Please note that this is an Archived article and may contain content that is out of date. The use of she/her/hers pronouns in some articles is not intended to be exclusionary. Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights.

By Quinn Nystrom

Many misconceptions exist about people living with an eating disorder (ED). What caused it? What do we look like? What do we eat? Or not eat? So many additional factors complicate an ED diagnosis—one of those main, often overlooked ones being food insecurity.

How does the USDA define food insecurity?

“A lack of consistent access to enough food for every person in a household to live an active, healthy life. This can be a temporary situation for a family or can last a long time.”

What does research tell us?

Carolyn Black Becker is a psychologist who studies eating disorders. She said that when she used to talk to her colleagues about her research on EDs and food insecurity, she would get blank stares. Her first major research study was eye-opening. She looked at clients of a food bank in San Antonio. She found:

· High levels of food restriction

· Deliberate effort to reduce the amount of food one eats.

· High rates of binge eating and purging

o Self-induced vomiting or laxative misuse

o Those rates increased depending on people’s level of food insecurity, from 2.9% among people who were only mildly food insecure to 37.6% among people who had so little food even the children went hungry.

· It wasn’t just that some people experiencing food insecurity ate more at times, which would make sense. It’s also that they felt guilty and ashamed for doing so. They reported vomiting after eating to keep from gaining weight, and 22.8% used laxatives or diuretics for the same reason.

How does food insecurity further complicate an eating disorder?

People with an eating disorder have complex relationships with food, which will be enhanced by food insecurity and panic buying.

In the Spring of 2020, at the height of COVID-10, 10 million Americans had lost their jobs with limited or no income or medical insurance. The number of people struggling with food insecurity skyrocketed.

Episodes of binge eating can be extremely costly and, at times of financial strain, can lead to theft of food and, if caught, then having to be criminally charged.

Food Insecurity Screenings for Health Care Providers:

1. Hunger Vital Sign: The Hunger Vital Sign™ – Children’s HealthWatch (childrenshealthwatch.org)

2. Radimer/Cornell Food Insecurity Measure: Validation of the Radimer/Cornell measures of hunger and food insecurity – PubMed (nih.gov)

When I was first in treatment for my eating disorder, I remember sitting in a process group and hearing from a friend of mine how she would go to the grocery store and stuff food in her clothes to binge on later. I had no idea. I was naïve. She struggled to stay alive with this deadly mental illness and had the tricky component of food insecurity and how she could continue to binge regularly.

We never truly know what people are going through. Be kind. Don’t be judgmental. If you need help, reach out.