Food Insecurity, Disordered Eating, Depression, and Anxiety in College Students

by Melissa Munn-Chernoff, PhD, FAED

Food insecurity, defined as not having enough money for consistent and dependable access to enough food to support an active and healthy life, continues to be an important public health issue in college students.1 Nearly 36% of undergraduate students have experienced food insecurity,2 which is considerably higher than the 11% in the general population.3 Individuals who are food insecure report more disordered eating than individuals who are food secure,4 yet it’s unclear how and why this occurs. Researchers wondered whether higher levels of depression and anxiety might drive the association between food insecurity and disordered eating since they know that people who experience food insecurity often experience depression and anxiety.1

Zickgraf and colleagues5 used data from the 2020-2021 wave of the Healthy Minds Study—a study of college student mental health and well-being in the United States. Over 120,000 undergraduate and graduate students with a mean age of 24 years old were studied. The majority (67%) of the sample identified as White. Overall, 58% of students were cisgender women, 39% were cisgender men, and 3% were transgender/gender diverse individuals. Participants answered two questions about food insecurity in the past 12 months, as well as questions about general disordered eating, depression symptoms, and anxiety symptoms.

Approximately 32% of the sample reported food insecurity in the past 12 months! Food insecurity was most common among transgender/gender diverse individuals; students who identified as Black/African American, American Indian/Alaskan Native, or Pacific Islander/Native Hawaiian; and students from lower socioeconomic backgrounds. Nearly 27% of the sample had a probable eating disorder, 40% reported probable depression, and 34% reported probable anxiety. Consistent with prior studies,1,4 food insecurity was significantly associated with all three of these conditions, even after accounting for age, gender identity, race/ethnicity, and socioeconomic background. Even after accounting for the presence of depression and anxiety, the link between food insecurity and probable eating disorder was still strong. Said another way, students who reported food insecurity in the past 12 months had a higher prevalence of probable eating disorders than their food-secure peers. Finally, the association between food insecurity and probable eating disorder was stronger in transgender/gender-diverse individuals than in cisgender women and cisgender men.

This study shows that depression and anxiety are not the sole culprits in the link between food insecurity and disordered eating. In fact, they saw this association across all ages, gender identities, races, ethnicities, and socioeconomic backgrounds. Their results also underscore a need to understand the association between food insecurity and eating disorders across multiple gender identities more thoroughly. Food insecurity is real and occurs on college campuses across the country. We must continue to provide financial aid to students who otherwise might not be able to afford an education, but we must also ensure that they have enough resources to nourish their brains and bodies while studying and to mitigate disordered eating, depression, and anxiety.

To find out more about what UNC and local communities are doing to address food insecurity on campus, please read our previous blog post and our “Dining on a Dime” series for hints about healthful eating on a limited budget.

References

1.         Oh H, Smith L, Jacob L, et al. Food insecurity and mental health among young adult college students in the United States. Journal of Affective Disorders 2022;303:359-63.

2.         Nikolaus CJ, Ellison B, Nickols-Richardson SM. Are estimates of food insecurity among college students accurate? Comparison of assessment protocols. PloS One 2019;14:e0215161.

3.         Food security in the U.S. United States Department of Agriculture, 2021. (Accessed March 16, 2022, at https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/key-statistics-graphics/.)

4.         Becker CB, Middlemass K, Taylor B, Johnson C, Gomez F. Food insecurity and eating disorder pathology. International Journal of Eating Disorders 2017;50:1031-40.

5.         Zickgraf HF, Hazzard VM, O’Connor SM. Food insecurity is associated with eating disorders independent of depression and anxiety: Findings from the 2020-2021 Healthy Minds Study. International Journal of Eating Disorders 2022;55:354-61.