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How Food Insecurity and Eating Disorders Are Connected

Blaming individuals experiencing food insecurity for their food choices and body size puts them at even higher risk for disordered eating behaviors and developing Eating Disorders. 

CW: discussions of disordered eating behaviors and eating disorders 

By Patrilie Hernandez

An estimated 50.4 million people currently experience food insecurity in the United States, and those numbers are rapidly increasing due to a rise in unemployment and lack of federal assistance brought on by the COVID-19 Pandemic. Even in DC, where I work and have lived for nearly eight years, food insecurity rates have worsened during the COVID-19 pandemic; it is projected that at least 16% (up from 11% in 2019) of DC residents experienced food insecurity during 2020, disproportionately impacting the elderly, households with children, unhoused individuals, and Latinx/Black communities.

Individuals who reside in so-called ‘food deserts’ are often more likely to experience food insecurity because food is simply more difficult to obtain where they live. The term ‘food desert’ (created in the 2000s by the USDA) is used to describe low income areas where a substantial number of residents have little to no access to a supermarket or large grocery store within a designated mile radius, depending on whether they are located in an urban or rural setting. Unsurprisingly, food deserts are also most likely to be situated in predominantly low income Black/Latinx urban neighborhoods or rural Tribal Nations. 

But according to many BIPOC food justice activists, the use of the term ‘food deserts’ highlights several problematic assumptions. First, the term seems to imply that a lack of affordable and fresh food just happens to be a geographic problem, not something that society is complicit in creating. The word “desert” also makes it seem like these communities are lacking or deficit when it comes to their own food resilience. 

This is why Karen Washington, a Black food justice activist and community organizer, proposes we instead use the term ‘Food Apartheid’, which acknowledges the human-driven model of scarcity and control upheld by decisions made by corporations, developers, and policy makers. Food Apartheid has multiple contributors: racist redlining and zoning policies that proliferated across the country during the 1940s and 50s, disinvestment in the development of inner cities after white residents fled to the suburbs during the 1960s (otherwise known as “white flight”), supermarket closures and bias against poor communities of color while instead opening new locations in more ‘marketable’ predominantly-white areas during the 1970s, and the federal government’s disinvestment from affordable housing in the 1980s and early 1990s. Consequently, all of these contribute to increased food insecurity that further marginalizes communities of color.

But instead of taking the time and effort to dismantle the racist systems and policies that drive the communities deeper into poverty, government agencies, academic researchers, nonprofit organizations, and advocacy groups frequently opt to align with Food Justice Movement initiatives, which sprung out of the Civil Rights and Environmental Justice Movement of the 1990s. While their collaboration demonstrates success in demanding access to healthy, nutritious, and culturally appropriate foods in low access communities, it also helps set up neoliberal narratives that place blame on food insecure individuals for their unhealthy food choices, poor health outcomes and eventually, larger body size. 

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Whereas there has been extensive research examining the relationship between food insecurity and larger body size, research examining the relationship between food insecurity, disordered eating, and eating disorders (ED) is far more significant and it has been largely ignored until recently.

An increasing number of studies demonstrate that households with the highest level of food insecurity (meaning food insecure households with adults who reported having children that were going hungry) also tend to engage in significantly higher levels of disordered eating behaviors, dietary restraint, internalized weight concerns, and worry compared to those with lower levels of food insecurity.

Some of these behaviors may be further compounded by policies that are meant to alleviate food insecurity. For example, because government agencies are directed to release SNAP benefits once a month, this can subsequently promote cycles of “feast or famine”, where food intake can fluctuate depending on food availability. USDA data shows that SNAP benefits are typically exhausted shortly after they are distributed, and individuals are thus more likely to engage in binge eating during those first few days, but are also more likely to engage in heavy food restriction the rest of the month. I do want to note that while some may draw the conclusion that we can easily remedy this by splitting up the distribution of SNAP benefits to twice a month, I am asking you to reflect if this either further underscores the insufficiency of current allocated SNAP dollars to cover the food needs of family over the course of the month, OR if this stems from the need to further control the behaviors and money of poor people (neoliberalism disguised as policy). 

In addition to binge eating and food restriction, compensatory behaviors (behaviors that the person believes will counteract periods of “overeating”) also increased as levels of food insecurity worsened. In one study, disordered behaviors like vomiting, laxative/water pill use, intentionally fasting for prolonged periods of time, and intense exercise were all seen to occur more frequently among adolescents in food insecure households compared to households that were food secure.

Similar studies also revealed that food insecurity was significantly associated with elevated concerns about body shape and weight status. These studies additionally reported that participants felt that weight stigma is the biggest barrier in receiving quality healthcare, as many of them were either fearful of visiting the doctor’s office in the first place or feel that they were denied adequate care or discriminated against because of their body size. 

As a result, patients delayed or altogether avoided care which highly contributes to the development or worsening of chronic health conditions typically associated with higher weight. Studies also noted that “anti-obesity” focused community programs had a negative effect on individuals who are food insecure and live in large bodies, given that weight stigma was high in a proportion of the individuals participating in and facilitating the programs. 

This research joins a growing body of evidence that eating disorders not only affect thin, white, affluent cisgender women (as the mainstream narrative often suggests), but entire communities made up of diverse racial/ethnic identities, gender identities, and higher weight individuals. 

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But for all individuals who struggle with disordered eating or eating disorders, it is known that times of stress can increase their risk of engaging in harmful behaviors. General data trends and a July 2020 study all point to the conclusion that the COVID-19 Pandemic has exacerbated eating disorders. One study found that since the start of the pandemic, participants with anorexia have become more restricted, and those with binge eating disorder or bulimia have had more binging episodes. These findings also line up with the increased volume of calls made to the National Eating Disorders Association helpline over the summer. 

Due to social distancing measures brought upon by the COVID-19 Pandemic, access to many of the in-person services and healthy coping mechanisms that can help treat and prevent disordered eating have been limited. Meanwhile, there has been a noticeable increase in harmful messaging around the risk of weight gain during quarantine. Weight-stigmatizing social media posts and memes about the “Covid 19” (which parallels the nickname “Freshman 15” given to college students about common weight gain that happens during this time) have flourished on FB timelines and IG feeds, which can dredge up obsessive thinking about dieting or losing weight and can be especially harmful to those suffering from disordered and eating disorders.

The COVID-19 Pandemic has triggered massive changes in socialization and routine, stress, and experiences of trauma that we have felt on a global scale and poses additional challenges for individuals with undiagnosed and diagnosed eating disorders. So it makes sense to conclude that there is a significant overlap between the number of individuals experiencing food insecurity and the number of individuals experiencing disordered eating and the people who fall into both of these categories are disproportionately low income and/or BIPOC. Generational trauma that Black and Indigenous people in this country suffer from due to systemic racism coupled with food insecurity, disordered eating behaviors, body concerns, and weight stigma have fatally detrimental health effects on the body; effects that many people continue to attribute to ‘unhealthy’ food choices and body size. 

As opposed to being used as a source of oppression, taking back ownership over our food and our bodies is an important part of the fight towards decolonization, Black liberation, and for Indigenous sovereignty. That is why addressing disordered eating, ending food insecurity, and working towards food sovereignty are all interconnected. This is part of reclaiming food as being a way to fully and truly nourish ourselves, as a source of our power. This sends a clear message to those who continue to uphold toxic systems based on white supremacist and colonial ideologies: Our bodies are more than just a commodity or something to be controlled.

Patrilie Hernandez, MS (she/they) has over 12 years of experience working in the health and nutrition sector as an educator, advocate, project manager, and policy analyst. She approaches Health at Every Size from an Intersectional lens and uses a Body Liberation framework as the foundation of her work. She combines her academic background in anthropology and nutrition/health, with her lived experience as a queer, fat, neuroatypical, multiracial, Puerto Rican femme to disrupt the status quo of the local health and nutrition community and advocates for a weight-inclusive paradigm in health and educational settings. 

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