Food insecurity and bulimia nervosa in the United States

Background: Food insecurity occurs when access to food is limited by financial hardship. Yet, paradoxically, food insecurity is associated with overeating, with emerging evidence that it may be related to disordered eating. A recent report found that food insecurity was associated with binge-eating disorder (BED), but it is not yet known whether food insecurity is also associated with bulimia nervosa (BN).

Methods: Participants were 873 respondents recruited online who completed a battery of established measures and were categorized into three study groups: healthy-weight (HW), BED, and BN. Hierarchical logistic regressions evaluated the extent to which low and very low food security were associated with BN compared with HW and BED study groups.

Results: Low and very low food security were both associated with increased likelihood of BN group membership compared with HW but not BED.

Conclusions: Our findings suggest that food insecurity is associated with BN and also suggest that food insecurity's association with BN is similar to that for BED. These findings highlight the need for greater clinical and research attention to associations between food insecurity and eating disorders that include binge eating to inform eating-disorder prevention and treatment.