Vol. 30 / No. 1 — Eating Disorders Review
Two seemingly polar opposites, food insecurity, or lack of food, often due to poverty, and binge-eating disorder, or BED, are associated, according to a recent report by Janet Lydecker, PhD, of the Department of Psychiatry Yale School of Public Health, New Haven, CT. She and her colleagues reported their findings in the International Journal of Eating Disorders, published online December 19, 2018.
The study recruited 1,2651 participants using Amazon’s Mechanical Turk, a web-based recruitment platform; participants then reported their weight and height, and the researchers calculated body mass index (kg/m2) for each. After this, the study participants were divided into three groups. More than half (56.8%; n=710) were classified as having a healthy weight with no eating disorder; 85 participants (6.8%) Had diagnoses of BED, and 456 patients (36.5%) were obese but had no eating disorder.
The researchers defined food security in three categories (1) if the individuals were able to afford regular nutritious meals, (2) low food insecurity if they modified food quality, variety, or desire to satisfy hunger, and (3) very low food security if they reduced their food intake or quality to the point of having physiological hunger. One-third (33.7%; n=422) were found to have food insecurity; 18,5% (n=231) had low food security; and 15.3% (n=191) had very low food security. Compared with persons who had healthy weights, those deemed to have low food security were 2.5 times more likely to have BED. The same pattern was associated with an increased likelihood of being obese. Other researchers, such as Tomoko Udo, PhD, of the School of Public Health at SUNY University at Albany, NY, have noted that the dietary restraint model of binge eating suggests that when a person engages in dietary restriction as a way to control calories or due to lack of access to food, he or she is more likely to engage in binge eating due to deprivation.
Dr. Lydecker noted that clinician s traditionally associate self-imposed dieting, seen as skipping meals or cutting back on calories to lose weight, as one of the causes of binge eating. However, she added, externally imposed restrictions on food, skipping meals or cutting back on intake because food isn’t available is also related to binge eating. “Food insecurity could be a factor making it more difficult for patients to get better if they cannot address it. By addressing it, clinicians and patients with BED can collaborate more effectively to treating binge eating,” she said.