person having a probable eating disorder. This food insecurity-eating disorder relationship exists across cisgender men, cisgender women and transgender/gender diverse individuals.

This study provides preliminary evidence for the existence of a causal pathway from food insecurity to risk of an eating disorder. That is, preliminary evidence that experiencing food insecurity may contribute to risk and subsequent development of disordered eating and eating disorders. Further research is needed to provide evidence for the presumed causal relationship (i.e. that food insecurity may lead to an eating disorder).

Authors: Hana F. Zickgraf, Vivienne M. Hazzard, Shannon M. O’Connor

Abstract/Summary:

Objective: To examine the association between food insecurity and eating disorder (ED) risk independent of co-occurring anxiety/depression.

Method: Data were provided by 121,627 undergraduate/graduate students who participated in the 2020-2021 Healthy Minds Study (HMS). Participants responded to questionnaire measures of food insecurity and risk for EDs, depression, and anxiety. Established cut-offs were used to identify students with food insecurity and probable psychopathology. Separate modified Poisson regressions adjusted for age, gender, race/ethnicity, and socioeconomic background examined the association between food insecurity and each form of psychopathology. The association between food insecurity and probable ED was then examined in a regression further adjusted for probable depression and anxiety.

Results: Food insecurity was significantly associated with all three forms of psychopathology when examined separately (prevalence ratios ranged from 1.41 to 1.54, all p’s < .001). When accounting for probable depression/anxiety, food insecurity was significantly associated with 1.19 times greater prevalence of a probable ED (p < .001).

Discussion: The association between food insecurity and EDs was replicated in a large, national sample of university students. To our knowledge, this is the first study to examine the independence of this relationship after adjusting for depression/anxiety. This finding supports the hypothesis that specific mechanisms, rather than general psychological distress, likely underlie the food insecurity–ED relationship.

Access: Closed access

Link: onlinelibrary.wiley.com/doi/abs/10.1002/eat.23668

Citation: Zickgraf, H. F., et al. (2022). Food insecurity is associated with eating disorders independent of depression and anxiety: Findings from the 2020-2021 Healthy Minds Study. Int J Eat Disord. https://doi.org/10.1002/eat.23668