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Reviewed by Millie Plotkin, MLS

Lydecker, J. A. & Grilo, C. M. (2019). Food insecurity and bulimia nervosa in the United States. International Journal of Eating Disorders, 52(6), 735-739.

One of the common stereotypes about people with eating disorders is that patients are always part of middle- and upper-class socioeconomic groups. Perhaps this is due to issues of treatment access for those from low-income households. However, the issue of food insecurity has become a focus for researchers during the last few years. In 2017, Carolyn Black Becker et al. published a ground-breaking study showing that 503 adults in low-income households using a food bank had higher rates of binge eating and overall eating disorder pathology. Becker’s group replicated this study, with findings on 891 food bank clients published in Clinical Psychological Science. Early in 2019, Lydecker and Grilo were part of a group (Rasmussen et al.) that published a study on the correlation between food insecurity and risk for binge eating disorder.

In this current study, Lydecker and Grilo have turned their focus to risk for bulimia nervosa in the food insecure population. 873 American adults responded to an online survey in English or Spanish. The researcher used a USDA measure to assess the level of food insecurity and the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) to assess eating disorder pathology. Results from the QEWP-% sorted 78 respondents into the bulimia nervosa (BN) study group. Within the BN study group, 28.2% of respondents had low food security and 25.6% had very low food security. These results closely match those of the earlier BED study group.

Why is this important?

Historically, low-income populations have been studied by obesity researchers, but not the eating disorders field. While the authors of this study are careful to point out that food insecurity is not necessarily the direct cause of binge eating or bulimic behaviors, restriction due to low food access could play a role. More research is needed for these marginalized groups who are often overlooked in prevention programs. Gathering more information could improve diagnosis and intervention rates, as well as public policy efforts.

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