(PS14-11) The Associations Between Trait Craving, Food Insecurity and Higher Body Mass Index and Greater Eating Disorder Psychopathology

Food insecurity refers to a lack, limited, or uncertain access to an appropriate amount of safe and nutritious foods that are necessary to maintain health and meet dietary needs. 12.8% of U.S households experienced food insecurity in 2022. Meta-analyses have shown that food insecurity increases the risk of obesity, and also the risk of an eating disorder such as Binge Eating Disorder almost three-fold.

How an individual-level factor such as appetite are important relative to a broader risk factor such as food insecurity in it’s association with continuous variables such as higher body mass index (BMI) and eating disorder psychopathology, is less well understood. Given the meta-analytic evidence, we predicted that high levels of food insecurity, as evaluated by the U.S Household Food Security Survey Module (HFSSM), rather than trait appetite or craving, (Food Craving Questionnaire, FCQ-T), would be associated with higher BMI and greater eating disorder psychopathology (Eating Disorder Examination Questionnaire, EDE-Q).

Online questionnaires were administered to 409 predominantly female (83.1%) young adults with a mean age of 19.9 years (23.2% Black, 15.4% Asian, .2% Hawaiian, .5% American Indian, 57.2% White, and 3.4% other, and 14.2% Hispanic) at a large urban college in a city noted for high rates of food insecurity relative to the national level. The median household income of the sample was < $5,000, and 40.3% reported high levels of food insecurity.

Two multiple regressions were used to assess the associations between food insecurity, trait food cravings, BMI, and eating disorder psychopathology, controlling for age, race, ethnicity, self-identified biological sex, and household income. For the two regressions, higher FCQ-T scores were significantly associated with higher BMI (adjusted R² = 0.150), and greater eating disorders psychopathology (adjusted R² = 0.330), where p< .001. Food insecurity was not significantly associated with BMI or with eating disorders psychopathology in these two models.

Contrary to our hypotheses, we found that greater self-reported trait appetite rather than greater food insecurity was associated with higher BMI and greater eating disorder psychopathology. Findings may be limited by the lack of representativeness of the sample – most of whom were female -- and need further replication in different samples. Examining the relative influence of individual-level and broader factors with regards to the risks for obesity and eating disorders may allow for better tailoring of interventions. If appetite regulation is more predominant in influencing weight gain or eating disorders, this may warrant therapy or medication; but if food insecurity is more influential, this may warrant public health interventions.