Authors note to readers: When using the word “obesity,” I use quotes as a matter of public health. The word “obesity” and the phrase “childhood obesity” are grossly overused and widely misused as a label to suggest poor or inadequate health, or – worse yet – to suggest a personal failing on the part of the person being labeled. Weight or body mass index (BMI) is NOT synonymous with health. When a person’s BMI measure is on the antiquated BMI spectrum at the level of “obese,” that person may be (and usually is) healthy and at the weight appropriate to support their health. Labeling weight or BMI as unhealthy (or healthy) is an oversimplification that causes real and lasting harm. The health issues of great significance are most often independent of one’s weight or BMI.
A “food desert” describes an area where residents have low incomes and limited or no access to a grocery store within a reasonable distance. Individuals who live in food deserts are often more likely to experience food insecurity because food is simply more difficult to obtain where they live. Unfortunately, food deserts are a disproportionate reality for Black, Latino, or Indigenous communities.
Food insecurity often goes hand-in-hand with barriers to other needs. In urban food deserts, there’s often less or no access to safe and inviting spaces to play and live. Low-income parents often have inflexible work schedules, which can mean little opportunity for family meals or quality time. Many risk factors overlap, and all need to be considered when looking at what a person in this situation deals with every day. As a child in this situation, it can have lasting consequences. Kids dealing with the ups and downs of food scarcity also tend to engage in significantly higher levels of disordered eating behaviors, dietary restraint, internalized weight concerns, and worry compared to those with lower levels of food insecurity.
Through the eyes of a kid, what is it like growing up in a food desert?
For a kid, it means limited or no access to the “healthy” foods we’re told to eat, which are often promoted as fruits, vegetables, whole grains, proteins, and fresh dairy. The food we’re told to limit, like soda, sweetened beverages, fried food, and sugar, generally are foods readily accessible in a food desert, and therefore a kid’s staple foods. Added to this is limited or no access to safe places to play and be outside, despite being told how important it is to get outdoors and exercise. Society suggests that all of these things should be within our control and we are bad and wrong if we don’t eat the right things and look the right way.
What are kids feeling as they live with a barrage of “should” messages that aren’t possible to implement given the situational reality?
Despair is a reasonable answer. And despair, shame, or feeling bad about the foods we eat (or don’t eat) and about our body size and shape is the start of disordered eating behaviors. Disordered eating too often evolves into clinical eating disorders, like binge eating disorder, bulimia nervosa, anorexia nervosa, and others. Given all of this, is it really any wonder why kids in this situation struggling with their mental health, body image, and eating behaviors?
Is there any data on food insecurity and eating disorders?
While we know food insecurity is associated with eating disorders among adults, there’s less research on how they relate in youth populations. A recent study found:
- 22.7% of young adults with lower incomes are dissatisfied with their bodies compared to 8.1% of those with high incomes.
- When it came to weight control behaviors, 53.5% of the poorer adolescent girls reported unhealthy behaviors such as skipping meals, purging, or taking laxatives compared to 37.2% of girls in the highest income bracket.
- Overall, young women in the low-income group were less likely to use lifestyle strategies, such as getting more exercise to lose weight, than their richer counterparts.
We still have a lot to learn about marginalized populations who have historically been overlooked in the eating disorder field, as well as the relationship between food insecurity and eating disorder pathology. Interventions to encourage children’s health, including those aimed at those growing up in a food desert, need to start by putting ourselves in the kids’ shoes to consider what their days are like. Only then can we come up with effective solutions.
Lisa Radzak is executive director of WithAll – a 501c3 serving a national audience with simple, actionable resources for adults to support and protect kids’ mental health related to their body image and food relationship via WithAll’s What to Say program. WithAll’s resources are developed by first considering a child’s perspective.