How to Handle Food Insecurity and an Eating Disorder
Written by CCTC Staff Writer
Food insecurity is one of the most — if not the most — visible outcomes of socioeconomic inequity today. Soaring food insecurity during and after COVID-19 have set off panic alarms on a global scale. It may seem confusing, but food insecurity is also associated with all forms of eating disorders.
Read on for:
An exact definition of food insecurity
Who is at the highest risk for low food security (and why)
The continued impact of COVID-19 on food insecurity and eating disorder treatment
How food insecurity is tied to eating disorders
Resources for getting more food into the household
How to access food if you live in a food desert and struggle with getting to a store
How to get diagnosed with an eating disorder when you are underinsured
Need-based eating disorder treatment grants and scholarship programs
How to access wifi to apply for these programs
What you can do today to get started with recovery (your own or a loved one’s)
What qualifies as "food insecurity"?
Food security depends on four factors:
Availability: Is there enough food in the household to meet the bare nutritional requirements of everyone living with you?
Access: Can you afford to purchase a variety of food? Do you have a way to get to a store to buy food?
Stability: Are you always sure that there will be enough food for everyone in the household?
Utilization: Are you able to properly store and use food (i.e. refrigerate, cook, open packaging, etc.)
If someone answers "no" to any of the questions above, they face food insecurity.
Contributing Factors
Finding, buying and using a variety of nutritional foods is, on the surface, up to these things:
Where you live
Whether you have access to a vehicle, bus, etc.
Your mobility status
Household income
What appliances you have to store food in
Your level of nutritional education
But these factors are multifaceted and can be impacted by a number of different circumstances.
Vulnerable Populations
Low-income individuals and families are at the highest risk of food insecurity.
These populations more often live in food deserts, where the only available food is from fast food restaurants and corner stores. They also don't have readily available transportation (especially when it comes to rural areas without public transportation providers.)
They may not have enough income to afford a variety of foods, opting to instead stick to cheap, dense, prepackaged foods to meet their nutritional requirements.
Households who cannot afford utilities or have broken appliances are not able to utilize many foods, which puts them at risk for food insecurity.
And those who do not have access to nutritional education cannot put together a balanced, healthy diet.
Discrimination plays a huge role when it comes to location, financial, and educational disparities. This is why BIPOC, Latino, LGBTQ+, and other marginalized populations are more vulnerable to food insecurity than the general population.
Food insecurity as it relates to eating disorders
Binge eating disorder and food insecurity
When the flow of food centers around one specific day of the week or month, such as payday or the day of the month when government assistance benefits (SNAP, WIC, disability check, etc.) then a sort of binge-restrict cycle arises.
Funds are dispensed, and many individuals spend most of those funds in the beginning of the month. After eating in relative abundance, they have to wait before their benefits roll out again, and are forced into a state of restriction.
This "feast-or-famine" scenario creates a binge-restrict cycle that's very hard to break out of.
Related: This is how to get out of the binge-restrict cycle.
Many food insecure shoppers tend towards those dense, prepackaged, shelf-stable foods because they are cheap, easy, available, and kids will probably eat them. Fresh foods, on the other hand, may go to waste if they're not consumed in time.
These foods are also usually very high in sugar, salt, and carbohydrates. They release a lot of dopamine really fast, but they don't leave you feeling sated or provide all the nutrition you need on their own.
It's very easy to binge on these relatively inexpensive foods in times of stress and anxiety. And low socioeconomic status lends itself to anxiety and stress.
Bulimia and food insecurity
While it seems counterintuitive, many food insecure individuals engage in compensatory behaviors across the spectrum. Behaviors like vomiting, fasting, overexercise, and diuretic use are more common in food insecure households than the general population.
These behaviors come from overwhelming shame, among other things. There’s shame about taking in so much food during a binge, shame about weight, and shame about not being the kind of "in control" person they thought they had to be.
Restrictive eating disorders and food insecurity
More severe cases of food insecurity (where at least one individual goes hungry for at least a day, often to feed a child or elderly relative) have been associated with restrictive eating disorders.
Individuals in this position often feel anxious about making sure others are fed, and guilty about eating before others. This guilt remains even after their household has reached food security.
Food insecurity and eating disorder treatment
Eating disorder diagnosis and treatment is, in most cases, a luxury.
Treatment, at every level of care, is notoriously expensive: most private insurance companies won't fund all of it, let alone government-backed insurance providers.
Many people facing food insecurity rely on Medicare and Medicaid, or have no insurance at all. This lack of insurance is a gatekeeper barring low-income individuals from receiving treatment.
Some people struggle to just get to an appointment, whether that's to get diagnosed with an eating disorder or to receive help for it.
Food insecurity is often not factored into designing meal plans. If an individual does receive help for their eating disorder, they will probably have difficulties when it comes to their meal plans.
This is because many treatment providers are not mindful of food insecurity when putting together meal plans and in nutritional therapy sessions. They don't consider food scarcity and food deserts, and often don't ask patients what they can reasonably access at home.
They simply give standardized meal plans that food insecure people can't meet. Then those individuals may slip back into eating disorder behaviors after realizing that they don't know how to sustainably meet their nutritional goals in their home environment, and might resort to eating disorder behaviors after leaving treatment sessions.
COVID-19 has shaken the financial world to its core and has caused food insecurity in the US to double. But it has also changed the way treatment providers reach patients. There is now an overwhelming amount of virtual treatment options available to those who are suffering.
Related: Read more about the continued impact of COVID-19 on eating disorder treatment and recovery.
If you have children, a job you can't afford to take time off of, or do not have access to transportation, support can now come to you. All you really need is a device that connects to wifi.
If you do not have readily available access to wifi, Comcast now offers an internet essentials plan that costs $9.95/month (plus tax) with no credit checks. You most likely qualify if you also qualify for the National School Lunch Program, SNAP, Medicaid, or other assistance programs. Comcast is also working diligently to increase the number of hotspots available for people to do homework, do their jobs, apply for benefits, and (in this case) meet with treatment providers or get free learning resources.
Note: If you apply and are approved before June 30th, 2021, you do not have to pay money owed to Comcast. You will also receive two free months of service.
Related: How effective is virtual eating disorder treatment?
A lot of the time, programs are designed specifically for seniors, children, or people with disabilities. If you do not fit these qualifications, but someone else in your family does, still apply for these programs.
If there’s even a small supplemental source of food, then your household is already moving closer to food security. The closer you are to food security, the closer you (or someone you live with) is to creating a stable environment that allows for eating disorder recovery.
Resources to help minimize food insecurity:
Feeding America has created a food assistance locator to help find local resources in your area. Just enter your zip code and you’ll get a list of food assistance programs in your area.
The National Council on Aging has created a senior benefits locator called BenefitsCheckup. It shows you all the benefit programs in your area — everything from food, to medication, to housing and utilities, and more. Just enter your zip code and click “Search.”
You can apply for SNAP (the federal Supplemental Nutrition Assistance Program) benefits over the phone or online now, largely in response to COVID-19. Applications are in several languages. SNAP is available for individuals of different immigration and refugee statuses, and for American born children of undocumented immigrants. To apply for federal food assistance programs besides SNAP, click here.
You do not need to be an American citizen to receive WIC (Women and Infant Children) food benefits. Call your local agency (English and Spanish language speakers available to take your call.)
There are many programs made specifically for feeding hungry children, such as the School Pantry Program, Summer Meal Program, and BackPack Program.
Many of these resources are food banks, which have been stretched thin due to COVID-19. If you call them, they can tell you about other programs in your area, if they don’t have the resources you need.
What if you live in a food desert?
Recall that food insecurity isn't just about affording food — it's also about having access to a wide variety of foods.
And almost no one who suffers the consequences of being in a food desert can "just move," as so many people who have never faced food insecurity say.
So, how can you work towards gaining balance in your diet when you can't readily access food?
If you have any form of assistance in terms of mobility (friend, family member, caseworker, etc.):
Take advantage of the times you are able to get to the grocery store.
Choose foods that keep well in your kitchen, so you don't feel the need to cook and eat everything all at once.
Be mindful of what you buy in bulk. You may be inclined to buy treats in bulk (it's cheaper than buying single servings and you know they'll get eaten). But you are more likely to binge on these as opposed to a pantry full of dried oats and lentils. (While treats definitely have their place in the pantry, overstocking high carbohydrate salty/sugary snacks is not setting you up for successful eating habits.)
Frozen food is a legitimate source of nutrition! Frozen fruits and vegetables are cheaper and last longer than fresh ones. You can also freeze low-cost protein sources and thaw them out later.
If you don't have any form of mobility assistance right now:
Find out what's available around you.
Local Harvest has created a Community Supported Agriculture locator that will show you all the pop-up farmers markets, local grocers, etc. that are near you.
There has been a nationwide push for vendors to accept SNAP benefits at farmers markets. WIC participants may also be issued produce coupons that you can use at farmers markets and roadside stands. The government has created wide scale grant programs to improve access to fresh food.
The USDA has announced that they are extending free school lunch meals through 2022 to fight child hunger. Many schools offer delivery services along student bus lines for families who cannot physically get to school. Families may receive meals regardless of income and without needing to fill out a formal application.
If you have a disability, there are many free food delivery and preparation services, shopping assistance programs, and even virtual food banks that deliver meals to your door.
Feeding America has also started a mobile pantry program and doorstep delivery services to get diet staples out into the community. This service is available through local food banks.
And if you are pressed for time/availability, explore your corner store or gas station. Grab common convenience store items like orange juice, packaged nuts, and protein bars to add more variety in your diet right now.
Resources to help individuals and families afford eating disorder treatment:
Note: Some scholarship programs require an eating disorder diagnosis, or require that you’re being evaluated for an eating disorder at the time you apply. This can be difficult for people who do not have insurance or are unable to reach a doctor’s office.
Search for free and low-cost treatment providers here (in-person and virtual).
If you have one, you can contact your PCP. They will diagnose you or (if they are not well-informed about eating disorders) refer you to an eating disorder professional. Since you PCP knows about your insurance/financial situation, they can probably help you find someone within your budget.
But it’s also really important to remember that you do not need to be formally diagnosed by a professional to have an eating disorder. If you struggle with food, exercise, binging, purging, body image, or any other eating disorder symptoms, or otherwise think you have an eating disorder, then you have an eating disorder.
This new, completely virtual eating disorder treatment platform offers family based eating disorder treatment at home for children, adolescents, and family members in their early 20’s. Families work with a five person multidisciplinary team to support the suffering individual find recovery.
Related: These are the pros and cons of family based treatment.
Access free or reduced cost eating disorder treatment, especially if you are in a marginalized community. This nonprofit organization has the largest network of resources for accessing eating disorder treatment. These resources include:
Free eating disorder treatment from qualified treatment programs and providers for the uninsured/underinsured
Free insurance navigation assistance to maximize any benefits you may have access to
One-time cash advances to help individuals: pay deductibles/copays that unlock their benefits and access treatment through their insurance; pay for transportation to eating disorder treatment; pay for other expenses related to eating disorder treatment
Since the start of the pandemic, Project HEAL has especially focused on assisting BIPOC, LGBTQ+, and other marginalized communities. They want to focus on those who have been disproportionately affected by the pandemic, and on those who don’t fit the “eating disorder narrative.”
Body Recovery Group is a virtual recovery collective that provides recovery grants to afford recovery services such as therapy and dietician appointments, support groups, and courses. They also provide:
Virtual peer support groups
A private Facebook group (for those who are uncomfortable with live virtual meetings)
Resource connection services
This program provides scholarship money to pay for residential and intensive partial hospitalization programs only.
This scholarship requires a diagnosis or an eating disorder evaluation at the time you apply. Cash awards are funded directly to participating locations.
This scholarship program is for inpatient and residential treatment only.
You must have at least one letter of recommendation. The program prefers treatment professionals such as PCPs, therapists, psychiatrists, etc. But if you do not see any of those currently, just make a note of any interactions you have had before concerning an eating disorder (from previous doctors, community based therapy or online support groups, etc.) and why you are not seeing anyone now. They also accept letters of recommendation from people like teachers and pastors.
You also have to have these lab tests done before sending in your application. You can go to your PCP, Quest Diagnostics, or some urgent care facilities to get these done.
If you have difficulty paying for or physically getting to a testing facility, click here for resources.
The best recovery environment is one where everyone is food secure. But getting to food security isn’t always fast and easy.
If you are facing food insecurity, It might take a while to get to a place where everyone in the household has access to enough nutritious food. It will take much longer to feel safe about stocking your kitchen in the long run.
There are things you can do today to start recovery.
If you are able, start applying to these programs as soon as possible. If you are not able, call someone to help, whether that’s someone you know, a caseworker, or a free eating disorder hotline (calling and online chat available.)
Learn what kinds of foods are low-cost, easy to store and use, and provide needed nutrition. Try to find these items the next time someone is able to go to a store, food bank, farmers market, etc.
You can also find a free or low cost support group to start talking about your eating disorder, get mealtime support, or (if someone else is struggling) get advice on how to help your loved one with an eating disorder.
The stress of food insecurity and an eating disorder is incredibly difficult. But hopefully with some of these resources, you can start the process of food stabilization and eating disorder recovery.
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic eating disorder recovery programs we offer.