Food Insecurity, Eating Disorders and the Impact of Covid-19 in Adolescents

Food insecurity, eating disorders and the impact of Covid 19 in adolescents (DClinPsy thesis; Katherine Smith, Lucy Serpell)

Background: The relationship between food insecurity and disordered eating has not been explored in the UK. Research in the US suggests that those who are food insecure are more likely to have disordered eating. This relationship has been significantly under-researched in adolescents, who are at a higher risk of food insecurity than their younger siblings and at the peak onset age for eating disorders. This study aims to explore the relationship between food insecurity and specific eating disorder behaviours and diagnoses, as well as the impact the COVID-19 lockdown had on eating behaviours in these groups.

Method: 579 adolescents in the UK completed an online survey measuring their food insecurity, their eating pathology and their clinical impairment based on their eating behaviours.

Results: Severely food insecure adolescents were significantly more likely to report instances of binge eating, self-induced vomiting, laxative or diuretic use, compensatory fasting and excessive exercise. They were also more likely to be clinically impaired due to these behaviours. There were also more likely to meet probable criteria for binge-eating disorder, anorexia nervosa, bulimia nervosa, and otherwise specified feeding or eating disorders. They were also more likely to report disordered eating during the UK’s first COVID-19 lockdown, and for these negative changes to have remained or escalated.

Conclusions: The findings suggest that food insecure adolescent in the UK may be of particular risk of eating pathology and that with the concerning increases in food insecurity in the UK and rise in eating disorder referrals warrants more research and consideration for this particular group.