Preliminary associations of body weight, weight bias, and dietary restriction with eating disorder diagnosis in women experiencing food insecurity

Understanding the co-occurrence of food insecurity and eating disorders is a pressing concern. Several factors have been hypothesized to increase risk for eating disorders in women with food insecurity including dietary restriction, body weight, and weight-related bias, but few studies have tested these factors simultaneously to determine which are associated most strongly with eating disorder status. We tested cross-sectional associations of dietary restriction, current body mass index (BMI), weight suppression (i.e. the difference between current weight and highest weight), and weight bias with eating disorder diagnosis in a sample of 99 self-identified women with current food insecurity (54% White; mean [SD] age = 40.26 [14.33] years). Participants completed two virtual study visits consisting of electronic questionnaires and interviews. A binary logistic regression model was conducted to test relations between the hypothesized correlates and eating disorder diagnostic status in the past 12 months, controlling for age, food insecurity severity, and body dissatisfaction. Higher levels of weight suppression and weight bias, but not current BMI, were significantly associated with the presence of an eating disorder. Contrary to our hypothesis, greater dietary restriction was associated with lower likelihood of eating disorder diagnosis. Results suggest high levels of weight bias and weight suppression characterize women with food insecurity who meet criteria for an eating disorder. Women who experience food insecurity and have lost a relatively great deal of weight and/or hold biases about high weight should be screened for eating pathology in clinical settings.