(PS7-69) Psychological Comorbidity Among Midlife and Older Women Living with Food Insecurity and Binge-eating

Background: Mounting evidence signifies that living with food insecurity (FI) is a risk factor for eating disorder (ED) symptoms, yet research focusing on midlife/older women is lacking. Importantly, midlife may be a window of vulnerability for developing EDs for women; also, 12-26% of midlife/older women engage in at least weekly binge-eating (BE; consuming an abnormally large amount of food in one sitting while feeling out of control), meeting the frequency criterion for binge-eating disorder. Midlife/older women living with FI experience intersectional disadvantage, thus necessitating independent investigation into unique cultural and contextual mental health considerations for this population. The current study examined the difference in psychological health and quality of life (QOL) among women living with BE and FI (BE+FI) versus FI without BE.

Method: Participants were female clients of a local food bank, aged 50+ (N = 295; M age = 62.1 years, SD= 8.2), living with FI. Participants completed measures of ED symptoms, QOL, anxiety, depression, internalized weight stigma, and ED-related psychosocial impairment on site while waiting for services. Measures were provided in English and Spanish.

Results: Most (80%) women endorsed Latina/Hispanic ethnicity; 25.5% of women weekly BE, while 74.5% did not. A multivariate analysis of covariance compared women living with BE and FI (BE+FI) versus FI without BE on outcomes related to mental health and wellbeing. Covarying for age, FI severity, and ethnicity, results indicated that women living with BE+FI reported higher anxiety symptoms, depressive symptoms, ED-related impairment, internalized weight stigma, and poorer QOL, than women living with FI without BE (all p’s < .001) Effect sizes ranged from small-to-medium to large.

Conclusion: Results highlight that approximately 25% of midlife/older women living with FI also reported BE on at least a weekly basis, as well as multiple additional social determinants of health. Further, those living with BE+FI report poorer psychological health and QOL that those living with FI without BE, demonstrating a multifaceted need for mental healthcare in this population. Notably, given intersectional disadvantage of women in our sample (i.e., female, older age, minority ethnicity, living with FI, living with lower financial resources and education), innovative solutions – and likely a portfolio of interventional approaches with various entry points and delivery modalities – are warranted if we are to make significant strides in improving mental health equity.