# Food Insecurity in Individuals with Eating Disorders: A UK-Wide Survey of Impact, Help-Seeking, and Suggestions for Guidance

## TL;DR

This UK-wide survey explores how food insecurity affects people with eating disorders, finding it worsens symptoms and recovery, and highlights the need for better clinical guidance and policy changes.

## Contribution

The study is the first UK-wide survey examining food insecurity's impact on eating disorder symptoms and help-seeking behaviors among people with eating disorders.

## Key findings

- Food insecurity was linked to increased food restriction and discomfort discussing it in clinical settings.
- Participants reported that food insecurity worsened eating disorder symptoms and recovery efforts.
- Low help-seeking was observed, with shame being a major barrier and suggestions for improved guidance and policy changes.

## Abstract

Background/Objectives: Food insecurity (FI) is significant and increasing in the UK’s general population. Previous research has linked FI to disordered eating and obesity, yet most of this research is conducted in non-clinical populations in the USA. As such, little is known about the perspectives of people with current or past eating disorders (PwEDs) on the effects of FI on their eating disorder symptoms and treatment in the UK. The current study explores these effects, as well as PwEDs’ experiences of help-seeking for food insecurity and their suggestions for clinical guidance. Methods: Data were collected via an online survey (n = 337) which included both open-ended and fixed response questions. A mixed methods approach was used for analysis, with a thematic analysis being used for qualitative data. Results: Recent FI was related to higher frequency of food restriction and less comfort discussing FI in clinical contexts. Additionally, participants reported that FI exacerbated symptoms and worsened recovery efforts. Help-seeking was generally low among participants. Shame was a barrier for help-seeking, and suggestions for guidance included adaptations to screening and treatment, improving clinician knowledge, and providing practical solutions to alleviate FI. Conclusions: FI is a serious public health issue in the UK that has large ramifications for eating disorder maintenance and recovery. Guidance is needed to address FI in clinical practice and reduce shame around FI. Ultimately, however, FI is a systemic issue that will require policy change to be eliminated.