“Fulfilling the hunger”: A qualitative study to understand the etiology of binge eating in adolescents experiencing food insecurity

Abstract

Food-insecure populations experience increased risk for binge eating. This study examined how food insecurity contributes to development of binge eating during adolescence—a key period for its onset—alongside broader contributing factors in this life stage. Semi-structured qualitative interviews were conducted with 30 adolescents ages 12–19 years who reported past-year food insecurity (via the Child Food Insecurity Experiences Scale) and any past-month objective and/or subjective binge eating (via items from the Youth Eating Disorder Examination-Questionnaire). Grounded theory analysis yielded the “Co-occurring Insecurities Model”, a new working theoretical model representing six interconnected themes: (1) co-occurring body image and food insecurities contributed to (2) internally and externally imposed deprivation of food, particularly desirable foods; binge-eating episodes tended to occur when (3) opportunities to eat desirable foods coincided with a drive to (4) satisfy current or anticipated hunger and/or (5) seek comfort from food to cope with life stressors/negative mood; and (6) binge eating often resulted in emotional, interpersonal, and/or physical discomfort. Results suggest binge eating in adolescents experiencing food insecurity is explained not only by factors known to contribute to binge eating in the general population (e.g., weight/shape concern-driven dietary restraint, negative mood), but also an instinct to seize opportunities to eat desirable foods when such opportunities are hard to come by. It may be important for binge-eating interventions in populations with food insecurity to increase food access and simultaneously acknowledge that binge eating may serve an adaptive function in the context of food insecurity but often has negative repercussions.