Beyond the Stereotype: Food Insecurity and Eating Disorders

Photo of a group of people at a protest, with signs protesting food insecurity.

When most people think of eating disorders, they often think of the thinness seen in hollow cheeks and loose hanging clothes on white women on TV or in magazines. This stereotype even has a name in the eating disorder research world: “SWAG” (skinny, white, affluent, girl). It has dominated media, public perception and research for decades, and while this population is certainly affected, eating disorders don’t discriminate. People of all races, ages, sizes, genders and socioeconomic backgrounds can suffer from an eating disorder.

One overlooked factor that can contribute to disordered eating is food insecurity – the lack of consistent access to nutritious food. The SWAG stereotype makes it seem like eating disorders stem from vanity and elitism, but the truth is that disordered behaviors can also stem from scarcity: binge eating, restriction, or purging are sometimes the result of not having access to enough food. In order to better recognize, prevent, and treat eating disorders, especially in marginalized communities, we need to change our view of what eating disorders look like and where they might come from.

Understanding food insecurity

What is food insecurity?

Food insecurity is defined by the USDA as both an economic and social condition of limited or uncertain access to adequate food. In 2023, over 47.4 million people in the United States lived in households experiencing food insecurity. This is not just a matter of missing a meal or two or even concern about finances. Food insecurity is also about the anxiety of not knowing when the next meal will be or if it will meet nutritional or personal dietary needs. It’s deeply tied to systemic issues like poverty, structural racism, and geographic barriers such as food deserts (areas lacking fresh or nutritious food access) and food swamps (areas over-saturated with fast food and convenience stores).

Who is most affected?

Food insecurity doesn’t affect everyone equally. Marginalized communities are significantly more affected. For example, in 2020, Black households were over 2 times more likely to be food insecure than the national average. Among Hispanic households, the prevalence of food insecurity was around 17% compared to the national average of 10.5%. Low-income families, single-parent households, older adults, and many college students find themselves juggling the rising cost of living.

These conditions force families to make impossible choices, like deciding to either pay rent or buy groceries. For many, choices like these come up every month, often being tied to people’s paychecks or SNAP (supplemental nutrition assistance program) benefits. This means families may sometimes have enough food early in the month but run out by month’s end, creating an environment where food may be more accessible in some periods than others and sometimes leading to cycles of binging and restriction. These struggles create damage not only to physical health but also mental and emotional well-being.

The link between food insecurity and disordered eating

How food scarcity shapes eating behaviors

When food access is unpredictable, biological and psychological responses are triggered that can lead to disordered eating. Periods without food can cause the body to go into “starvation mode,” increasing hunger hormones and causing the mind to obsess with food. When food becomes available again, it’s natural to overeat or binge as a survival mechanism.

Repeated cycles of scarcity and plenty resemble the binge/ restrict cycle seen in eating disorders like bulimia nervosa and binge eating disorder (BED). In fact, research shows food insecurity is associated with higher rates of binge eating, emotional eating, meal skipping, and behaviors such as purging or excessive exercise.

A study from a large U.S population sample found that adults experiencing food insecurity were 1.67 times more likely to meet criteria for BED and had increased binge eating symptoms during adolescence. Additionally, 17% of adults who endured food insecurity in childhood met criteria for an eating disorder; This is far higher than the general population.

It’s important to understand that restrictive eating patterns due to lack of access can be just as damaging as voluntary dieting. Both involuntary restriction and dieting can lead to binge episodes and disordered eating behaviors. Those living with food insecurity due to poverty or limited access frequently hear advice like “make better food choices,” which ignores the very complex set of factors that make up their lived reality. Advice like this only serves to create feelings of shame, failure and isolation.

Binge eating, shame, and scarcity

Binge eating is often misunderstood. It’s not a sign of moral failing or “lack of willpower,” and while there’s no single cause of binge eating, it’s often a conditioned response to the biological and emotional stress of inconsistent food availability. The body will prioritize getting energy when it can, preparing for the next period of scarcity.

Binge eating is often followed by an emotional fallout. This can include guilt, shame and secrecy which can be intensified by societal fatphobia and stigma around poverty. These feelings can trap individuals into cycles of disordered eating and prevent them from seeking help.

Media portrayals: who gets left out

Media and public awareness campaigns often present eating disorders as problems of affluence. The “SWAG” stereotype can be linked back to early research on anorexia when many psychologists came to believe eating disorders only affected girls who had been raised in privilege. However, there is no pattern of evidence for a relationship between higher social-economic status and eating disorders. This is important because this research has dictated how eating disorders are now screened for and understood. This narrow representation leaves out vast populations including people of color, lower-income individuals, men, older adults and those living in food deserts. This exclusion impacts who gets diagnosed and who has access to care, and further reinforces gaps in treatment availability and research funding. Individuals facing food insecurity may not even recognize their behaviors as disordered because societal messages don’t reflect their experience.

Why nutrition advice alone isn’t enough

Mainstream wellness messaging often promotes “clean eating,” cutting out processed foods or encouraging expensive organic options. This can lead to individuals feeling like healthy living is out of reach or feeling shame around the choices they are forced to make. Well-intentioned advice often ignores economic and social realities which can reinforce shame and worsen disordered eating behaviors.

True support involves flexibility, compassion, and meeting people where they are without pushing perfectionist ideals.

Moving towards solutions:

Addressing the link between food insecurity and eating disorders requires:

Inclusive, trauma-informed screening tools to identify those at risk
Provider training in anti-diet and weight-inclusive care models
Policy and community support such as expanding SNAP benefits and supporting food justice initiatives that empower communities to access nutritious food
Advocating for equitable research funding and treatment accessibility for all populations

Food insecurity is a powerful yet underrecognized driver of disordered eating and eating disorders. Broadening awareness beyond outdated stereotypes allows us to create more inclusive, effective care and prevention strategies that reach those who need it most.

If you or a loved one are struggling, know that help is available, and you are not alone. A list of North Carolina food resources is here:

If you’re struggling with an eating disorder or disordered eating, we can help! We’re a group of dietitians who take a non-diet, body-positive, identity-affirming approach to recovery and healing your relationship with food. Go here to learn more about nutrition counseling for kids, teenagers, and adults, in-network with most major insurance companies and offered virtually to clients in North Carolina and over a dozen other states.

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