Examining associations between food insecurity and disordered eating in U.S. Veterans

Abstract: Food insecurity is a well-established risk factor for disordered eating behaviors in non-veterans. Because United States (U.S.) veterans are vulnerable to both food insecurity and disordered eating, the present study aims to evaluate associations between food insecurity and binge eating, purging, dietary restraint/restriction, and night eating behaviors-commonly occurring disordered eating behaviors in U.S. veterans. A national sample of U.S. veterans completed an online survey (n=405). General and generalized linear models evaluated associations between food insecurity (predictor variable) and disordered eating (outcome variables), adjusted for race, ethnicity, gender, age, education, and employment status. Compared with veterans with food security, food insecure veterans reported twice the number of binge eating episodes, almost four times the number of purging episodes, nearly a third more dietary restraint/restriction, and mildly-to-moderately worse night eating symptoms. Exploratory gender-stratified models suggested that the relationship between food insecurity and disordered eating behaviors, such as purging and night eating, may be stronger in veteran men than women. U.S. veterans with food insecurity demonstrate greater disordered eating, particularly night eating and purging behaviors, than those with food security. Gender differences suggest that disordered eating may function differently in men and women with food insecurity. The present study can inform screening and treatment of U.S. veterans with food insecurity and disordered eating, including the need to concurrently assess both issues. Given the cross-sectional design, future research is needed to clarify the temporal relationship between food insecurity and disordered eating in U.S. veterans and to elucidate similarities and differences by gender.